11/13/11

Drummond Commission: Structural Redesign of health care. Oh great...

Don Drummond says his Commission on public services in Ontario is spending 40% of its time on  health care “structural redesign”, Martin Cohn at the Toronto Star reports.    Drummond adds,  “We do not even have an integrated health care system”.   

"Structural redesign" and more "integration" could mean a lot of things, but it sure sounds like he is contemplating more restructuring of health care employers.  Proposals to move money out of hospitals are also  possible (and perhaps even privatization  -- although Drummond was told not go there). 

Drummond claims his reforms will be more 'strategic' than past system redesigns that failed.  But the Mike Harris government also tried 'structural redesign' of the health care system.  Ultimately the costs of the Harris redesign went through the roof, many of the the plans to shutdown or merge hospitals were abandoned, and the Harris government began providing funding increases to hospitals again.
  
Cohn says Drummond is worried the reforms won’t get traction with the public. After convincing McGuinty to reduce the government's funding plans last week from 1.8% increases to 1% increases, Drummond told Cohn, “You’ve got to understand there’s consequences to a number like that, and the consequences aren’t easy. That kind of worries me — if you’re out of sync with the general expectations . . . you just meet resistance all the time.”



One might also ask why a Bay Street banker thinks he has the knowledge to propose “structural redesign” of health care. The failed Harris reforms actually involved significant consultation and research. 

Cohn also notes that Drummond hopes to benefit from a realignment of political forces.   That is credible: the Liberals and PCs are both focused on the same deficit cutting track, and both parties would probably prefer to package cuts as 'structural redesign.'     

There's not even a hint that Drummond will take a hard look at what his former colleagues are doing to us through P3 private finance of hospitals.  There's a lot of money there and the financial crisis looks set to make this an even worse deal for the public.  Moreover, we are bound to pile up a lot of debt there and, last I heard, that P3 debt was still hidden from the province's books, despite longstanding talk that it would be brought onto the books. 


Finally, despite reducing funding plans from 1.8% to 1% per year, Cohn reports the Liberals are still contemplating 3% increases for health care, a relatively modest cut from previous Liberal promises.   Except for 1% increases in education, the plan is to stick funding cuts on the other sectors, it seems.

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