I T E M S P E N D I N G F U R T H E R R E V I E W

DECISIONS FROM THE HSIC MEETING, FEBRUARY 12-14, 2008

MISSION STATEMENT

concerns about our Group

Health Insurance Plan will

be answered in writing

and distributed to all

DHRs/UHRs at the semi-

nar.

The Manufacturers Life

Financial Agreement for

2008 was assessed and

recommended to the Pro-

vincial Executive (PE) for

signature.

The DHR/UHR’s seminar

for 2008 has been con-

firmed for Thursday, Fri-

day, June 12/13 at the

Renaissance Toronto Air-

port Hotel. Registration

forms for the 2008 work-

shop are appended to the

Newsletter. Registrants

are asked to

make note of

the date, and

the change of

location. Health

Plan Enhance-

ment Submis-

sion Forms,

(HPES), are in-

cluded to be

filled out by DHRs/UHRs

on behalf of their District/

Unit, and returned either

with their registrations, or

turned in at the seminar

itself. Any questions or

The final draft of the HSIC

Governance Manual was

completed. Committee

members will review all

aspects of the Manual for

errors, omissions, neces-

sary interpretations, etc.

and formally approve the

document at the April 2008

HSIC meeting.

The HSIC will begin a de

tailed review of our Ex-

tended Health Care Plan at

its meeting in April.

The RTIP/ARM comparison

chart is nearing completion

and should be available by

the end of February 2008.

The 2008 HSIC Priorities

have been revised and will

be finalized at the April

HSIC Meeting.

V o l u m e 5 , I s s u e 1

I n s i d e :

Decisions from the

HS&IC Meeting,

February 12-14, 2008

2

Items Pending

Further Review

2

Drug Information and

Update

2

Additional Information Items

3

Long Term Care 4

Pedometer Use Findings

5

Trans-Fat Bans – Only Part of the Solution

6

P u r p o s e :

This newsletter is in-

tended to keep DHRs/

UHRs current with mat-

ters considered at

Health Services and

Insurance Committee

(HS&IC) meetings and

current items which

may be of interest to

your District/Unit

membership. Please

feel free to use any of

the following informa-

tion when communi-

cating with members

at meetings or via local

newsletters.

The Health Services and Insurance Committee of the Retired Teachers of Ontario /Les

Enseignantes Et Retraites De L’Ontario will provide a most cost effective, high quality

and competitive Group Health Insurance Plan that meets the needs of the majority of the

membership.

F e b r u a r y 2 0 0 8

H E A L T H M A T T E R S

The Benefit Statements

and Income Tax Letters

for the 2007 taxation

year were mailed to par-

ticipants beginning Janu-

ary 29th, 2008 and was

completed by February

8th, 2008.

This year, the revised

Health Plans Booklets

were distributed with the

Benefit Statements and

Income Tax Letters. The

new booklets were in-

serted by the mailing

house into the same en-

velope as the partici-

pant’s Statement/Letter

and mailed together.

This reduces postage

costs over separate mail-

ings.

Please encourage your

members to read the

material carefully to un-

derstand the benefits

they are entitled to re-

ceive. Also, remind mem-

bers to place the Book-

lets in a safe and known

location as it will be

three years until the next

printing. Updates over

this period of time

should be placed in the

booklets when received

and read. Members are

encouraged to recycle

(where available) their

old booklets to have only

current information avail-

able.

If members need clarifi-

cation to ensure that

they are covered for spe-

cific benefits then they

should contact Johnson

Inc.’s Claims department

side effects and lingering

appointments or proce-

dures. If members have

family members or

friends who tend to be

timid, step up as their

advocate. DHRs/UHRs are

also excellent advocates

for our members and

A request is made of

DHRs/UHRs to encourage

your District/Unit mem-

bership to become their

own advocate in looking

after their health needs.

Members must speak up

and question reasons for

treatment, medications,

more senior members

who are shy or unsure.

There are many cases in

our Health system where

the squeaky wheel gets

the grease. ADVOCATE,

please for our members.

B e n e f i t S t a t e m e n t a n d I n c o m e T a x M a i l i n g

A d v o c a c y !

D o c t o r s p r e s s O t t a w a , P r o v i n c e s o n W a i t - t i m e G u a r a n t e e s

scans, and radiation on-

cology. Due to the sig-

nificant progress in the

original five sectors, the

Alliance is proposing that

the effort be expanded to

new areas.

The goal is to adopt

benchmarks for

“minimum acceptable”

wait times in the new

areas as a start toward

eventual reductions.

The alliance also wants

governments to address

one huge gap in the defi-

nition of the wait-time

issue – the time it takes

for a patient to see a spe-

cialist after the initial

referral from their family

doctor. Currently wait

times are defined as the

span from specialist to

procedure.

From the patients’ per-

ception, “the wait really

begins”, at the moment

they see their primary

care doctor.

Source: The Canadian

Press, November 26,

2007

The fourth report of the

Wait Time Alliance was

released in November

2007 calling for an ex-

pansion in an effort to

reduce wait times in five

new areas: emergency

room care, psychiatric

care, plastic surgery for

burns, infections and

trauma, gastroenterology

and anesthesiology.

The original five sectors

were: cardiac care, hip

and knee replacements,

cataract surgery, diag-

nostic imaging like CT

Page 2 H E A L T H M A T T E R S

Prescription Trends

Canadian Quick Facts

Over the past five

years, there was a

decline in rising drug

costs due in part to

late phase failures in

brand name drugs.

The top 10 drugs

account for 60% of the

total prescription drug

costs.

The average

prescription drug cost

per day rose from

$1.39 in 2003 to

$1.90 in 2006, and is

projected to rise to

$2.90 by the year

2010.

A significant cost

driver in drug

expenditure is the

rising drug use as a

result of the increase

in changing drug

mixes (more choices

within a therapeutic

class).

Source: Accerta School

VIP CE Series seminar

Page 3 V o l u m e 5 , I s s u e 1

P r e s c r i p t i o n D r u g V a c a t i o n S u p p l y

N e w P r o c e d u r e

Effective January 1,

2008, participants

travelling outside

their province of resi-

dence for an extended

period of time will be

able to obtain up to a

200 day supply of

medication before

leaving the province.

Previously, a partici-

pant was only able to

obtain up to a 100

day supply.

For claims submitted

electronically by the

pharmacy, the phar-

macist should contact

the Johnson Pharmacy

line, and Johnson will

fax a form to the

pharmacy for comple-

tion by the partici-

pant. The form can be

completed while the

participant is at the

pharmacy and faxed

back to allow John-

son’s claims system

to be updated so that

the 200 day extended

supply can be proc-

essed electronically.

The eligible amount

payable will, however,

still be subject to the

calendar year maxi-

mum for the year in

which the drug is pur-

chased. Participants

who have already

reached their maxi-

mum will not be eligi-

ble for the extended

vacation supply.

Johnson has noted the

increasing incidence of

claims being submitted

for drugs that have been

administered in a hospi-

tal. Under the Canada

Health Act, the hospitals

are required to fund the

cost of medications that

they administer. The

medications should fall

under their global budg-

ets with no direct cost to

the patient. However,

some hospitals’ re-

sponses have been that

these drugs are not cov-

ered under their global

budgets, causing frustra-

tion for the RTO/ERO

participants who are be-

ing “caught in the mid-

dle”.

The RTO/ERO Extended

Health Care Plan will pay

any eligible ingredient

costs of prescription

drugs that are used to

treat an approved medi-

cal condition, regardless

of where the drug is ad-

ministered, as long as

the drug is purchased at

a pharmacy. The fee to

administer the drug in

the hospital would still

be declined, as doctors’

fees are not an eligible

expense under the Plan.

showed that only pa-

tients with a history of

cardiovascular disease

should avoid Avandia,

the new results show that

even those with no his-

tory of heart problems

are also at an increased

risk. The study shows

older diabetics have a

60% higher risk of con-

gestive heart failure, 40%

higher risk of heart at-

tack, and 29% higher risk

A new Canadian study

has found the strongest

evidence to date of the

dangers posed by the

popular diabetes drug

Avandia, particularly

when used by seniors. In

2007, Health Canada

advised that Avandia was

under review for possible

links to increased heart

events and that further

studies were required.

While earlier research

of death, than their coun-

terparts who are taking

other diabetic medica-

tions. While the drug has

an important role to play

in the management of

diabetes, physicians will

need to be careful to

avoid prescribing them

to patients with existing

heart disease.

Source: The Globe and

Mail, December 12, 2007

D r u g s P u r c h a s e d a t a P h a r m a c y a n d A d m i n i s t e r e d i n a

H o s p i t a l

A v a n d i a — N e w H e a l t h W a r n i n g

R a s i l e z — N e w D r u g f o r H i g h B l o o d P r e s s u r e

oral tablet taken once

daily. The drug has been

shown to sustain control

of blood pressure over a

24 hour period. The

drug is also well toler-

ated when used with the

most common cardiovas-

cular and anti-diabetic

medicines.

While this drug is not yet

approved by Health Can-

ada, the uptake on this

new drug is anticipated

to be rapid if and when

approved. The high

prevalence of hyperten-

sion among the aging

population, and the need

to treat hypertension as a

precursor to other dis-

ease states, make this

product a possibility for

high demand.

Source: Cubic Health,

Novartis Canada, January

Rasilez, a new drug

manufactured by Novar-

tis for the treatment of

hypertension, works by

suppressing renin. Renin

is a central component in

an enzyme that results in

elevated blood pressure.

This is the first new ap-

proach to treating people

with high blood pressure

in over a decade.

The planned dosage is an

Page 4 H E A L T H M A T T E R S

Drug Inform

ation and Update

As referenced by John-

son at the December

2007 HS&IC meeting,

The Council on Aging

of Ottawa has com-

pleted a broad review

of Long Term Care

(LTC). Their 24-page

report, “Long Term

Care Insurance in Can-

ada: What is it and do

I need it?”, was pro-

duced to help indi-

viduals and families

understand the is-

sues surrounding

long term care and

the insurance op-

tions available to pay

for such support.

The report is a com-

prehensive look at

LTC, including what it

is, where it is pro-

vided, what it costs,

and what insurance

options are available.

For more informa-

tion, please refer to

The Council on Aging

of Ottawa website at

www.coaottawa.ca

paigns to reduce the

trans fats in foods are

gaining momentum,

some nutrition ex-

perts are concerned

that consumers will be

no better off. Some

experts believe that

with the reduction of

trans fats in greasy

foods and snack

foods, consumers will

revert to eating these

under the false belief

that they are now

“healthy”. In some

cases, restaurants and

manufacturers have

In January 2008,

Calgary became the

first Canadian city

to ban trans fats in

restaurants. Restau-

rants are no

longer allowed to

cook with fats or

oils in which trans

fats make up

more than 2 per-

cent of the total

fat content.

Many restaurants

and food manu-

facturers use trans

fats, as they are

typically cheaper

than other oils,

provide a rich tex-

ture and have a

longer shelf life.

However, health

organizations and

advocacy groups

have led major cam-

paigns against the

use of trans fats due

to their link to in-

creased risks of

coronary heart dis-

ease and higher

cholesterol levels.

Although the cam-

reverted to using

alternatives which

are nearly as detri-

mental to health as

the trans fats, and

therefore no more

healthy for con-

sumers than be-

fore. Even with the

elimination of trans

fats, there may still

be harmfully high

levels of sodium,

saturated fat, sugar

and other preserva-

tives in the foods.

Experts suggest

that to make a big

impact on overall

health, instead of

focusing solely on

trans fats, consum-

ers will need to fo-

cus on a number of

initiatives, such as

exercise, nutritional

awareness and

greater incentives

for restaurants to

offer more healthful

items.

Source: Globe and

Mail, January 3, 2008

L o n g T e r m C a r e

T r a n s - F a t B a n — O n l y P a r t o f t h e S o l u t i o n

“You reap what you

sow. Plant well.” - DJR

Page 5 V o l u m e 5 , I s s u e 1

Researchers at Stanford University School

of Medicine pooled together the results

of 26 studies evaluating pedometer use

and physical activity and found the fol-

lowing:

� Overall, pedometers users in-

creased physical activity by 2,000 steps per day, the equivalent of one mile per day, and burned an additional 100 calories per day.

� Pedometer use is linked to a sig-

nificant drop in systolic blood pressure; the equivalent of 4mm HG.

� Having a daily step goal and using

a step diary were key to boosting a patient’s exercise.

� A 10,000 step per day goal is opti-

mal for lowering blood pressure and improving blood glucose con-trol.

� A 15,000 step per day goal is opti-

mal for weight loss. Source: The Globe and Mail, November

21, 2007

Please remind your members that pe-

dometers may be purchased through

Souvenir Canada, suppliers of RTO/ERO

items.

P e d o m e t e r U s e F i n d i n g s

Health Services and Insurance Committee

Newsletter Editor: Dave Ross

RTO/ERO Provincial Office

18 Spadina Road

Suite 300

Toronto, ON M5R 2S7

Your RTO/ERO HSI Committee for 2008:

Doug Carter, Chair

Harold Brathwaite, Executive Director

Margaret Couture, Provincial Executive

Shirley Greenwood

Daisie Gregory

Melanie Johnson, Administrative Assistant

Brian Kenny, Provincial Executive

Roger Pitt

Dave Ross

Joe Santone

Tony Sawinski, Pension & Benefits Officer

Lyle Sutherland

Clarice West-Hobbs, Provincial Executive

The Health Services and Insurance Committee of the Retired Teachers of Ontario /Les Enseignantes Et Retraites De L’Ontario will provide a most cost effective, high quality and competitive Group Health Insurance Plan that meets the needs of the

majority of the membership.

Requests are being made

for extra copies of the

2008-2010 Health Plan

Booklets and Out- of-

Province/Canada Travel

Booklets at RPWs and

District/Unit meetings.

The cost of printing the

two Booklets prohibits an

unending supply. Please

encourage members or

prospective members to

use the RTO/ERO Web-

site. Access to all avail-

able Health Plans may be

obtained using the fol-

lowing procedures; a)

Call up the RTO/ERO

Home Page b) At the bot-

tom of the page is a se-

ries of current items

available. Click on Group

Benefits c) This takes

you to Johnson Inc.’s

website. Select the Bene-

fit(s) of interest and read

the information. Hope-

fully, this will offer an-

other avenue for informa-

tion and reduce the re-

quests for additional

Health Booklets. Thank

you for your assistance.

2 0 0 8 — 2 0 1 0 H E A L T H P L A N B O O K L E T S A N D

O U T - o f - P R O V I N C E / C A N A D A T R A V E L B O O K L E T S

H e r e f o r y o u n o w … H e r e f o r y o u r f u t u r e À v o t r e s e r v i c e … p o u r l e s o i n d e v o t r e a v e n i r

Phone: 1-800-361-9888

Fax: 416-962-1061

Website: www.rto-ero.org

Email: healthcommittee@rto-ero.org