Diamonds -new wealth is good for health and well being

When the wolf is at the door, a diamond is just what the doctor ordered . It was a great experience to get $5000 from a $100 investment that I had forgtten about!

• Personal Proof that Canadian Diamond Traders (CDT) works and delivers
  
  Endorsement and Reference from Traderpc, my trading name -
  
  
  On May 15,2008
  
  Carrier from registered delivery arrived
• The package contained· 3 diamonds
  · cheque
  · marketing material
  · record of transaction
  100$ feeder turns into net $4480 USD – 2 years in the making
  Over 4000% return
  
  In summary -What we learned is that the Canadian Diamond Traders (CDT) system really works and delivers! A pleasant and ethical surprise after all the other misguided opportunity and big buck dream and try options – such as- TTI, BIM, FSI. The big promises, poor return options that failed. We did learn that the CDT diamond trading system works:
  
• The CDT tools work -are easy to use and useful especially the self replicating sites –your immediate web presence
• It is real - Real tools now not in the distant future. CDT is a real, credible e-business that is operational Now , where you can supplement your income Now with a real customer delivery structure that works Now.
• CDT has a solid , credible reputation, a real web presence and real operating tools in place – No more MLM hype and hope meetings just real true web marketing and sales delivery with a real return on your time ,money and effort.
  
  Dare to be great –check it out - You have Nothing to lose and everything to gain
  
  Duplicate my success -The Doctors presription for well being
  
  
  http://www.cdtforever.com/eclipse/rep/client/index.cfm?rep=TraderPC&reinit=1

Background information - useful statistics –Canadian Diamond Traders (CDT)

• CDT Community Statistics and tracking as of - May 19, 2008
  
  161,269(one hundred sixty one thousand two hundred sixty nine) Diamond Traders .
  
  There are currently: 125409 active users. 20908 are waiting to become active.
  14952 of 125409 active diamond traders multiple times earned $3000 and a $2500 worth of diamond .
  14954 of 125409 active diamond traders recieving $3000 and a $2500 worth of diamond Now!.
  29908 of 125409 have one step to become collector .
  59816 of 125409 competing with 29908 polishers to become collector .
  20731 new diamond traders of 161269 completing their perfect team .
  1312 new registered Diamond traders for the last week .

• Our immediate personal challenge and objective:
  Traderpc and the affiliated teams will do better , faster in next time performance cycle
  Based on the experienced success and the completed due diligence learning curve
  Based on the rapid development of effective CDT marketing support tools
  Based on the basic benefits of diamond ownership ( product appreciation and portability of high value products in demand worldwide )
  Based on CDT membership benefits – credibility and independent distributor financial and time investment returns
• Special Time incentives and other performance promotions available
  
  

to be or not to be

To be or not to be an independent entrepreneur – that is the question?
To be really effective as an entrepreneur – you need the will and drive to have many real customers and products to drive and diversify your business revenue and income..

When you first begin your entrepreneurial career-whether as a business owner, distributor, inventor, writer, photographer, web designer, graphic artist or whatever challenges, motivates and inspires your personal interest -you have to face the ultimate challenge of getting clients or users of your products and services. This is your ultimate and primary golden hurdle!

So you scour all the Internet articles and marketing books, and you prudently and diligently do your home work, talk with others who have gone before you, to see if they have a secret to make your dream opportunity and desire for financial independence a successful reality. You build up your knowledge, resources and the courage to take the “less safety and security” risk jump.

Then, one day, you take the leap. You begin to market your entrepreneurial business. You soon come to realize that if you don't aggressively market your products and services, you are going to get nowhere fast. That's not why you became a driven self directed independent entrepreneur or is it? You became a entrepreneur because you wanted to call your own shots, make a difference and you believed that you could make more money working for yourself than for someone else-right!

If you are diligent, focused and determined, your marketing efforts will soon begin to pay off. You land a couple of clients. One of them, in fact, may be a big one. It's a well respected, credible large company with lots of work for you to do and plenty of money to give you in return for your effort and performance. Excellent and bravo, you’ve cleared a major hurdle, you've managed to impress and wow them .Your new clients have given you the .opportunity to strut and show case your talent, energy and capability.

Welcome to the gravy train! Welcome to the world of the chosen- those who get paid for their creative effort and talent at some else’s expense.

Can this pleasant dream turn into a nightmare? What are the pitfalls, and other considerations that you should consider and be aware of? Is it just too good to be true?

A pragmatic reality check

Too many entrepreneurs make the mistake of allowing a large percentage of their income to come from one source. If one client supplies more than 20 percent of your revenue on a consistent basis, you need to find more clients and other sources of revenue...as soon as possible. Client diversification is a prudent and survival must!

Everyone knows people who worked full-time and then decided to do entrepreneurial work as an independent consultant, almost exclusively, for their former employer. This is a simple mistake. Don't let familiarity doom your bottom line. Always be on the lookout for new clients or “opportunities”. The more golden eggs in your diversified talent portfolio or nest, the better and stronger you truly are.

It is reasonable in the very beginning of your entrepreneurial career, to have only one or two clients to start, so they will, naturally, contribute a large percentage of your income.. Drive yourself to get more clients. Set a realistic target –after about six months, you really need to have multiple clients and many baskets full of all those golden eggs. Client diversification is a prudent, important common survival sense that you must instinctively follow.

Complacency, the lack of discipline and your negative time wasting self indulgences are all critical and common business mistakes of Independent entrepreneurs. These mistakes often turn self-employment into an excuse for self-indulgence, procrastination and ineffectiveness. Remember your time is your money and real sweat capital-spend it wisely to succeed.. Having one big, lucrative, timeless client is a surefire way to fall into the trap of self-indulgent complacency. Self-indulgence leads to all kinds of excuses for not working or working effectively. The sad reality and fact is -that when you're a non-working independent entrepreneur, you are destined to be a broke independent entrepreneur.

While it is okay - and quite rewarding - to have a big, lucrative client, don't let that client dominate your time or make you financially dependent on him or her for your livelihood. Be disciplined enough, self-motivated enough to always diversify your client and business customer base. The alternative is to remember your past before the entrepreneurial plunge- motivate yourself to get new clients, or quit being a self employed entrepreneur. Do you really want to go back to a dismal or less appealing work environment in that restrictive company box or cubicle with its many restrictions, constant pressure, few if any fast track chances, a reduced and different destiny, with little prospect for advancing in your field of endeavor, lower freedom to make your difference or mark in the world and no chance to make more money-no matter how hard you work.


About the author

Siegfried Holle, BS, M.B.A , is a seasoned business consultant and entrepreneur , who gives enterprising people the confidence, support knowledge and action plans they need to start, run and grow their own lucrative independent entrepreneurial businesses - much sooner and more easily than they could by themselves. For information, resources, more business survival tip articles and a complimentary new business recommendation, contact the author at siegholle@gmail.com or visit his latest opportunity site

A professional business leader registered in the National Registers Who's Who in the executives and professionals' classification, Holle holds an M.B.A. in marketing and logistics from Indiana University and a B.S. in business with honors. He is a serial business and social entrepreneur, with extensive experience in real life client challenges,

Googling your health - power to patients

How do we improve access to our medical reords?

Placing information that's as highly sensitive as personal medical records into the care of unregulated Internet storage systems is risky business, and it could open the door to all manner of marketing and false advertising people who are eager for this gold mine of medical information.
Unfortunately, the only way to safeguard against this sort of thing is to get the government involved … and while I'm not fool enough to believe that the Federales cannot get their mitts on your personal medical records if they really want them, I'm incredibly uneasy about handing over stewardship of medical records to the government.

The authors of this article are doctors after my own heart. As Dr. Isaac Kohane, one of the authors said, "I'm a great believer in patient autonomy in general, but there is going to have to be some measure of limited paternalism."

One potential solution to this problem would be to extend the HIPAA to cover Internet players like Microsoft and Google. This seems to be the quick and easy solution to the problem. But what worries me is, as Dr. Kohane called it, the idea of "limited paternalism."

If you've been paying attention, you're well aware that once a government department or bureau is created, it grows. There's nothing at all "limited" about any government organization. I'm always suspicious of central authority, especially when the government has, in my humble opinion, such a bad track record with healthcare bureaucracies (as you know, my favorite example is the FDA).

But does the government really need to get involved? After all, every day millions of Americans already trust incredibly personal information to Microsoft and Google's care in the form of emails through free webmail services such as Hotmail and Gmail – this is merely the electronic form of the mail handled by the U.S. Postal Service, and it is often just as sensitive (if not more so) as medical records. Emails sent via Hotmail and Gmail routinely contain loads of personal and financial information. And yet this never seems to be compromised by Google or Microsoft.

I say leave Uncle Sam on the sidelines on this one. The security for personal medical records is already in place – Microsoft and Google are more than ready to safeguard Americans' medical records. They have the unique opportunity to usher in a new age of empowerment for patients all over the country. Let's give them the chance.

Power to the patients!
William Campbell Douglass II, M.D.

Patient advocacy growing as a business | www.azstarnet.com ®

Patient advocacy growing as a business www.azstarnet.com ®: "Patient advocacy growing as a business
Your hired help at hospital or in ER could be lifesaver
By Carla McClain
Arizona Daily Star
Tucson, Arizona Published: 04.27.2008
advertisementAs patients die waiting in emergency rooms, as they lay neglected in hospitals beds, as they struggle to find proper care for injuries and illness, a new first commandment has emerged for anyone forced to seek medical care:

Never, ever go alone.
Do not enter a hospital, an emergency room, or any other medical facility without competent, assertive help by your side at all times. To do so puts your very life at risk. Even doctors and nurses on the front lines of the system will tell you that today.

As hospital care grows increasingly complex and medical errors kill some 100,000 Americans every year, a whole new industry is forming to deal with this disaster — offering hired help to get you through your hospital stay alive.

It is a trend emerging here and across the country, though it's not without controversy — and a hefty price tag. But it may be offering a vital, even lifesaving service in a severely overburdened medical system plagued by a shortage of nurses, doctors and hospital beds."

Patient advocacy growing as a business

Cash Up Front or Else — Why Hospitals Are Gouging Their Patients | Health Care Industry Blog | BNET

Cash Up Front or Else — Why Hospitals Are Gouging Their Patients Health Care Industry Blog BNET: "Cash Up Front or Else — Why Hospitals Are Gouging Their Patients"

Mydoctor launched by CMA

Mydoctor.ca launched by the Canadian Medical Association
Email the Editor Email a Friend By: Lisa Williams, assistant editor, InterGovWorld.com(Apr 03, 2008 06:00:00)
The Canadian Medical Association has launched a new health portal dubbed mydoctor.ca, which has online tools for tracking chronic diseases, as well as a physician-driven Canadian electronic patient health record platform.

The health portal allows patients to directly link to their physicians, and was developed by Ottawa-based Practice Solutions (a CMA company).

"The mydoctor.ca health portal provides a new way for physicians to give each patient the care and attention they deserve while also empowering patients to become active participants in their care," said Brian Day, president of the CMA in a released statement.

The portal was designed by physicians and allows patients to be registered by their doctors with any of the online tools on the portal, including an asthma tracker and a personal health record.

The setup is similar to online banking in which the patient inputs their health information via the secure portal in order for their physician to access and monitor. The data is then converted into a chart that displays the patient's results over time.

For more information visit www.mydoctor.ca

"Telemedicine" links Africans to Indian expertise on Yahoo! Health

"Telemedicine" links Africans to Indian expertise on Yahoo! Health: "Telemedicine' links Africans to Indian expertise
By Barry Malone - Thu Apr 3, 12:54 AM PDTProvided by:

An Ethiopian woman inside a clinic in Bahir Dar, March 10, 2007. Ethiopia's health problems are mirrored across Africa where doctors and nurses are often overworked and underpaid, villagers have to walk miles to the nearest clinic and drugs and treatment are often beyond the means of ordinary people. (Eliana Aponte/Reuters)
ADDIS ABABA (Reuters) - Troubled"

High Speed Internet Access & Health Care

High Speed Internet Access & Health Care: "Telemedicine
Learn More
High speed Internet and $15.5 million telehealth grant help care for rural patients in New Mexico
Telemedicine helps save time and lives in smaller hospitals
A National Blueprint for Technology and the Public Good
» View All Entries

» View Relevant ExamplesHigh-speed interactive broadband with instantaneous contact between health professionals and patients enables remote monitoring, efficient chronic disease management, and more effective responses to emergencies."

Combining Internet With Office Visits Cut Heart Attack Risks on Yahoo! Health

Combining Internet With Office Visits Cut Heart Attack Risks on Yahoo! Health: "Combining Internet With Office Visits Cut Heart Attack Risks
By HealthDay - Sun Mar 30, 8:45 PM PDT"

Overall, the results show that good communication -- whether it's done in the office or over the Internet -- between patients and doctors helps prevent cardiovascular disease, said Alfred Bove, professor emeritus of medicine at Temple's School of Medicine and chief of cardiology at Temple University Hospital.
He noted that telemedicine does have certain advantages.
"With rising health-care costs, a telemedicine system can encourage communication between patients and their doctors with less cost and time commitment than frequent doctor visits," Bove said in a prepared statement.
He believes telemedicine may help underserved patients lower their risk of cardiovascular disease and bridge the "medical divide" between treatment and outcomes for lower- and upper-income patients.

New Beginnings Seniors home fights to stay open

"Seniors' home faces closure; long-term care residence to close as of march 31
Posted By HEATHER TRAVIS

As Janet Spierenburg helped Howard Randall, a 78-year-old resident at New Beginnings put on his coat for the last time, she had tears in her eyes.
Spierenburg can't stand to watch the Ridgetown business she helped build, deteriorate in front of her eyes.
'I worked so hard to keep this place going and make it a home for seniors,' she said. 'It's hard to watch it go downhill.'
Spierenburg owned the long-term care facility for five years before selling it to current owner, Sieg Holle, in January 2007.
As the remaining three residents prepared to move out of the residence on Thursday, Spierenburg got choked up.
'Most of the people don't want to leave,' she said. 'They are not hard to care for.'
Above all, Spierenburg's heart broke as she helped Randall get into his son's truck to leave.
'It's hard, especially with Howard,' she said. 'We just seem to connect.'
Randall has spent the past seven years living at New Beginnings and was reluctant to leave the staff and his home.
Randall was relocating to a long-term care facility in Blenheim.
'I loved it here,' he said. 'They just give me everything I want.'"

The 18-room residence is scheduled to close on March 31, unless the owner is able to find new residents to fill the facility or if he receives financial support prior to that date to allow the place to stay open.
"We could (shut the doors), but we will probably keep them open until the 31st (of March)," said Holle. "If there is the support, then you can sustain it and keep it open. And if there isn't, well, there is no purpose (of staying open)."
Holle, who is located in Brantford, operates a similar long-term care facility in the city, called Sunridge. There are currently four residents living in the 10-room facility, however Holle said the low numbers are more manageable because the operation cost are lower.

save for chronic care

Solutions at long last but how long to put in place ? QJ

Canadians urged to save for chronic care expenses
Posted By CHRISTINA SPENCER

Creating a registered chronic care savings plan, similar to an RRSP, could help Canadians with the steep health bills they will face as they grow old, says a sweeping new report on health care and the elderly.
The study by the Special Senate Committee on Aging notes that chronic illness, particularly heart disease, arthritis, diabetes and dementia, is "a major concern for seniors."
It also notes that Canada's publicly funded health care system doesn't adequately cover home or long-term care, which people with chronic illness often require.
"Because home care is not entirely publicly funded, some . . . have suggested that Canadians be urged to save so that they will eventually be able to afford services to meet their needs," the committee says. "This could be done through the creation of a registered chronic care savings plan, similar to an RRSP."
An RRSP (registered retirement savings plan) lets people shelter income from taxation up to a certain annual maximum if they are saving for their retirement. A chronic care savings plan would operate on the same principle but permit people to use the money for old-age health needs.
The proposal is one of many explored in the committee's second interim report, "Issues and Options for an Aging Population." Among some of the other options identified:
Providing tax credits for seniors who volunteer. "Volunteering is strongly associated with social connectedness," the report says;
Expanding educational tax credits beyond those given for people who take accredited courses, so that seniors could also enrol in a range of classes. "Active learning helps maintain brain health," experts told the committee;
Creating a national respite program, so that those caring for an older relative could obtain temporary help in order to take a physical and emotional break;
Making compassionate care benefits, which already exist under Employment Insurance, available for longer periods so people looking after a frail elderly person could benefit;
Introducing a national home care program to provide minimum standards across all provinces. The committee asks, however, whether such a standardized program might actually reduce service in places that already have high levels of care;
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Expanding the number of training spots in gerontology and geriatrics. "The incorporation of interdisciplinary education about aging into the core programs of all health professionals would improve the delivery of age-appropriate services," the committee says;
Increasing training in palliative care and end-of-life care.
christina.spencer@sunmedia.ca
Article ID# 956232

Rural Care Crisis

What are the alternatives? better cost effective delivery systems maybe QJ

Forced to close; Newbury hospital loses outpatient physiotherapy
Posted By CHIP MARTIN

In a move called devastating to its local community, one of Ontario's smallest hospitals is being forced to close its outpatient physiotherapy program to balance its budget.
That means many of the 23,000 rural, small-town and elderly residents served by Four Counties Health Services in Newbury will have to travel farther and pay from their own pockets to replace the service. Or do without.

"This will have a huge impact," said Yvonne Lambert, board chairperson of the Middlesex Hospital Alliance that operates the 16-bed facility in Newbury. The physiotherapy service is slated to end Sept. 1.
"These are retired people, farmers and small businesspersons and less than a quarter of them have private (health) coverage" to cover the cost of private clinics. And the closest private clinic is 35 minutes away.
The announcement comes on the eve of today's provincial budget, expected to have little new money for health care.
New funding is unlikely despite hospital bed shortages across the London region and elsewhere because of a shortage of long-term and chronic-care beds.
For the Four Counties area, there's a slim chance residents will find replacement service at a hospital in Chatham covered by government health care, Lambert said. Private clinics are more likely.
Lambert said to balance its $10-million operating budget, Four Counties has had to chop $500,000, of which $300,000 is the 38-year-old outpatient clinic with three physiotherapists, an assistant and a manager shared with Strathroy-Middlesex hospital. The clinic had 6,350 outpatient visits last year.
"In a small hospital it is very hard to cut anything," Lambert said. She said talks about the situation continue with the Southwest Local Health Integration Network.
Monte McNaughton, a Newbury businessperson, described the closing as "devastating for patients, for the local economy and health care in Ontario."
McNaughton, a board member who ran for the Progressive Conservatives against local Liberal MPP Maria Van Bommel (Lambton-Kent-Middlesex), said provincial Liberals will buy 22 Made-in-Scotland buses for Toronto but won't support health care for local residents.
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"It just doesn't make sense and is a further slap in the face to our rural communities," he said.
Conservative health critic Elizabeth Witmer said the Four Counties situation "is happening across the province."
She said termination of services "has a very negative impact on people" and the government should allow private delivery of health care covered by government insurance.

All is not well in nursing homes

Provided by: Canadian PressWritten by: Alison Auld, THE CANADIAN PRESS
HALIFAX -

Almost half the residents at several nursing homes in Nova Scotia exhibited aggressive behaviour that ranged from outright violence to resisting help, according to a new study that buttresses concerns over the risks care-providers face on the job.

The report, released Thursday by the Canadian Institute of Health Information, also showed that many of the behaviours were linked to a handful of health conditions, including dementia, delirium and depression among the elderly.
Nancy White, the institute's manager of home and continuing care, said the findings shed light on how nursing home residents behave and why they might lash out.

"What we found was that certain types of behaviours are associated with certain underlying health conditions," she said from Ottawa. "Knowing this and understanding these conditions is really the first step to treatment and prevention."

In the survey of five facilities in the province from 2003 to 2007, the most common aggressive behaviour was resisting care, which could include pushing away a worker trying to administer medicine or change a diaper.
About 45 per cent of the 700 residents - or two out of five - showed behavioural symptoms, with a third of the residents resisting help. About 16 per cent were verbally abusive and 14 per cent engaged in "socially inappropriate" actions, like screaming.
About 10 per cent of the residents were physically abusive, which included hitting, scratching or sexually abusing others.
Doreen Charman, a long-term care provider at a Halifax nursing home, said the report backs up what care workers have been saying for years - that aggressive behaviour is a part of daily life.
"It's a day-to-day issue in dealing with aggression and fear and residents who are reacting to their environment," she said, adding that she's been kicked, punched and scratched on the job.
"It's not the person doing it - it's the condition that they're dealing with."
Charman, who's been in the sector for 21 years, said staff need more education on how to deal with challenging behaviour, and more resources to help over-taxed, weary workers.
"This report is reinforcing what we've been saying all along in long-term care - we need more education and we need more staff," she said.
Albert Banerjee, who led a recent study on abuse suffered by care providers, said the institute's findings corroborate a number of reports outlining the challenges of working in nursing homes.
Banerjee, a doctoral candidate in the sociology department at York University in Toronto, found that long-term workers in Canada are seven times more likely to be physically abused by elderly residents than their peers in Nordic countries.
"In Canada there seems to be a myth that this is just part of the job and what this shows is that it's not necessary," he said, referring to his study released earlier this month that surveyed workers in Ontario, Nova Scotia and Manitoba.
"But you need legislation to guarantee minimum standards of care, so documenting the needs of residents and workers is the first step."
White said the five nursing homes in Nova Scotia used a new model of assessing residents when they first entered the facility, giving workers a better handle on what health conditions they might need to address.
"Having good assessment information on these residents is a very important way of preventing behaviours or for dealing with them in a more effective manner," she said.
Nova Scotia was the first province to tabulate its findings for the institute and eight others, including British Columbia, Ontario and Saskatchewan, are going to provide information for the database.
White said the Nova Scotia rates appeared to be similar to other provinces, but added that the data will be used to track trends in the future.

New savings plan holds promise

New savings plan holds promise: "New savings plan holds promise


Article By: Gordon Pape

The new Tax-Free Savings Accounts announced in the budget will offer a range of investment opportunities, from income splitting to education savings.
One of the centrepieces of Finance Minister Jim Flaherty's recent budget was the announcement of legislation to create Tax-Free Savings Accounts (TFSAs), starting in 2009.
These plans will allow every Canadian over 18 to contribute up to $5,000 a year to an account that will tax-shelter all investment earnings. Unlike RRSPs, contributions will not be tax deductable, nor will withdrawals be taxed.
There is no doubt that this is an important program, one that will provide savers with a new range of strategies. Here are a few possibilities."

MindMentor, the first robot psychologist | Emerging Technology Trends | ZDNet.com

MindMentor, the first robot psychologist Emerging Technology Trends ZDNet.com: "People affected by emotional problems are often reluctant when they’re told to see a psychologist. Now, they can confidentially consult online MindMentor, the first robot psychologist. It will cost them €4.95 for one hour session (or about US$7.65 as of today). MindMentor has been developed by two Dutch psychologists specialized in Neuro Linguistic Programming (NLP). The system was tested on 1,600 ‘customers’ from over the world and 47% of them said they were satisfied after only one session. I haven’t tested the system myself, but one thing is really interesting. Instead of looking at a database, MindMentor uses a personal process to discover the right solution with you."

Interesting use of high tech -

More money for Hospitals?

Solutions not more public hand outs needed QJ

Chatham Daily News
Hospitals face tough timesPosted By JOHN MINERPosted 25 mins agoHalf of Ontario's hospitals are poised to operate in the red, a situation projected to get much worse next year despite the province's law banning hospital budget deficits.

The tough times for the key health-care sector were disclosed to hospital executives and boards this week by the Ontario Hospital Association, which surveyed member hospitals March 5.
Unless they cut services, 75 hospitals face a deficit for the fiscal year starting April 1.
That jumps to 104 hospitals - 68 per cent - the following year, the OHA survey warns.
The dire financial outlook for the province's hospitals comes less than two weeks before the Liberal government brings down its next budget.

Ontario prohibits hospitals from running deficits and, to end budget uncertainty, now tells the sector what its funding will be at least two years ahead of time. For example, it will get 2.4 per cent more money this coming year, and another 2.1 per cent the next.
The multi-year funding was supposed to end an era of annual standoffs between the hospitals and the Health Ministry over money, with hospitals demanding more to cover their operating shortfalls.
Hospitals in Strathroy and Newbury have already drawn up plans for service cuts in the face of significant deficits.
The Strathroy hospital is facing a $2.2-million operating deficit out of a $30-million budget, while Newbury hospital, with a $10-million operating budget, is short $500,000.
In its report sent to hospital executives this week, the OHA said Ontario hospitals are already very efficient compared to others in Canada.

"In fact, it would require $100 more per capita, or $1.2 billion, to bring Ontario hospitals up to the spending level on hospitals in the rest of Canada," the OHA report said.
OHA president Tom Closson said the annual increases from the Health Ministry aren't enough for the province's hospitals to deal with significantly higher wage and energy costs.

"Just looking at inflation alone, it is a big challenge," he said.
Hospital costs are also being pushed higher by increasing demands from the aging population and population growth.
"Hospitals are working hard to improve their efficiencies, but efficiency can only be improved so quickly," Closson said.
Unlike in previous years, when Ontario's hospitals negotiated with the Health Ministry, they now are required to reach balanced budget deals with Local Health Integration Networks, health care agencies set up by the government.
Closson said the OHA is advising hospitals in financial difficulty not to cut services, but to keep negotiating with their LHIN.
"We don't think the province wants us to cut services," Closson said.
An OHA advisory on tactics for negotiating with the LHINs warns hospital boards not to sign any agreement unless they can meet their obligations.
Laurel Ostfield, spokesperson for Health Minister George Smitherman, said this is the first year the hospitals have negotiated budgets with the LHINs and it's a difficult process that requires a lot of hard work on both sides.

"We do have a lot of confidence in the Local Health Integration Networks and we feel very certain they will be able to come to a resolution with the hospitals on their budgets," Ostfield said.
Hospital shortfalls
Based on no service cuts, 75 Ontario hospitals (49 per cent) project deficits for 2008/09.
For 46 hospitals (30 per cent), the deficits are greater than two per cent.
For 2009/10, 104 hospitals (68 per cent) project deficits.
For 66 hospitals (43 per cent), the deficits are greater than two per cent.

Go public, go private

Go public, go private: "Go public, go private


Article By: Jayne MacAulay

Will private for-profit clinics flourish in Canada, and will they be the death of medicare as opponents claim?"

Health Care Brief: Canadians not receiving adequate health care

Health Care Brief: Canadians not receiving adequate health care: "Health Care Brief: Canadians not receiving adequate health care


Article By: Athena McKenzie

More accessible, comprehensive and coordinated care is required, says agency report.
Are Canadians receiving adequate health care? According to the Health Council of Canada, the answer is no.
The intergovernmental agency prepared Fixing the Foundation: An Update on Primary Health Care and Home Care Renewal in Canada. It says the current health-care system is not well-coordinated, comprehensive or always available when needed. The report is based on the Canadian Survey of Experiences with Primary Health Care.
“Canadians continue to tell us reform is needed,” Dr. Jeanne Besner says. Besner is the chair of the Health Council of Canada.
The report highlights that more then 30 per cent of people who visited an emergency room believe they could have been treated by their family doctor if one was available. In addition, family doctors rarely learn if a patient is seen in an after-hours clinic.
Participants said that some doctors do not explain test results, nor do they warn of the possible side effects of medication. Other complaints included a lack of information from their physicians on adopting healthier lifestyles.
To address the issues within the system, the council is recommending several courses of action. These include electronic patient records, inter-professional care teams, and better communications between family doctors and after-hour clinics. The report also stresses the need for better coverage of home care strategies.
Read the council's report, Fix the Foundation."

excellent review

(lesson in being a good informed patient

Lessons in Being a Good Patient

It used to be that doctors were considered god-like, the keepers of life-and-death knowledge and abilities. This view of the medical profession is intimidating -- and in light of the troubling findings of a recent Dutch review study, it appears that many older individuals still feel that way. Researchers reviewed three studies with a total of 433 older patients to determine whether personal face-to-face coaching or printed materials would better help them become savvier consumers of health care, specifically at doctor visits. Not surprisingly, personal coaching (face-to-face, either group or individual) was found more effective, but even when coached it seemed that many elderly patients remained stubbornly passive about their care.

One study showed that after being educated about the importance of preparing for the visit and asking questions, when study participants next saw their doctor, more than half still didn't identify specific issues to discuss and more than 80% failed to bring a list of questions, problems and/or medications with them. In fact, very few asked the doctor any questions about their illness, tests or procedures. Here's the problem: The more passive patients are about health issues, the lower the likelihood of successfully solving their problems.

GET GOOD INFORMATION

Gerontologist Audrey Chun, MD, director of the Martha Stewart Center for Living at the Mount Sinai School of Medicine, had some interesting ideas on how to help older patients understand how they'll benefit by preparing for their visits. She points out that doctor/patient visits are limited to about 15 minutes, so it's more effective and efficient to come with an agenda. It's a good idea to bring along a son, daughter or other relative to visits -- mostly to offer support and strength, but also to ask questions and make note of details that are easily forgotten.

To get other suggestions about how older adults can be taught to become more active health care consumers, I also spoke with Robert N. Butler, MD, president and CEO of the International Longevity Center and professor of geriatrics and adult development at Mount Sinai School of Medicine, both in New York City. He agreed that it is crucial for all patients, regardless of age, to know as much as they can about their health issues. Since doctors now have, on average, more than 1,000 patients, it's far less likely they'll know patients' medical histories well -- though that is the way it used to be and older folks may not realize how much things have changed. The ideal way to gather information is, yes, the Internet -- and happily many older adults are comfortable using it today. But even those who spend lots of time on-line may not understand how important it is to filter advice by researching only credible sites -- Dr. Butler recommends www.mayoclinic.com and medlineplus.gov as good starting points for in-depth background information on health issues.

WHAT TO BRING TO YOUR VISIT
In order to better the odds of success at your doctor's visit, Dr. Chun urges all elderly patients to bring the following to every appointment:

A list of all medications or, if there are more than five or six, a brown bag with the medications themselves. A periodic review of drugs is vital, says Dr. Chun, because some may no longer be necessary, one may be causing problems that need to be investigated, or the combination of two or more may cause interactions that are problematic.

A list of all symptoms and any recent physical changes that might be pertinent for diagnosing a health problem.
A list of questions concerning any medications or conditions, whether new ones or those that were previously diagnosed.
A notepad for the doctor to write down names of unfamiliar diagnoses, tests and medications so that patients can investigate them further at home.

Also, patients should ask the doctor to list instructions for taking any newly prescribed drugs -- and, before leaving the office, make sure they can read the notes from the doctor.

If they get home and the writing is illegible, the instructions are useless. At the end of the visit, Dr. Chun suggests asking the doctor to briefly summarize the content of their time together. Patients may also want to ask about other sources of information they can explore on their own, along with resources such as support groups for those who have a chronic condition.

RESPECT IS KEY
Don't expect that one conversation will get an elderly parent or relative over the hurdle of being a passive patient. Given that many have spent a lifetime thinking they should never question a doctor, you'll likely need to reframe the issue. Dr. Chun notes that an important aspect of patient/doctor relations is good communication -- and a vital ingredient of communication is the patient's willingness to ask questions. Showing respect is a value that previous generations emphasized -- she says that many older patients worry their questions might send a message of doubt and disrespect. Try explaining that, in fact, when a patient asks questions, it lets doctors know whether they understand the information they've been given.

Not infrequently, misunderstandings cause problems down the road that a question or two might have cleared up right away. Patients can ask when is a good time to call the doctor if they have further questions.

Even better though, say both Dr. Butler and Dr. Chun, is to schedule a follow-up visit several weeks later. This additional time enables the doctor and patient to understand what's happening, how treatment is going and for questions to arise naturally. Also, the additional time together may increase the patient's comfort with the doctor, as well as allow the doctor to get to know the patient a little bit better. As a rule, insurance pays for the second visit and it is time -- and money -- well spent to maximize personal health care.