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Tuesday
Mar282017

New seniors’ group boosts ‘grey power’: Grey Panthers chapter opens with a Canadian touch

 

By David South

Today’s Seniors (Canada), April 1993

Check your prejudices at the door, look beyond your self-interest, and open your mind, because the Grey Panthers are here in Canada.

Joe Moniz, the 26-year-old founder of the Canadian Grey Panthers, is confident that his ambitious plans for a new national seniors’ organization are just what Canadian seniors need. 

That’s right: 26-years-old. Modelled on the U.S. Grey Panthers, the Canadian Grey Panthers believe in harnessing the power of all age groups, making the connection that everybody will eventually be a senior and that seniors benefit from a better society for everyone. 

“The major difference between us and any other organization is our slogan, “Age and Youth Working Together,” he says. “Look at our pension fund. It’s depleting. I’m concerned about my future as a senior citizen - will there be a pension fund? We want to act now, to bring youth and age together to improve the situation of seniors today and improve our situation in the future. 

“Membership is open to all age groups. We want to bring seniors into day care to interact with children. We want to deal with the universities, give people the opportunity to discuss and unite. It’s a different approach, but it can make a huge difference.”

Moniz has already organized the group’s first chapter, in Hamilton, complete with a board of retired university professors and doctors. The group has put together insurance packages that will “blow the others out of the water.”

“All seniors’ attempts at lobbying in the past have been short term,” says a blunt Moniz. “We are the organization that will make the difference. We will lobby provincially, federally, and municipally, and we are non-partisan.

“The reason I’m introducing the Grey Panthers is to keep grey power alive in Canada, and to provide the necessary channels to do so through lobbying efforts. If anyone has problems with local politicians, they can call us, and we in turn let them know the channels they should use. There are a lot of seniors out there being cheated, and it is up to us to help them.”

The Canadian Grey Panthers (which uses the British spelling, as opposed to its American counterpart) will initially concentrate on four issues: pensions, drug plans, affordable housing and long-term care, and will communicate information through newsletters, surveys and meetings. 

Moniz promises to make the Panthers accessible to all, no matter what their income. He plans to hit the streets and visit institutions to inform seniors of the group’s presence. As if to prove the group’s potential for excitement, an enthusiastic gentleman from a local retirement home interrupts Moniz during a coffee shop interview. “That’s the best thing I’ve heard from a young person in Toronto,” he says. 

The U.S. Panthers were formed by political activist Maggie Kuhn and five friends in 1970. Back then, their name wasn’t as exciting. It was the convoluted and unsexy “Consultation of Older and Younger Adults for Social Change.” In 1972, they adopted the media’s pet name - a grey twist on radical African-American rights organization the Black Panthers. 

The radical milieu of political activism was contagious - and the Panthers symbolized its jump from the youth of America to other generations. 

“When we formed, we were an intergenerational group,” says Panthers’ U.S. national chair, Charlotte Flynn. “The first issue the group addressed was mandatory retirement. We combat the stigma of ageism, which is making decisions about people based on chronological age. Ageism isn’t just confined to the elderly - ageism exists for young people as well.”

The agenda of the Panthers is just as radical today. Flynn, who is candid about the group’s failures as well as its successes, admits that it isn’t the easiest route to popularity. With membership at about 45,000, the U.S. Panthers have spoken out on now-popular issues like health care, the environment, affordable housing - and taken brave stands against mainstream opinion when it came to the Gulf War and the invasion of Panama. 

And they think big. Not content with just influencing the American political scene, the Panthers have taken on the world, gaining official advisor status at the United Nations. 

Although involved in a broad range of issues, Flynn says the Panthers are primarily seen as a strong voice for the rights of American seniors. 

“We have tried very hard to let people know we are not a special interest group for the elderly,” says Flynn. “But we are always getting called upon to highlight what any legislation is doing to older people.” 

With Panther groups sprouting in Europe and now in Canada, the important issue of maintaining the integrity of the Panther name has arisen, says Flynn. She points to the flip side of having a reputation for action: people want to start branches without being interested in the full agenda of the Panthers, using the name for shock value. At the last convention in November 1992, the Panthers formed a committee to act as quality control monitors for the name. 

One thing is clear from the ambitious agenda of the Grey Panthers - they aren’t for everyone. 

But Moniz’s pragmatic approach seems distinct from the American Panthers. He shies away from some of the American group’s positions, emphasizing a balance between insurance policies and political policies. 

“If you read the American Panthers’ position sheet, it’s anti-this and anti-that,” he says. “We aren’t going to take that approach. It would be suicide.”

But he is quick in his praise of the group and its founder Maggie Kuhn. “People may consider her actions to be radical, but they’re not. Look at the achievements. She is one of the top 25 active women in the U.S.

“The Gray Panthers are achievers. They have proven the effectiveness of intergenerational attempts at social justice.”

A quick call to seniors’ groups drew many surpised faces. 

“I can’t say anything about them - I don’t know who they are,” responded Murray Morgenthau, executive director of the Canadian Association of Retired Persons (CARP). 

Jane Leitch at the United Senior Citizens of Ontario had heard something was happening but wonders why a new group is forming “with so many groups out there.”

One Voice spokesperson Andrew Aitkens says his group is closer to the American Association of Retired Persons than the Panthers in their approach, and that they “have found that there are much more effective ways for advocacy. We don’t march on the Hill at the drop of the hat.”

But Flynn says the Panthers embody a philosophy distinct from all other seniors’ groups. “As Maggie Kuhn said, ‘those of us who are older are the elders of the tribe and should be concerned about survival.’ We look at all issues that deny people the ability to realize their full potential, whether young or old. We are really interested in empowering people rather than being a special interest for the elderly.” 

Tuesday
Mar282017

Government urged to limit free drugs for seniors

 

By David South

Today’s Seniors (Canada), May 1993

Another blow may be coming to seniors on top of last August’s cuts to the Ontario Drug Benefit Plan (ODBP). Health minister Ruth Grier has been advised to terminate the policy offering free drugs for Ontario residents over 65. 

Assistant deputy health minister Mary Catherine Lindberg says the 13-page report from the Ontario Drug Reform Secretariat urges the government to replace universal coverage with a system based on income. 

The government argues that fiscal problems, a desire to make wealthy seniors pay, and a need to extend the program to the working poor has driven them to consider the move, while critics argue it will hurt modest-to-lower-income seniors. They say costs could be better contained by keeping universal coverage and attacking the source of escalating costs: pharmaceutical manufacturers and doctors who over-prescribe or misprescribe. 

Concession

If implemented, the cuts will represent a concession by the NDP on the once-sacred principle of universality. Just last year, former health minister Francis Lankin said, “I believe strongly in universality, and we’re not looking at ending it for drug coverage of seniors.”

The proposed plan calls for single people, regardless of age, who earn over $20,000 a year, and families earning over $40,000, to pay a premium of up to $300 for drug coverage. 

Those earning less than that amount will have to pay for their own drugs until they reach a limit tied to their income to become eligible for free drugs. 

The government says this changes qualifying for coverage from age to income-based. 

In a recent interview, health minister Ruth Grier wouldn’t be specific about what plan she would go for. But she agrees with the report’s authors that the drug plan needs reform. 

“While the drug plan makes drugs available in an open-ended way to everybody over 65,” says Grier. “In many cases it doesn’t help the low-income family with parents in minimum wage jobs and has a child needing constant drugs. And when we reform the system we aren’t just looking at how we can contain costs, but also how we can make it fairer. The underlying principle of all that we are doing is equity and fairness.”

The drug benefit plan, which also covers welfare recipients, hit $1.2 billion last year out of an almost $17 billion health budget. That was an increase of 13.8 per cent from 1991, but lower than the 18.1 per cent average for the last 10 years. 

David Kelly at Toronto’s multi-service agency Senior Link suggests the government go after the drug industry for wasting money promoting drugs and duplicating research projects. 

According to the industry advocate Pharmaceutical Manufacturers Association of Canada’s own statistics, drug companies spent $186 million on “marketing” in 1990 while $286 million actually went to research and development. 

The federal government’s own Patent Medicine Prices Review Board, in an internal study leaked to The Globe and Mail, found Canada to have some of the highest drug prices among the seven industrialized nations. 

Anger

Seniors organizations and agencies almost overwhelmingly expressed anger over the report, seeing it as another attack on universality of medicare. They feel the government isn’t being creative enough solving fiscal problems. 

“I strongly disapprove,” says Sara Wayman, chairperson of the Ontario board of Canadian Pensioners Concerned. “The concept of universality when it comes to services is a basic democratic principle we support strongly. People who earn $20,000 a year are still struggling to make ends meet. This would represent a real hardship. 

“We also feel strongly that the high medical costs that everybody is talking about aren’t really due to universality. They are really due to the high cost of drugs, and because there has been a restraint of generic drugs by our legislature.

“They are tip toeing around the medical profession. I hope people will speak out.”

Kelly feels savings could be reaped by taxing back any benefits given to wealthy seniors, while maintaining the universality of programs. 

“The group they are talking about is very tiny,” says Kelly. “And so the cost savings to the government are going to be really minimal. A whole process will have to be set up to decide who gets free drugs, and what you get is another layer of bureaucracy everyone has to go through. Studies have shown this adds to the net costs of government in the long run.”


Monday
Mar272017

Seniors falling through the health care cost cracks

 

By David South

Today’s Seniors (Canada), December 1993

When Orangeville senior Donald Potter was told he was too old to receive a bone marrow transplant, he paid $150,000 to get one in the United States. 

His case, recently made public by provincial Conservative leader Mike Harris, has raised the disturbing issue of health care rationing for seniors. 

Potter, who has Hodgkin’s lymphoma, says he was told the cut-off age is 55; since he was 64 at the time he needed a transplant, he was told last February it was too risky to obtain the procedure. Faced with a few months to live, he went to Rochester, New York, where bone marrow transplants were done on patients into their late 70s. 

Money

Potter believes the real issue is money. The government doesn’t have enough, so he couldn’t get the treatment that could save his life. 

Cost-cutting resulting from the provincial government’s social contract and expenditure control plans has left physicians with the quandary of serving more people with less money. This dilemma has led them to prioritize who gets services, though physicians maintain such decisions are based on many factors other than age, including lifestyle, prognosis and effectiveness of the therapy. 

Transplants

Bone marrow transplants are a particularly emotional issue for Premier Bob Rae, who in early October was driven to tears handling questions regarding rationing of this service. His brother died of lymphatic cancer in 1989 after a failed bone marrow transplant for which Premier Rae was the donor. 

“I can’t knock the system that hard, I just don’t feel the government spends the money properly,” says a calm and unresentful Potter.

Many seniors are frightened when they hear the government needs to make cuts, fearing they could be the first to go when it comes to allocating rationed services. 

“From the perspective of seniors it is a very scary time right now,” says David Kelly of Toronto’s Senior Link, a community social service agency. “Everything is being questioned, all our social services. Instead of looking at how to solve the problems, we’re just going to cut out things, and that’s going to be our solution. It doesn’t necessarily work.”

The issue of rationing services based on age is a dicey one. Ministry of Health spokesperson Layne Verbeek says the schedule of benefits makes no mention of age; and he’s right, because that would be unconstitutional. But when a doctor is presented with a fixed budget and a bulging sack of patients, the physician on the hospital ward has to decide who gets treated and with what. How a physician does this is theoretically based on a combination of factors, but doctors also have prejudices and misconceptions. 

Rationing

Many argue such queuing is a dangerous departure from the belief that the sick deserve to be treated. 

“Part of the problem is that few would admit to rationing on the basis of age alone,” says bioethicist Eric Meslin of Toronto’s Sunnybrook Health Science Centre. “Most clinicians I’ve spoken with and worked with recognize that age alone is not a relevant criterion. But most clinicians would agree age does play a role in thinking about limiting care.”

Meslin admits the idea of denying health services based upon age alone has been making the rounds among health care professionals. 

Ethics

“There has been a debate in the last seven years in North America over whether age-based rationing is ethically acceptable,” says Meslin. “There is of course a spectrum of views, including the very extreme that says after a certain number of years you have obtained your benefit from society and you should step aside and allow others to make use of those resources.”

Meslin doesn’t feel good about going through any kind of health care rationing without a public debate over society’s values and what to expect from the health care system. 

And he is adamant that anybody who focuses solely on attacking the high costs of high-tech medicine and an aging population is making a value judgement about how society should spend its money, not stating a fact.

“A clinician who chooses to discriminate based on age alone is not only unethical, but unconstitutional. Having said that, no clinician worth their salt would be telling the truth if they did not consider who the patient was in the fullest sense of the term, including their age. However, not giving treatment because they are 80 is a numbers game; there isn’t good enough data to support it.” 

Meslin suggests a public debate on rationing services needs to take place. 

Needs

“We need to ask the elderly population what they want. It may be that they don’t want the kind of things the researchers and clinicians believe they want.”

Kelly at Senior Link believes cuts to free drugs are already one example of rationing. 

“There are a lot of ways we can go about changing our social services without cutting income support or access to medication. The same goes for what procedures will be performed,” says Kelly. 

Potter’s case graphically shows the human cost of the heavy hand of bureaucrats in a public system trying to save money. But the high cost of U.S. health care also leaves a bad taste in Potter’s mouth. 

“In the States, the cost is horrendous. At least we have that protection. But I happen to be one of the unfortunate ones that fell into the wrong slot. And there’s a lot of people like me.” 


Monday
Mar272017

New legislation will allow control of medical treatment

 

By David South

Today’s Seniors (Canada), December 1993

It isn’t the nicest thing to think about, but if accident or illness strikes, you could end up receiving unwanted treatment. 

But in 1994 things will change. The living will or advance directive - a document clearly stating a patient’s wishes about how they want to be treated - will become part of the doctor-patient relationship. 

A trio of acts passed last December - the Advocacy Act, the Substitute Decisions Act and the Consent to Treatment Act - allow, albeit in rather vague language, for Ontarians to set out in advance which medical procedures they would or wouldn’t accept and let’s them name a proxy in case they are incapable of expressing their wishes. 

This vague language - intended to allow patients to customize their wishes - means that writing a living will can prove to be a troubling and confusing experience. 

To aid decision-making, the University of Toronto Centre for Bioethics is offering advice through a “model” living will. 

The centre’s Dr. Peter Singer has geared the “model” to meet Ontario legislation and to offer a guide for anybody who doesn’t know where to begin. 

“We put a lot of detail in the advance directive about states of incompetence people get into, and also the sorts of procedures providers might recommend in those health states.”

Singer sees living wills as an effective tool aiding patients to control their own health care.

“Unless the doctor is a longstanding friend it’s hard to know what patients want. As a practicing doctor, I have run into an incompetent person where their family member has no idea what sort of wishes the person would have wanted. The goal of a living will is to provide the personal care the patient would want.”

But there is a danger. Dr. Singer urges the need for informed and detailed language in a living will. 

“If I have a couple minutes to make a decision I need a document that gives me a lot of confidence that this person wouldn’t want this treatment.”

In an emergency, the doctor might not even know of the living will’s existence. Dr. Singer advises giving a copy to your family doctor, lawyer, or proxy, and keep one with you at all times. When so-called “smart” health cards come along, Dr. Singer would like to see the living will recorded on the magnetic strip along with other health information. 


Monday
Mar272017

Specialists want cancer treatments universally available

 

By David South

Today’s Seniors (Canada), December 1993

A newly-formed group representing cancer doctors says it is fed up with the inhumane and bureaucratic approach to cancer care in Ontario. 

Dr. Shailendra Verma of Access to Equal Cancer Care in Ontario (AECCO) says he’s had enough. 

“My group has served the government notice that we’re fighting on our patients’ behalf,” says Verma, who faces gut-wrenching quandaries every day in his growing Ottawa practice. “In a public health system, I’m damned if I’m going to be divided into giving one set of patients a Cadillac treatment and the other Hyundai-type treatment; I don’t think that’s why we have a public health system.”

Verma says cutbacks to health care funding have meant that doctors must leap increasingly high hurdles to get the drugs their patients need. 

In jeopardy

While chemotherapy drugs administered in hospitals are still free, he says the important drugs necessary for patient comfort and treatment effectiveness are in jeopardy. 

These drugs were once free under the Ontario Drug Benefit Plan (ODBP), but now their status is tenuous. One drug, GCSF - which is crucial in helping patients between treatments of chemotherapy - is now listed under Section 8 of the ODBP and requires doctors to plead with the government each time for coverage. Often the bureaucracy moves so slowly that the course of chemotherapy is seriously disrupted, Verma says. 

“As an oncologist I’m particularly interested in ensuring everyone has access to all treatment. I think we are at a very sensitive crossroads. Over the last three or four decades we’ve developed certain treatments for diseases that more often kill than cure. And now we are at a point where we’ve got new treatments that can make the older treatments more effective. Or we’ve got brand new treatments that we are hoping to apply, and the one thing that is holding us back is cost.”

Cost

“The decisions are not based on science, they’re based on cost. It would not be an issue if treatments cost a penny a shot.”

Verma says colleagues can’t introduce some new drugs because the costs would be too high to offer it to everyone. So no one gets it.

“We have patients who walk in and say they would like to pay for it,” continues Verma. “Ethically, as a physician do you allow a patient to pay for it while sitting next to a similar patient who can’t afford it?”