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Thursday, May 2, 2019 - 17:00

Part 1: Access

Improve access to the right programs and services that build on our strengths as a territory and respond to local community needs.

What’s working? What’s not working?

 

John Glynn-Morris
Engagement Process Support

Comments

annel
Monday, May 13, 2019 - 10:10
This is a challenge in a large geographic area with scattered small population centres. The issue in smaller communities is getting the right access at the right time. Critical care caused by trauma is responded to quickly and often results in an expensive medevacuation. Having been the patient on two medevacuation flights out of my communitynover the past 33 years I can say how much i have appreciated this quick access. I have also paid a lot of taxes over those years to get this service. Chronic care is also something that is managed as a satisfactory level. What is not managed well is early diagnosis of life threatening disease. While general wellness activities take place the diagnosis of more complex system issues require access to skilled diagnosticians and folks at the front end with the skills to know when someone is in a situation that will lead to crisis. As we move from a primary care physician model in our community to a pilot. use practitioner model I am mostly concerned about ability to diagnose promptly, to be able to have that conversation about a malaise with a highly trained professional who not only orders tests, but intuits how systems are connected and what tests might be needed.
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BJMcLennan
Tuesday, May 14, 2019 - 06:15
Thanks "Annel" for all your thoughtful comments in each of the topic areas. I did not reply on every one, but I did read all your input and suggestions. I really appreciate you taking the time to provide your input. All comments by yourself and other participants will be taken into consideration by the IEP (Independent Expert Panel) in arriving at their recommendations. Bruce McLennan - Chair IEP
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Thursday, May 2, 2019 - 16:55

Part 1: Quality

Deliver innovative, high-quality services that make Yukoner’s lives better.

What’s working? What’s not working?

 

John Glynn-Morris
Engagement Process Support

Comments

annel
Monday, May 13, 2019 - 10:14
What is it working is the place to go when you need access to non urgent medical care in a reasonable time frame. My Dr's clinic, located in Whitehorse, does a valiant job of attempting to meet this need by having a "sign in/drop in" clinic every afternoon with one of their resident doctors taking turns. They have access to your file and can at least get a glimpse of who you are. It would be helpful if everyone's file was available to health practitioners patients giver permission to to access. In Whitehorse your choice seems to be wait for your Dr appt in two eels or go to emergency or go to a walk in clinic who don't know you, Some sort of centralized record keeping would make sense, Also, utilization of technology for access to experts would be good too,
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KAT1955
Thursday, May 16, 2019 - 20:41
Health prevention and promotion need just as much attention and increased resources so there are less resources required for chronic care. Yukoners who are striving to live a healthy, active lifestyle should be rewarded for their efforts through tax incentives or other innovative incentives. We need to encourage healthy lifestyles to reduce the demand on our medical system that is already over taxed and has huge costs that are not sustainable. We have an aging population and the longer they stay healthy , active and vibrant the less they will use the medical system.
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Thursday, May 2, 2019 - 16:50

Part 1: Sustainability

Address the factors driving costs and make the best use of the money and people we have to improve wellness.

 

What’s working? What’s not working?

 

John Glynn-Morris
Engagement Process Support

Comments

annel
Monday, May 13, 2019 - 10:19
As noted earlier, geography and a small population is a challenge. On one level, if we had better general wellness access (ie we used to have the annual physical where you went in and talked about whatever was going on and those discussions sometimes sparked an investigation, now it is every three years unless you need something or have an immediate crisis) then does it correspond that we would have fewer surprises where we had to throw a lot of money and resources fast and hard? We used to, and maybe still do, have well women clinics in the communities....these discussions were with nurses but triggered further investigations. Would something like this work?
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Thursday, May 2, 2019 - 16:45

Part 1: Coordination of Care

Make prevention a key priority and influence health and social service providers and programs to work together to respond to the multiple needs of Yukoners.

 

What’s working? What’s not working?

 

John Glynn-Morris
Engagement Process Support

Comments

annel
Monday, May 13, 2019 - 10:29
I think that we spend a lot of $ putting up posters, telling people to not drink while pregnant, or smoke or do other harmful things. we have advertising and educational campaigns that are targeted at people with specific issues all of which depend on the people they are intended for reqdingnthe poster, absorbing it, and changing their lifestyle. Ok, maybe not a simple as that but you get the drift. Do we have a small enough population that we could do case files, address people individually? Crazy idea, but innovative? The people who fall through the cracks, I think, are folks in the mid income range, we don't qualify for social services, we don't get escorts to whitehorse and are dependent on family and friends to drive us, house us while in Whitehorse, or we spend $300 on fuel to get to an appointment and $180 on hotel plus meals and get a partial subsidy of $70/day and some gas money. And when we go outside for an appointment, yew, our airfare is paid, and we get the $70 but we are out thousands of dollars to stay in the city for appointments and treatments. Decreasing subsidies will hurt these folks. I have a chronic care situation which requires time sensitive treatment, I seem to have the choice of waiting for the specialist to come to Whitehorse on a schedule that is not recommended for my treatment, or buying my own ticket to vancouver and staying with friends, which i do. Anyway, thatnis probably a different question!
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Thursday, May 2, 2019 - 16:40

Part 1: Reconciliation

Value the traditional health practices of Indigenous peoples and recognize the impact of colonialism on the health and wellness of Indigenous peoples. Work with Yukon First Nations to improve culturally safe health and social programs and provide services through a trauma-informed lens.

 

What’s working? What’s not working?

 

John Glynn-Morris
Engagement Process Support
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Thursday, May 2, 2019 - 16:35

Part 2: Primary health care and delivery models

When Yukoners are not feeling well, an easy option is to go to the emergency department. Sometimes this is the best choice, but it is also the more expensive option in our system. The emergency room is designed to provide specific emergency care, and often cannot fully address the needs of Yukoners using it instead of more appropriate health care options like walk-in clinics, substance use services, doctors’ offices or other hospital programs.

When Yukoners feel unwell, or when they are looking for information and supports on wellness, where else could people go for these services?

What type of providers would be available to meet with?

What kind of programs or options do we need to keep people healthy in the community, before they need to go to a hospital?

 

John Glynn-Morris
Engagement Process Support

Comments

annel
Monday, May 13, 2019 - 10:45
some sort of wellness option, we used to be able to depend on our annual physical, or general discussion with nurses in the community....now you have to have a reason....someone to help advocate and triage all your stuff would go a long way. the FN folks in our community have a community care facilitator who helps set up the paperwork and the travel, an ombudsman, advocate, someone to help organize the medicanstuff....can the average yukoner access that? maybe then we wouldn't wait so long to get into que and maybe we would know what que to get into, as one ages it seems yunare dealing with one issue and another crops up andnyou are on your own to figure it out. maybe the nurse practitioner will be able to help with this? right now some yukoner have access to advocate andnhelp and some don't.
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Thursday, May 2, 2019 - 16:30

Part 2: Coordination of Care within, and out of the territory

Most Yukoners prefer to receive care close to home. Can we better use technology so people don’t have to travel to receive care?

When they do have to travel, how do we make sure there are no gaps when people are moving between providers or services?

How do we reduce confusion for Yukoners?

 

John Glynn-Morris
Engagement Process Support

Comments

annel
Monday, May 13, 2019 - 10:38
I live this one, I have been in tears at the medical travel counter trying to figure out what I qualify, how much of my own money I will have to spend and what hoops I have to jump through. People are already stressed, going out to an unknown procedure, diagnosis and the eternal question, "maybe you can get the service here". That has already been determined by the medical professional/specialist. I have solved this problem by putting medical travel in my personal budget and paying for airfare and staying with friends, sometimes, paying for a companion to come with me because walking the streets of vancouver after treatment is difficult. YG does not help me at all negotiate my ongoing specialist appointments that require outside travel. The occasional one that has the right paperwork and my Dr's office helps push through does work. But I am still on my own. I am awaiting right now a phone call as to whether or not medical travel will be approved for an appointment I am going to go to in Vancouver regardless. So I don't have a solution but I do know that other than the receptionist at my Dr office or the Health Centre I do not have a health advocate. I know other people of other means who do have people who can help them navigate the system but for the average Yukoner you are on your own, which papers, who needs to sign them, if you qualify is all up to you,
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Thursday, May 2, 2019 - 16:25

Part 2: Individuals with multiple layers of needs

Many people have multiple health, mental health, and substance use challenges, and they may be affected by social inequities. Often they have to access different services and providers in different locations before they receive the treatment and support needed to start to feel better.

How do we make sure Yukoners in need receive the right care and support matched to their needs, at the right time, in the right place?

 

 

John Glynn-Morris
Engagement Process Support
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Thursday, May 2, 2019 - 16:20

Part 2: Aging in place

Yukoners want to remain independent and in their community as long as possible but there are some gaps in services for seniors and elders.

What services do we need to provide to allow older Yukoners to maintain independence and stay in their home and community?

 

 

John Glynn-Morris
Engagement Process Support

Comments

annel
Monday, May 13, 2019 - 10:47
As per above, someone to help us keep track of everything, right now it is appointments and treatment, but someone to check in with or who checks in with us....
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Thursday, May 2, 2019 - 16:15

Part 2: Pharmacare and Pharmaceutical Benefits

Some Yukoners receive coverage for drug benefits, others may only receive limited coverage, while some are not covered at all. It can be difficult to support wellness when Yukoners have difficulty obtaining drug coverage. Universal drug coverage can be expensive, though we know that a lack of drug coverage results in poorer health outcomes.

How can we make sure that Yukoners have access to the drug benefits they need while making sure we can still afford to pay the bills?

 

John Glynn-Morris
Engagement Process Support

Comments

annel
Monday, May 13, 2019 - 10:50
it would be good to have some relief from drug bills. particularlynifnyuo have treatment outside and you are not hospitalized, you have to pay for all the drugs yourself, some are a thousand dollars a shot. unless you are on a chronic care list, and can fine your way onto the list (quite a challenge) you pay your own. some families take their vacation money and make a medical trip to vancouver the highlight of the summer.....we all figure it out but bills of $300 a month are not unusual in my household
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Thursday, May 2, 2019 - 16:10

Part 2: Social Supports

Our social assistance programs were designed many years ago and don’t meet the diverse needs of today’s society. Individuals with chronic conditions often have complex health and social support needs.

Our existing systems don’t do the best job of helping people get back into the workforce. How can we make sure that we can better meet the needs of clients?

 

John Glynn-Morris
Engagement Process Support

Comments

annel
Monday, May 13, 2019 - 10:58
Social assistance is a great thing that we have in Canada, I have worked my whole life, paid into EI, etc. and have never resented my taxed dollars going to social programs and helping others who need the help. It is what makes our societies work. I have never been on the receiving end of social assistance, EI or any other help.....now, at the other end of life. I could use some help. I am not rich, I am not poor, I have some resources, I still have most of my mental faculties and can figure stuff out, but it is pretty stressful. I am lucky that I have a GP in Whitehorse who knows me and can help focus me when I can get into see her,,,,,but I get tired of getting handed the sheaf of papers and organizing things, phoning medical travel to see if things got through the system yada yada, waiting until the last mimute to see if it is approved, hanging onto an air pass in my back oocket in case it isn't. Friends are not so lucky, they go to the clinic in a Dawson, see a different Dr every time, have to explain everything again, get differing advise,and get even more confused. So we need consistent health care with. consistent practitioners who know us and someone who can help organize all the paper work, and some certainty that we are in the right line up.....
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Thursday, May 2, 2019 - 16:00

Part 3: Key Considerations

As Yukoners, what are the most important things we should think about as we conduct this review?

How do we make the best use of our limited financial resources?

How do we make decisions about what to spend our money on?

What advice would you give to create a healthy and sustainable future?

What trade-offs should we think about?

 

John Glynn-Morris
Engagement Process Support

Comments

annel
Monday, May 13, 2019 - 11:12
Well, when I think about this I think that the Yukon budget has quadrupled in the last number of years and the population hasn't and surely inflation has not been that high so I wonder about the limited resources? Maybe we limit our own resources and choose not to spend them on medical care? There few things that we expect of good governance but one is the health, safety and education of our families. A healthy, educated population is a productive one. So all the studies in the world, building better mouse traps should have at their core serving the people, not trade offs or limited budgets. These are artificially induced by a growing beurocrqcy that will ultimately chip away at the core services Yukon needs. Perhaps we need to look at streamlining government not streamlining the services we offer, Just by asking this question you are going to a place of scarcity, not abundance. So I would suggest you rethink your key considerations or you are going to get answers that fulfill this prophecy. Hmm, would I trade off and pay a monthly premium on top of the expenses I already pay to have??? if so, for what??? my advocate? "free" drugs...maybe I would.....we need to build a system that is fair to all Yukoners and right now we have some haves and we have some have nots. Some of this is income and need driven, some is geographic location, but there are only 35,000 of us...,,,can we find a way to have relevant health care for everyone, can we be the example? Can we create eutooia? Or can we create a bureaucratic nightmare. Our choice. Your choice as the independent committee investigating this. Do you make a more cumbersome system or do you just create something that is fair, equitable and truly a service. Tax dollars are paid with an expectation of service, not more sacrifice. .
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BJMcLennan
Tuesday, May 14, 2019 - 06:02
Thanks for your input.
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