Skip to main content

"Disrupt" hospitals. What, again?

A new report from the Mowatt Centre makes various recommendations to reform health care.  A key proposal is set out in yesterday's Toronto Star by author Will Falk:
Modernize the organization of hospitals by disrupting existing models. Services in today’s general hospital could be provided more efficiently elsewhere: academic centres focused on excellent diagnostic work-ups; specialty clinics providing routine procedures efficiently and accessibly, and networks of care that monitor patient well-being for chronic conditions — an organized system with public funding and in partnership with traditional hospitals.
Demands to remove work from hospitals are old hat. Obviously such moves would have a major impact on hospitals and their employees. Unlike similar proposals from other reports, this study does not advocate privatization. But the Falk does argue that "regulatory barriers need systematic review and removal".


The full report is here: Fiscal Sustainability and the Transformation of Canada's Healthcare System


Tom Walkom in today's Toronto Star  adds:
"the report  hints at introducing market mechanisms such as auctions into the system. Britain did something similar when it required doctors and hospitals in its public National Health Service to form trusts that competed with one another and with private health firms. Critics in that country say these changes are paving the way for full-scale privatization of British medicare.  But in Canada, there has been little discussion so far of what happens when faux markets are created in health care. As things heat up, expect more."


No surprise, the report was supported financially by 1% adviser, KPMG,"because of its commitment to help its clients understand the challenges faced by governments and to contribute to the discussion of strategies that can be used to address these challenges.


Sure.  


Fifteen years ago, the Mike Harris government promised hospital cuts and restructuring would solve our problems and reduce costs.  The restructuring itself ended up costing much more than promised and the Harris government eventually reversed the funding cuts and increased hospital funding sharply.


We may well be gearing up for something similar once again.



Comments

Popular posts from this blog

More spending on new hospitals and new beds? Nope

Hospital funding:  There is something off about the provincial government's Budget claims on hospital capital funding (funding to build and renovate hospital beds and facilities).    For what it is worth (which is not that much, given the long time frame the government cites), the province claims it will increase hospital capital spending over the next 10 years from $11 billion to $20 billion – or on average to about $2 billion per year.   But, this is just a notional increase from the previous announcement of future hospital capital spending.  Moreover, even if we did take this as a serious promise and not just a wisp of smoke, the government's own reports shows they have actually funded hospital infrastructure about $3 billion a year over the 2011/12-2015/16 period. So this “increase” is really a decrease from past actual spending. Even last year's (2016-17) hospital capital funding increase was reported in this Budget at $2.3 billion - i.e. about 15% more th

Ford government fails to respond to 72% increase in COVID inpatient days, deepening the capacity crisis

COVID infections continue to drive up hospital costs and inpatient hospitalizations in Ontario. For the most recent fiscal year (April 1, 2022- March 31, 2023) hospital stays related to COVID cost $1.221 billion, according to new CIHI data.   This is about 4% of total hospital spending, creating a very significant new cost pressure beyond the usual pressures of population growth, aging, inflation, and rising utilization.   Costs for COVID related hospitalizations increased 22.2% in Ontario in 2022/23 from the previous fiscal year, rising from $999 million to $1.221 billion.  That rise is particularly notable as the OMICRON spike of late 2021 and early 2022 had passed by the the 2022/23 fiscal year.   The $222 million increase in COVID hospitalization costs came in the same year as the Ford government cut special COVID funding and, in fact, cut total hospital funding by $156 million.     In total, there were 60,653 COVID hospitalizations in Ontario in 2022/3, up from 47,543 in 2021/2. 

Paramedic Services in Canada: Structure, Privatization, Unionization and other issues

Governance and Funding :  While police and fire services are usually municipal services, Emergency Medical Services (EMS) are typically controlled by provincial governments.  In Ontario, regional municipal governments have responsibility for delivering and funding EMS.  But even in Ontario the province plays a key role, strictly regulating EMS, providing funding for 50% of the approved land ambulance costs, and paying 100% of the approved costs for air ambulance, dispatch, base hospitals, First Nation EMS, and for territories without municipal government. Delivery :  Like police and fire services, EMS is predominantly a publicly provided service in Canada.   But businesses have now made some significant in-roads into EMS, primarily  Medavie,  a private corporation based in the Maritimes that describes itself as not-for-profit.  Medavie goes back over 70 years, with its roots in health insurance.  It still operates Medavie Blue Cross with 1,900 employees.  It now a