Country-wide Physicians' health checkup

Doctors across the country are getting a checkup.

A national study launched by the Centre for Physician Health and Well-being of the Canadian Medical Association will survey physicians' health, from nutrition and physical activity to job satisfaction and burnout.

"There's abundant data in the literature showing a relationship between mental health issues such as depression and exercise for example," said Dr. Erica Frank, the principal investigator and the Canada Research Chair in Preventative Medicine and Population Health at the University of British Columbia.

"There are a number of other areas that we'll be looking at as well. One of the key pieces that we're going to be looking at is physicians' personal health practices because there's a lot of really interesting research that shows that can really make a difference in the population."

The surveys are sent out to more than 8,000 randomly selected practising physicians.

Dr. Vino Padayachee, the chief of staff at St. Joseph's Hospital of Estevan and the past Saskatchewan Medical Association president, is keen to participate and hopes many of his counterparts do the same.

"This is not just about physician health," he said. "Indirectly it's about patient health. If you have healthy physicians, then you'll have healthy patients. We don't allow airline pilots to fly beyond a certain number of hours because of the risk to the passengers and we should look at the same thing for physicians as well."

CMA research conducted in 2003 reported that 46 per cent of physician respondents were in advanced stages of burnout.

Read the full story here

Saskatchewan Union of Nurses might go on strike

In Saskatchewan, angry union leaders were assessing their options Thursday, a day after the provincial government proposed sweeping changes to labour law, including new essential services legislation.

It appears health care workers could be the first on the battles lines early in 2008 in the fight against the legislation.

Major contracts affecting health care workers, including the Saskatchewan Union of Nurses (SUN) which represents more than 7,000 registered nurses and registered psychiatric nurses, are slated to expire March 31.

Union leaders said Thursday they are not pleased by the essential services legislation.

While no one talked specifically about going on strike in defiance of essential services legislation, similar actions have happened in the past, such as in 1999 when SUN continued on strike in defiance of back-to-work legislation introduced by the NDP government in power at the time.

Read the full article here

Aggressive nurses recruiting program in Alberta

Alberta plans to fast-track international recruits, launch an aggressive cross-Canada campaign to lure back locally trained nurses and retrain those who have left the profession in an effort to deal with a province-wide nursing shortage.

In the last six months, the province's College and Association of Registered Nurses has received more than 1,000 applications from international nurses. While an experienced nurse from an English-speaking country can be assessed and start working within four to six months, others with language and education barriers can wait more than a year to gain the proper credentials.

Alberta's health department has given the college $500,000 to hire more staff to deal with the applications and help speed that up, Health Minister Dave Hancock said.

Starting in January, provincial officials will travel to other provinces hoping to entice locally trained nurses back to Alberta.

The Star Phoenix

Victorian Order of Nurses protest in Hamilton on Friday

Tomorrow, Ontario Nurses' Association (ONA) registered nurses employed by St. Joseph's Home Care, will join their President, Linda Haslam-Stroud, RNs and other unionized nurses to protest the competitive bidding process that will result in the loss of more than 200 jobs.

The ONA home care RNs will join OPSEU members in Hamilton as their employers, St. Joseph's Home Care and the Victorian Order of Nurses, are briefed by the local Community Care Access Centre on why they have been eliminated from the competitive bidding process to provide home care services for area residents.

ONA represents the 59 RNs who work for St. Joseph's and who have provided home care services for decades.

The Association is urging its RNs to consider nursing positions outside of the community sector unless the government guarantees successor rights that would provide job security for nurses, and most importantly, continuity of care for the residents of the community.

ONA is the union representing 53,000 registered nurses and allied health professionals working in Ontario hospitals, long-term care facilities, public health, the community and industry.

The protest will take place tomorrow at the Courtyard Marriott Hotel in Hamilton.

Source: CNW Group

Related article:

Victorian Order of Nurses to be made redundant

Trans fat reduction going the right way, but more to be done

According to their latest study about trans fat reductions, Health Canada says that more needs to be done to lower the levels of trans fat, although progress is being made.

A trans fat task force recommended in 2006 that processed trans fats should be limited to no more than five percent of total fat.

The federal government then gave the food industry two years to reduce the amount of heart-clogging trans fat in their foods.

Sally Brown, CEO of the Heart and Stroke Foundation of Canada and co-chair of the national trans fat task force, says many companies have made "significant progress in reducing trans fats."

However, she adds that other companies "do not seem to be getting the message" and points to fast food restaurants as the leading culprits, Burger King in particular.

Brown says that Burger King has "unacceptably high levels of trans fat in many of their products" and this makes her wonder if they care about their customers.

Canadian Press and Marketwire

Premier Nova Scotia wants to allow more private competition in health care

Rodney MacDonald, Nova Scotia's Premier, should be applauded for his openness to a greater role for private competition in health care.
In his recent state-of-the-province address, he said specifically that the provincial government was moving towards a greater role for the private sector in the delivery of publicly funded health services.

For far too long, Canada has been out of step with the rest of the industrialized world in its steadfast opposition to tapping into the competitive market for solutions to our health care woes, to the detriment of both patients and taxpayers alike.

Consider for a moment what Canadians receive in return for this steadfast commitment to the status quo.
Among the 28 developed nations that have universal health insurance programs, Canada ranks third in age-adjusted health care spending as a percentage of GDP.

At the same time, Canadians endure relatively poor access to physicians and medical technologies, while wait times for health care in Canada are not just unacceptably long but are among the longest in the developed world.
Perhaps a closer look at why other countries are getting more for less is in order.

Among the world’s 28 most developed nations that have universal health insurance coverage like Canada, the majority allow private providers to deliver publicly funded services.

All of the nations that outperform Canada across several measures of mortality related to health system performance (Australia, Sweden and Japan) employ private competitive providers in the delivery of publicly funded health care.

Allowing private hospitals to compete for the delivery of publicly funded care is a proven policy that would improve the state of Medicare for all Canadians.

Premier MacDonald’s willingness to sit down and take an honest look at those policies that have worked so well elsewhere in the developed world, bodes well for both patients and taxpayers in Nova Scotia.

Read the full story here

Calgary Counselling Centre threatened to loose its residence

The Calgary Counselling Centre, since 1962, has provided counselling programs to help individuals, families, couples, children, men and women resolve domestic abuse, depression, stress, emotional and social programs.
Last year, the non-profit organization served 6367 clients, through 32,264 hours of counselling.

Through its ongoing research and education program, Calgary Counselling Centre strives to meet the changing needs of the community.

Now, with 10 working days notice, the Calgary Counselling Centre is in jeopardy of losing the space they have leased and occupied since June 1992.

Mid way through a ten year lease, the Calgary Counselling Centre has been advised that its lease may be terminated on coming 31 December.

Editor's opinion:

"Is it coincidence or well planned that health care workers are being told life changing bad news just before Christmas?
Earlier this week I already reported about the Victorian nurses in Hamilton who were told they'd loose their jobs coming April.
What is it with these people, these bringers of bad news?
Do they think that those people won't kill themselves around Christmas when around family and friends?
A happy Christmas to you too, you inconsiderate @%%40!e5"

Surgical masks insufficient protection during flu pandemic

In a report released yesterday, a panel of experts said that surgical masks aren't adequate to protect people from becoming infected during an influenza pandemic,

The report, written for the Public Health Agency of Canada, suggested industrial respirators known as N95s, would be needed to minimize the risk of transmission of flu.

"Surgical masks don't really fit the bill," said Dr. Donald Low, chair of the panel which brought together infection control specialists, nurses and occupational health and safety experts.

"Even if they have a good filtering capacity, inhalable virus particles will take the route of least resistance, which will be around the mask and through the gap that exists between the surgical mask and the face, just because they're not affected by gravity"

The panel was asked to advise the public health agency on one of the most contentious issues in influenza science - how flu spreads.

The answer will be used to craft guidance for provinces and territories on what protective equipment they should consider stockpiling for health care workers in a pandemic as well as advice for the public on how to reduce the risk of getting sick in such an event.

Read the rest of the article from the Canadian Press here

Canada most dangerous to the United States?

Which country is most dangerous to the United States?
This question was posed to the presidential candidates in the United States by CBS' Katie Couric last week.
Most of the candidates named Iran as the most worrisome country with Pakistan coming in a somewhat distant second place.
There was one vote for China which is not an unreasonable choice considering the quality of their exports.

"In pondering my choice, I must admit that I was heavily influenced by the recent Michael Moore movie, "Sicko." There is no question that Canada must be considered the more immediate danger to the United States...................................................."

Read what a Massachusetts' Doctor has to say about Canada and the Canadian health care system here

Lobby to reverse directive on $500 administration fee out-of-country patients

Whistler Mayor Ken Melamed has thrown his support behind an initiative by Whistler Health Care Centre (WHCC) staff to lobby B.C. Ministry of Health officials to reverse a recent directive on administration fees charged to out-of-country patients.

Local health care providers say that in the past three weeks they’ve counted at least 64 people who have left the centre after learning of the $500 administration fee for anyone who needs to see a doctor.
In an article in The Question last week, Dr. Bruce Mohr and others said they worry that some patients whose conditions should be assessed and treated by a doctor will go untreated, potentially leading to “adverse outcomes.”

Before Nov. 22, non-Canadian residents coming to the WHCC emergency room were charged a $400 administration fee for significant problems such as broken limbs, but only a $90 “minor” fee for issues that required only a brief doctor’s assessment and perhaps a prescription. Since then, all out-of-country WCSS patients have been required to pay $500 to see a doctor for either an initial or follow-up visit, no matter what their medical condition.

Mayor Melamed said he supports Dr. Mohr’s call for community leaders to send a letter to B.C. Health Minister George Abbott seeking to reverse the directive because of the number of out-of-country patients who visit the WHCC.

“We think there are provincial and national interests at stake here,” Melamed said. “In many cases, Whistler is people’s first and only visit to Canada and it reflects on Canada and British Columbia if people’s first experience here has that negative aspect.”

Melamed said he agrees that fees are necessary and added that local officials aren’t seeking a free ride for anyone.

“What we’re potentially asking, and we’re not there yet, is for some kind of a sliding scale,” he said, adding that health professionals in other B.C. resort towns probably have similar experiences, but perhaps not with the same frequency as those in Whistler.

“It’s not special treatment for Whistler,” Melamed said. “We’re just looking for recognition that it’s not one size fits all. Don’t try and shoehorn all situations into one model.”

Dr. Mohr said that in the short term, the doctors working in emergency at the WHCC are looking at using the offices of Whistler Medical Clinic doctors, upstairs, after hours as an alternative for patients who are non-residents of Canada.

“If patients feel it’s too expensive, we would just take them upstairs,” he said, adding that that doesn’t cover the larger issue.

Question

Health Committee Nova Scotia: "government tries to create crisis"

A recently organized citizens’ health committee in Nova Scotia, feels the government is trying to create a crisis to push for privatization by closing hospital emergency departments.

Judy Davis, spokeswoman for the North Shore Citizens’ Health Committee, said the provincial government has been creating a sense of crisis in the health care system for years, and the emergency department closures scheduled at Lillian Fraser Memorial Hospital in Tatamagouche this week is one of its methods.

“Why is the ER closing again?” asked Davis. “Despite bringing a new doctor to the area, the provincial government is failing to solve the problems.”

Health Minister Chris D’Entremont said he would much rather see committees created to look at solutions to heath care issues working through district health authorities and the Department of Health, who are well aware of issues affecting the health-care system.

“I think it is preposterous to see that kind of misunderstanding of the health- care system and exactly what happens in it,” said D’Entremont about the committee’s allegations.
“ER closures are something we’re living with. It is something that is going to happen from time to time.
“It’s an issue that is happening all across Canada not just here. But to see them try to attach it to the issue of private health care, or what have you, it is absolutely preposterous."

The minister said the department has been grappling with human health resource issues for a while and solutions are very slow in coming as people train to fill vacant positions.

“A couple locums have been located and will be in place at Lillian Fraser Memorial Hospital as of January so that will mitigate any closures that will happen there for a while,” said D’Entremont.
Davis feels one of the solutions to improve health care in Tatamagouche would be to bring a nurse practitioner to the area.

In the new year, working to establish a nurse practitioner in the community, along with keeping the emergency department at the rural hospital open, are top priorities for the local committee, organized by the Nova Scotia Citizens’ Health Care Network.

Truro Daily News

Alberta might eliminate health premiums

It's for the first time Alberta Premier Ed Stelmach is talking about the possibility of eliminating health care premiums as part of his party’s next election platform.

Even though Alberta has been awash in surplus cash for years, the Progressive Conservative government has resisted the idea of dropping health premiums, which only exist in three provinces.
But now Stelmach is signaling that a policy change may be in the works for premiums, which cost $1,056 per year for families and $528 for singles.

Earlier this week Ontario's premier McGuinty announced that despite soaring government revenues, health tax is not going to be scrapped for Ontarians. (read related article here)

“The revenue is close to $1 billion,” he told The Canadian Press in a year-end interview.
“There are a number of ideas coming forward from people that are looking at developing policy positions for the campaign. But we’re far from making any kind of decisions.”

Health Minister Dave Hancock said he has been talking to government caucus members for months about how the province can eliminate or at least reduce health premiums for some people.
Hancock says he would like to see the province create incentives for people to lead healthy lifestyles. "Whether we collect it as a premium or we collect it as tax, we should give people credit for the things that they do to remain healthy," he said Wednesday in an interview.

The message to Albertans would be: "We can take health-care premiums off, but you have to do something for it."

“That’s what I’m promoting, that we take a look at how you can earn your premium back by doing some pre-screening tests, by engaging in health activity, those sort of things.”

The group Friends of Medicare was delighted to hear that the government appears to have had a change of heart over health premiums, which are also charged in Ontario and British Columbia.

“This is the time to get rid of these premiums. We’ve never been wealthier,” said Suzanne Marshall, executive director of the Edmonton-based lobby group.

Edmonton Sun

Goverment criticized about care refugee claimant Singh

Volunteers are caring for quadriplegic refugee claimant Laibar Singh 24 hours a day, but it is unclear how many of them have formal medical training, despite his supporters' assertions that he needs access to Canada's top-notch medical care.

Harjap Grewal, a spokesman for Mr. Singh and refugee advocate with No One is Illegal, said in an interview that hundreds have volunteered to care for Mr. Singh since an aneurysm left him paralyzed, but he did not provide specific numbers of formally trained people who have been tending to him.

He said that a maximum of 10 people with training as nurses or doctors have volunteered to care for Mr. Singh, but that most volunteers are not health-care professionals. They have been helping him with needs such as hygiene and going to the bathroom that he cannot handle himself.

Mr. Grewal added that Mr. Singh would not receive the treatment he needs in India because neither he nor his children can afford to pay for it.

"A lot of people have the means to make sure that he gets that care here," he said.

Harsha Walia, also with No One is Illegal, said that money for Mr. Singh's care has come through community donations. For example, Maninder Gill, owner of Radio India, has donated $5,000 toward his care.

When asked why such donations could not be used to pay for private health care in India, Mr. Singh's home country, Ms. Walia said his case is a "simple issue of justice and humanity."

"If that argument were to be made that everyone here that's in need of care just raised money and went somewhere else, it defies a basic value of human dignity," she said. "His wish is that he feels safe here. He chooses to be with his community here."

Read the rest of the story here

"His condition just deteriorates rapidly every time he's put through this game that the government's playing...................................."

GlobeAndMail

41 Employees will be losing their jobs at Bridgepoint Community Rehab (B.C.R.)

On November 29, 2007 therapy and clerical staff of B.C.R. were informed of the Board of Directors decision, that they would not renew their contract to provide home rehabilitation services with the Toronto Central Community Care Access Centre.

As a result of this decision, 41 employees, members of Canadian Office and Professional Employees Union, Local 550 will be losing their jobs as of March 28, 2008.

Since 2001 B.C.R. employees have been providing therapy services in the home to patients/clients in the Greater Toronto area, including East York, such as Physiotherapy, Speech Language Pathology, Social Work and Occupational Therapy.
B.C.R.'s decision not to bid on the next request for proposal (RFP) for therapy services in Toronto, will mean that these services will as of April 01, 2008 be subject to the RFP bidding process, and will ultimately be provided by a different service provider.

This change in service provider will result in the disruption and continuity of care to approximately 40,000 patients/clients visits a year.
This decision by B.C.R. will also have a major impact on the lives of the 41 B.C.R. employees, who will be losing their jobs as of March 28, 2008, and will no longer have access to health and welfare benefits, HOOPP, paid vacations, job security, etc as a result of B.C.R.'s decision to not engage in the bidding process for therapy services provided by the Toronto Central CCAC.

This will lead to the loss of experienced and long service community therapists.
The Ontario Government has mandated the provision of Home Care.

CNW Group

"Where is the government's support for its front line professional workers that provide this service in Toronto?"

Japanese study finds: Green Tea halves risk of Prostate Cancer

Drinking green tea may reduce the risk of advanced prostate cancer, according to a study by researchers at Japan’s National Cancer Center.
It finds that men who consume 5 cups a day or more could halve risk.

It said men who drank five or more cups a day might halve the risk of developing advanced prostate cancer compared with those who drank less than one cup a day.

“This does not mean that people who drink green tea are guaranteed to have reduced risk of advanced prostate cancer,” said Norie Kurahashi, a scientist who took part in the study.

Prostate cancer is much less common among Asian men than Western men, and that may be partly due to the effects of the high consumption of green tea in Asia, the study said.

But it said further studies are needed to confirm the preventive effects of green tea on prostate cancer, including well-designed clinical trials.

The study, published in the American Journal of Epidemiology, compiled data from 50,000 men aged 40-69 over a period of up to 14 years from 1990.

British charity Cancer Research K says on its Web site that a study of almost 20,000 Japanese men published in the British Journal of Cancer in 2006 found no relationship between green tea and prostate cancer.

Reuters

Drug industry used too much as source for Doctors' prescription

Following my earlier article of today about drug use among seniors:

Dr. John Haggie, a Canadian Medical Association board member who chairs its ad hoc working group on pharmaceutical issues, said government warnings often get lost in the stack of documents physicians routinely receive.

Haggie warns that there is a lack of impartial information available to doctors.

"Most of the information the physician would receive in the general course of a week on medication by and large tends to come from material from drug companies," he said.

Drug companies have a very active sales and marketing team, he said, and they follow Health Canada warnings by issuing their own.

Health Canada warnings are sent out to physicians by fax, e-mail and mail, but are often one among many documents received.

Haggie said the CMA is trying to work with the academic community to provide doctors with unbiased education material to replace documents received from drug companies.

The association is also trying to get tools on its website so doctors can quickly access the latest peer-reviewed information on what drugs are safe and which need to be used with caution.

Source: CBC

Related article:

Dangerous drugs still prescribed to seniors

editor's opinion:

"Just as I thought...............the power of marketing"

11th Case of Mad Cow Disease confirmed in Alberta

Yesterday, Canada confirmed a new case of mad cow disease (also called BSE), the country's 11th case since the disease was first discovered there in 2003.

The Canadian Food Inspection Agency said no part of the cow's carcass entered the human food or animal feed chains and is therefore no threat to the public health.

The animal was identified as a 13-year-old cow from Alberta by the national monitoring program, which targets cattle most at risk for the disease also known as bovine spongiform encephalopathy and has tested about 190,000 animals since 2003.

The animal, from an unidentified farm, was born before the implementation of Canada's feed ban in 1997.

They expect to detect a small number of cases over the next 10 years as Canada progresses toward its goal of eliminating the disease from the national cattle herd.

"This detection confirms the ongoing high level of commitment and stewardship on the part of Canadian cattle producers to food safety and animal health," the CFIA said in a statement, saying it did not expect the latest discovery to affect Canada's international standing as a country with a controlled risk for BSE.

Eating meat products with infected tissue is linked to a rare, fatal illness, variant Creutzfeldt-Jacob disease, that has killed more than 150 people worldwide, most of them in Britain.

The Associated Press

Editor:

"The government states that the 11th case was reported last May 2nd, which means the latest one is the 12th case!"

Dangerous drugs still prescribed to seniors

Doctors are still prescribing dangerous drugs to seniors, despite government warnings.

Over two years ago was reported, that more than a million seniors were prescribed atypical antipsychotics. Atypical antipsychotics are specific kinds of antipsychotic drugs. They are considered by many experts to be ineffective or even dangerous for elderly patients.

Health Canada followed up with warnings pointing to the drugs' side effects according to 13 scientific studies, which included a 60 percent greater risk of death in seniors who were taking the drugs than in patients taking placebos.
It also warned that elderly patients taking atypical antipsychotics were almost twice as likely to die from side effects such as heart failure.

In its advisory, Health Canada requested that the drugs' manufacturers include a warning describing the risk in the safety information sheet provided along with the drugs, and that health care providers refrain from relying too much on the drugs to treat dementia.

Atypical antipsychotics are drugs such as Risperidone (Risperdal), Quetiapine (Seroquel), Olanzapine (Zyprexa) and Clozapine (Clozaril).
Many of these types of drugs have never been tested on seniors.
They are intended to treat severe mood disorders, symptoms of schizophrenia and bipolar disorder in adults under 65.

A new investigation has revealed that the number of prescriptions of these drugs for seniors actually increased in spite of and after the Health Canada warnings.
They shot up in six provinces, including in Ontario and Quebec.

In some cases, they increased by 40 percent, according to sales data provided by IMS Health, a business intelligence and strategic pharmaceutical and health-care consulting firm.

Read the rest of CBC's story here

Editor's opinion:

"Hmm, I wonder if the drug industry with its incentive programs has anything to do with it..................."

In Newfoundland and Labrador an initiative for drug use among seniors has just been announced last week:

New program to help seniors taking medication in a safer way

IT solution makes Jewish General Hospital in Montreal more efficient

At Jewish General Hospital in Montreal, you won’t hear the buzzers triggered by patients’ call buttons, and you won’t hear the public address system paging doctors.

Physicians and nurses now carry wireless telephones that work over the hospital’s computer network.
Call buttons with voice capabilities are linked to the phone system, so a patient in need can let an assigned nurse know what the problem is right away rather than just ringing a buzzer at the nursing station.

"It means better response to patients’ needs and it means doctors waste less time," says Stephen Rosenthal, the hospital’s associate director of medical informatics.

In the past, Dr. Rosenthal explains, the usual way to reach a doctor was to page him or her via the public address system. This added noise in an already busy environment where patients need quiet. The doctor being paged had to find a telephone to call back, and by that time the person at the other end might be unavailable.

Cellphones weren’t an option because of potential interference with some sensitive medical equipment, Dr. Rosenthal says.
But the wireless IP phones serve the same purpose: Calls can now go directly to the doctor, eliminating the paging and telephone tag.

Jewish General first tried a wireless phone system in its emergency room, using older technology, then switched to a voice over IP (VOIP) network and expanded throughout inpatient areas about a year ago. This past summer it was extended into outpatient clinics as well.
Put together by IBM Canada Ltd. and Symbol Technologies Inc., the system now supports about 100 phones for physicians, nurses and administrators.

Read the full story here

Editor's opinion:

"This is a great example of how technology can make communication processes in the hospital more efficient. It will reduce time which can be better used to serve patients. More institutions in health care and hospitals should adopt initiatives like this to cut costs.

There's a task for IT companies to promote their solutions and cater to the health care industry."

Dalton McGuinty says: no scrapping of annual health tax

There's no chance the annual health tax of up to $900 a person will be scrapped, according to Ontario Premier Dalton McGuinty, despite soaring government revenues and a looming legislative review of the levy.

While the Liberal government will launch an examination of the controversial tax in the New Year, McGuinty struck a decidedly Grinch-like tone yesterday for those who hoped he might give taxpayers a yuletide surprise.

"That was raised during the course of the campaign. I dealt with that very specifically and straightforwardly and said, `No, we cannot eliminate or reduce our health tax,'" the premier said in an interview with CJBK radio's Steve Garrison in London.

"We need that money to continue to invest in our continuing capacity to assure that we've got health care there for people when we need it," he said.

The health premium, which was introduced in the 2004 budget just months after McGuinty had won power with a promise not to increase taxes, brings in about $2.6 billion a year.

Coincidentally, in last Thursday's economic statement, Finance Minister Dwight Duncan revealed that higher than expected personal and corporate tax revenues mean this year's income projections have grown by $2.6 billion, from $91.5 billion to $94.1 billion.

Progressive Conservative Leader John Tory, who campaigned to phase out the health tax, said the surplus proves the Liberals could afford to scrap the premium.

But Duncan also disclosed in his economic statement that spending would rise by $2.2 billion, to $93.3 billion from $91.1 billion.

McGuinty didn't think it was necessary to make apologies for retaining the health tax or for the broken promise of the 2004 campaign.

"We've got huge pressures associated with the delivery of health care, and what I said to Ontarians during the course of the campaign is that if I'm elected I will continue to invest in our health-care system to ensure that at all times we always have the capacity to care for each other in times of sickness," he said on CJBK.

About 42 percent of all taxpayers earn enough to pay the levy, which rises to a maximum of $900 a year, depending on income.

The Star

Editor's opinion:

"I hope they will use those billions to invest in efficiency, better management of health care institutions and IT so we can have that tax cut next time and make our health care system really accessible and free for everyone!"