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Health care funding falls, again

Real provincial government health care funding per-person has fallen again this year in Ontario, the third year in a row.  Since 2009 real funding per-person has fallen 2.6% -- $63 per person. 

Across Canada real per person funding is in its fourth consecutive year of increase. Since 2009, real provincial funding across Canada is up $89 -- 3.6%.
In fact the funding gap between Ontario and Canada as a whole has gown consistently for years (as set out below in current dollars).

Ontario funds health care less than any other province -- indeed, the province that funds health care the second least (B.C.) provides $185 more per person per year, 4.7% more.  
Provincial health care spending in the rest of Canada (excluding Ontario) is now  $574 higher per person annually than in Ontario. 

 Ontario has not always provided lower than average health care funding increases-- but that has been the general pattern since 2005.
Private expenditures on health care have exceeded Ontario government increases …
Recent posts

Public Sector Unionization Grows

The composition of the labour movement has fundamentally changed over the last twenty years. The article below reviews dramatic changes in public and private sector unionization and some surprising differences that have emerged between Ontario and the rest of Canada. Potential for growth is possible, even in the public sector.

Ontario has 1.3 million public sector workers and currently 943,000 of them are covered by a union. That means that 72.2% of public sector employees have union coverage.   
Since 1997, public sector union density has modestly increased from about 70% to 72% of total public sector employees.  With a significant increase in public sector employment also occurring over that period, there has been an increase in public sector union coverage from 652,000 to 943,000 employees– about a 47% increase in 19 years.




That still leaves another 363,000  unorganized public sector employees. Assuming that 10% of public sector employees are management (130,000) then there would be r…

More room for public spending in lead up to election

The 2016-17 Ontario Public Accounts came out yesterday – almost a month early. The Accounts finalize the books for 2016/17 and show that the deficit is down a further $500 million from the last estimate for 2016-17 (which was made in the spring in the 2017 Budget).  
The Shrinking Deficit: The deficit is now down below the billion dollar mark to $991 million.  That is a full $3.3 billion less than the estimate made in the 2016 Budget, continuing the long term trend by the Liberals to massively overestimate the deficit.  Contrary to those who have claimed the deficit was insurmountable, the real story is that it has been consistently overestimated for years. Revenue wobbles: Revenue did beat the 2016 Budget estimate for 2016/17  -- but only by $2.2 billion, 1.6% more than projected. The spring 2017 Budget estimated that revenue would beat the 2016 Budget projection by a larger figure -- $2.64 billion, 2% more than projected (albeit with a somewhat different accounting methodology). So th…

Public Health Restructuring Proposed

An “expert panel” appointed by the Minister of Health and Long-Term Care (MOHLTC) has now recommended the reduction in the number of Public Health boards from 36 to 14, matching the number of Local Health integration Networks (LHINs — provincially controlled regional bodies that oversee hospitals, long-term care, home care, and other health services).

The 36 currently existing public health units provide health promotion and disease prevention, health education, communicable disease control, immunization, screening services, and food premise inspections.  Each health unit is governed by a board of health and is administered by a medical officer of health who reports to the board. 

The boards are largely made up of elected representatives from the local municipal councils (and, in some cases, are the municipal council).  The MOHLTC cost-shares
the expenses with the municipalities, providing up to 75% of costs for ministry approved programs, 100% of costs for certain programs (e.g. Heal…

Ontario long-term care staffing falls far short of other provinces

CUPE and others are campaigning for a legislated minimum average of four worked hours of nursing and personal care per resident per day in long-term care (LTC) facilities.  New research indicates that not only is LTC underfunded in Ontario, it is also understaffed compared to the other provinces. 
LTC staffing falls short:  The latest data published by the Canadian Institute for Health Information (and based on a mandatory survey undertaken by Statistics Canada) indicates that staffing at long-term care (LTC) facilities falls far short of other provinces. 
Part of this is driven by a low level of provincial funding for LTC.





Ontario has 0.575 health care full-time equivalent employees (FTEs) per bed staffed and in operation.[1]  The rest of Canada reports 0.665 health care FTEs.[2] The rest of Canada has 15.7% more health care staff per bed staffed and in operation than Ontario.[3] 


No other province reports fewer LTC health care staff per resident (or per bed) than Ontario.[4]

Occupancy r…

Hospitals rely on private sector funding more and more

The Canadian Institute for Health Information (CIHI) reports that total expenditures on Ontario hospitals increased to $23.7 billion in 2016.

This is an increase of 2.4% since 2015 and 6.1% since the 2012. While provincial government expenditures increased 4.7% over the four years between 2012 and 2016, private sector expenditures on hospitals increased at a much faster rate -- 15.8%. That is more than three times the percentage increase of the provincial government increases. 

Private sector expenditures increased $124.9 million in 2016 to $3.62 billion.  That was a typical increase. The four year private sector increase was $493.1 million, averaging $123.3 million per year.  

That's  a lot more than chump change. Key types of private sector payments to hospitals are payments by private insurance companies and out-of pocket payments by individuals. 

Hospitals are now relying significantly more on private sector funds.  In 2012 private sector expenditures accounted for 13.99% of to…

Ontario is not sinking into deficit: Better public services can be won

The Financial Accountability Office (FAO) predicts significant deficits over the next several years - despite also predicting significant economic growth. Using the government's accounting method, the FAO is predicting budget deficits of $0.5 billion this year, increasing to $3.6 billion in 2021-22. 
Ifthe FAO is right then we do have a problem in terms of building our campaigns for better funding. Deficits will be used to clobber popular expectations for improved public services.  Already the right has taken up the FAO report to spread the deficit alarm.  
While the FAO does make some useful other points, its conclusions about the deficit are likely off base.


Revenues and Expenditures: The FAO expects tax revenue to grow 3.9% on average over the next five years, slightly below their expectations for nominal economic growth.  This is significantly better than their forecast for expenditure growth of 3.3% (which, notably, is a little below the underlying cost and demographic pressures…