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Harper continues harm-reduction denialism

Announcing the new federal anti-drug strategy this week, Prime Minister Stephen Harper

Harper unveiled a $63.8-million, two-year drug strategy in Winnipeg Thursday, saying harm reduction is not a "distinct pillar" of the Conservative strategy.

Vancouver's safe injection site is "a second-best strategy at best," he said, "because if you remain a drug addict, I don't care how much harm you reduce, you're going to have a short and miserable life." [...]

Harper said Thursday: "I remain a skeptic that you can tell people we won't stop the drug trade, we won't get you off drugs, we won't even send messages to discourage drug use, but somehow we will keep you addicted and yet reduce the harm just the same."
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Urgent Health Canada warning: "Turkey Safety"

The government's obviously very hard at work this week:

Health Canada reminds you:

Store your turkey in the refrigerator or freezer immediately after it is purchased.

Do not thaw your turkey at room temperature. Thaw turkey in the refrigerator or in cold water.

If you thaw your turkey in cold water, keep the turkey in its original wrapping and change the cold water regularly to ensure that the water remains cold.

Do not rinse raw poultry. This can spread bacteria everywhere the water splashes, creating a safety hazard.

Clean and disinfect surfaces and kitchen utensils touched by raw turkey or drippings from thawing turkey.

Use a food thermometer, and cook turkey until the temperature of the thickest part of the breast or thigh is at least 85ºC (185ºF).

Cook stuffing separately in its own oven dish or on the stove top. If you do stuff your turkey, stuff loosely just prior to roasting, and remove all stuffing immediately after cooking. Cook stuffing to a minimum internal temperature of 74ºC (165ºF).

Refrigerate all leftovers within two hours of cooking.
Click on the turkey above to read a longer analysis of poultry safety.

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Insite safe-injection clinic's licence extended

Health Canada this afternoon that Insite, the downtown Vancouver safe-injection clinic, will be granted an extension to its federal exemption to narcotics-control laws that permit it to stay in operation -- but only for six more months. The extension announced today will expire on June 30, 2008, meaning that the clinic's uncertain future continues to be unresolved, and that the same stressful waiting game will replay itself six months from now.

The extension was granted because Health Minister Tony Clement wants more "research on how supervised injection sites affect prevention, treatment and crime."

I wrote last month about the forthcoming federal anti-drug plan (which will this month, it seems) and Insite's status, which was accompanied by written by researchers from BC Centre of Excellence in HIV/AIDS, who have been some of the lead scientists studying Insite's effects.

At the time I wrote my article, the outlook for Insite looked grim. (In fact, even in , the outlook looked grim.) Dr Keith Martin, an MP from British Columbia, told me he spoke to Tony Clement and got the impression that the end was near for Insite.

Was Dr Martin wrong? It's not clear, based on today's two-sentence proclamation from Minister Clement's office. What is clear from the short extension and the reiteration of the need for more research (when a scientific consensus has already been established, essentially), is that the federal government is still unconvinced that the benefits of harm-reduction initiatives outweigh the risks.

*Update, Oct 2, 6pm: The Canadian HIV/AIDS Legal Network released criticizing the government for its decision to extend Insite's exemption for just six months rather than indefinitely.

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Conservative government looks to further decentralize healthcare

Through an access-to-information request, Hill Times reporter Bea Vongdouangchanh has unearthed some of the current state of federal-provincial relations as they pertain to healthcare funding issues and the Conservative government's grand "open federalism" decentralization agenda.

This story is a little old by now, but it got such a minuscule amount of attention when it was published a month ago that it's worth bringing up now even if we're a bit late.

Here's an excerpt, but it is worth reading in full:

Feds' 'direct participation' in national health care being limited: documents

The Conservative government's approach to national health care is one of "collaborative federalism" with "little or no hierarchy" and the provinces and territories are trying "to limit the direct participation of the federal government" in the review of health policy and programs, according to a 2006 Health Canada briefing package released to The Hill Times. [...]

The briefing note is a year old, but is still significant to the health care debate, said University of Regina professor Gregory Marchildon. "The broader issue of the respective roles has always been important and there's always been real tension between provinces and territories, which want as much maneuver ability [sic] as possible, yet they want to optimize the amount of federal financing going into it; and the federal government wants to minimize the amount of federal financing yet maximize its policy influence[...]"

The Conservative government has stated that it does not want to interfere in provincial jurisdictions, however, putting forth the idea of "open federalism." The briefing note states that although intergovernmental experts such as Harvey Lazar, a fellow at Queen's University's institute of intergovernmental relations, believe that "disentangled federalism may be appealing ... intergovernmental relations in the health sector should preferably fall into the collaborative federalism category where the different orders of government are working together with little or no hierarchy but are subject to ongoing and difficult bargaining."

The federal government "recognizes and respects the division of powers, responsibilities, accountability and jurisdiction of [provinces and territories] ... under open federalism," the briefing note says. As a result, the government "continues to review many activities to ensure they fall clearly within our federal roles and responsibilities-disentangling the department from those activities where we do not belong-while ensuring that we maintain appropriate processes to facilitate collaborative federalism with the P/Ts."

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CancerMatch dating: Marry a Canadian for healthcare

Diagnosed with metastasized breast cancer and melanoma, and rapidly approaching bankruptcy, Jeanne Sather of Washington state (right) posted a on her website looking for a Canadian to marry in order to gain access to Canada's universal healthcare system. (See Canadian Medicine's earlier post about this.)

Although she now admits the personal ad was a ruse to draw attention to the failure of the US healthcare system, it turns out the idea is paying off: , and she reports that she's been getting a fair number of responses from Canadians. The Post-Intelligencer writes:

"The profile was meant to be funny and a political statement," Sather, 52, said one morning at a bookstore coffee shop near her Ravenna home. "Now it's taken a life of its own." [...]

But she did begin receiving e-mails from Canadian men, most serious about wanting to meet her, date her and perhaps marry her. About a dozen candidates, including one woman -- who proposed to Sather as a joke -- sent her messages.

"It's a difficult thing for a guy to take on a sick, metastasized woman," Sather said. "Why would a guy get involved with me? All the cards are on the table and they still e-mailed."

The oldest man to respond is 69 and has lost two wives to cancer. The youngest is 40. She has talked to four men over the phone, and she met one man in Vancouver last weekend for crêpes and coffee. She said the love connection didn't happen.

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Are politicians hiding behind the courts in healthcare reform?

, Patrick Monahan, the dean of York's Osgoode Hall law school, told me that major Canadian healthcare reform may come about as a result of legal action rather than legislative change.

"I think if we don't see responses from governments that are more direct and deal with the issues in Chaoulli, we will find further cases in other provinces," he told me. "The political stalemate on this issue results in status quo," he says. "No one is looking at real reform. But litigation can break the log jam. It can be the catalyst."

But things aren't as simple as they seem, surmises the Calgary Herald. In an editorial published last week, the that some lawmakers don't want to be seen as directly involved in the potentially radical reforms being put forward in constitutional challenges like Murray v Alberta and McCreith-Holmes v Ontario. Therefore, despite their apparent reluctance to open the can of worms of Canada Health Act reform in Parliament, they may in fact be hoping that the Supreme Court continues to chip away at the universal healthcare system, as it did in Chaoulli v Quebec in 2005. The Herald writes:

The question is really whether legislators want courts to deliver an ultimatum they can only dodge using the politically risky notwithstanding clause. A cynic might think they secretly do; elected officials have been glad before to blame controversial change on court rulings.
Considering some of the views espoused by Conservatives like Stephen Harper and Tony Clement in the past, that cynicism may be warranted in this case.

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Drs Brian Day and Penny Ballem set to guest-edit Vancouver Sun

CMA president Dr Brian Day and former BC deputy minister of health Penny Ballem have been named guest editors of the Saturday, October 27 edition of the Vancouver Sun, a special issue all about health news. Every section of the newspaper will cover health stories, -- from sports medicine to healthcare business issues.

Dr Day, of course, is well known for his support of expanded private delivery of healthcare, while Dr Ballem made news last year in protest of the BC government's healthcare planning. (You can read her resignation letter .)

The Sun asked Dr Day about the two doctors' differing views. He responded diplomatically: "We both have the same goal: to create a great Canadian health system. We may differ on how to get there. Having different views will stimulate debate, which is healthy."

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New passport regulations free MDs of guarantor hassle

Thanks in large part to Canadian Medical Association lobbying, the Canadian government's new passport application rules -- which come into effect today -- no longer require guarantors to be professionals like doctors, lawyers or engineers.

Generally doctors in Canada can bill patients directly for noninsured services, such as filling out forms, but federal law forbids passport guarantors from charging money for their help. According to today's celebratory CMA announcement, physicians have been guarantors for about 22% of passport applications.

Any measure to reduce doctors' paperwork is a good one, and this is no exception.


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