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Sick notes can be costly

Howard Levitt's perspective on doctors' notes for verification of illness (Doctors' notes keep costs in line, Jan. 16) is narrow and simplistic.

A significant number of people attend primary health care sites for the sole purpose of meeting their employers' requirement for a sick note and not for a medical opinion, investigation, treatment or intervention. This places an additional burden on primary-care practitioners and increases health care costs, while bringing no health benefit to the employee or patient.

As outlined by Dr. Scott Wooder, president of the Ontario Medical Association, this might also contribute significantly to the spread of infectious illnesses by forcing ill people, who would otherwise be much more comfortable at home, to congregate in primary-care facilities.

A more nuanced discussion needs to take place between employers, employees and society at large to find other tools that might be helpful in reducing the high rates of absenteeism. Looking at the wide variation in rates of absenteeism between differing types of work and work environments might help develop other more helpful strategies to decrease this significant societal cost.

There is no credible evidence forcing individuals to seek unwanted health-care consultation leads to reduced absenteeism.



Lower taxes worsen services

In Top earners are tops in taxes, too (Jan. 15), Mark Milke fails to acknowledge the backlash against top earners' wages is a result of dramatic increases in recent years.

Of the top 100 CEOs in Canada, compensation increased 73 per cent from 1998 to 2012, with the average now $7.96 million annually. Comparatively, the average pay for Canadians working full-time increased just six per cent from 1998 to 2012, with the average now at $46,634 per year.

Wealthy people pay a higher, but declining, share of taxes. The top one per cent of earners paid 20.8 per cent of the total share of federal and provincial income taxes in 2011, down from 23.3 per cent five years earlier.

Overall, taxes are lower, too; $1 billion of tax revenue has been cut from the Manitoba budget over the last decade. The result of these tax cuts is the erosion of the social-welfare state, exemplified in higher rates of homelessness and a housing crisis amongst low-income people.

The tax system plays an important redistributive role that is the foundation of the social-welfare state.

CEOs and their shareholders should be happy to pay their share of taxes so others may simply have a roof over their heads.



Digging up problems at city hall

Bartley Kives is zeroing in on some real problems (Plow talk is pandering, Jan. 16). There are many issues that, when taken together, have resulted in some of the bungles that have characterized our civic government in the past few decades.

The public service has been gutted and demoralized, and some excellent staff have quit and moved to other cities.

Taxes were frozen, resulting in a backlog of infrastructure problems.

In the upcoming election it would be refreshing to see one or more candidates run on a platform of civic reform, spelling out the changes they would make if elected.



EPC should follow city charter

Am I the only one who finds it worrying that Mayor Sam Katz admitted to a closed-door meeting of the executive policy committee (Clashing accounts of EPC discussions, Jan. 16)?

The City of Winnipeg charter clearly states that all meetings of committees council and their subcommittees must be open to the public and minutes to be kept.



Patient advocate needed

Re: Discharge policy not followed?, Jan. 14.

Almost every sick person needs a patient advocate, especially when going to hospital emergency rooms.

Sudden illness or injury is more challenging for a person who lives alone than for one with a supportive family at home.

Older adults might try to handle emergencies on their own, and depend on ambulance paramedics for protection en route to hospital. Once there, there may be no opportunity for the patient to contact a friend or caregiver.

Medical personnel in ERs know this, but have no time to make phone calls for the unaccompanied patient. Emergency rooms need to be staffed with capable patient advocates.

Any person who arrives alone at an ER would be assigned an advocate tasked with obtaining patient consent to contact his or her relative, friend, or neighbour, as well as contacting the patient's chosen helper.

That friend would agree to take responsibility for the patient after discharge from the ER.

When there is no available friend, the advocate would accompany the patient in a taxi to ensure the patient's safe arrival inside the door of his home.

Just as airports have roving ambassadors to help travellers, so too should emergency clinics have patient advocates acting in support of the principle of patient-centred care.



Republished from the Winnipeg Free Press print edition January 20, 2014 A8

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