Defend Public Healthcare

In the lead up to the Ontario provincial Budget, it's useful to flag just how unreliable they have become as a guide to public spending and provincial deficits in recent years under the Ford government.  The government has shown a significant ability to increase funding for public programs and health care programs if the public demands it. The Public Accounts report that total provincial government program expenses for 2024-25 increased by $16.9 billion or 8.7 per cent over the previous fiscal year. That is an increase from $195.2 billion in the previous fiscal year to $212.1 billion in 2024/25. Furthermore, the actual 2024/25 spend was $11.5 billion more than the 2024/25 Budget plan.  The Budget was a very unreliable indicator of actual program spending. A similar scenario played out in health sector funding.  It increased by $6.2 billion or 7.2 per cent over the previous fiscal year. The total health sector spend was also $6.7 billion more than the Budget plan. ...

While Canada has achieved universal public healthcare coverage, that does not mean conservative forces have given up trying to erode that coverage and expand corporate care where it does not currently exist. The battle has become particularly intense in Ontario under the Ford Progressive Conservative government, which is implementing serious cuts to the level of care and moving to bring in for-profit mini-hospitals. Inadequate Staffing.   Less and less of hospital spending is on staff.   Employee compensation as a share of hospital expenditures has consistently shrunk in Ontario. This is not some immutable law of hospital development.  It is in stark contrast with the rest of Canada, where compensation has become a larger share and now accounts for 67.1%. Hospitals in provinces other than Ontario now have 18 percent more staff per capita than hospitals in Ontario. Overall, if Ontario had the same staffing capacity as the other provinces and territories, there would be another...

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...

Despite the current health care capacity crisis, the Ford government plans to cut health care service levels. Hospitals : The news  is bad for hospital services.  The new Financial Accountability Office (FAO)  report   on the government's health care funding plan reports the government plans 3,000 new beds over the next decade.  That’s about an 8.4% increase in nominal capacity.   Measured against need, however, this will mean a sharp decrease in service levels.   The public wants improved service levels, but the opposite is planned. That "increase" won’t come  even   close to covering off increasing demand for services due to population growth, which according to provincial government projections  will be about 15%. The demands on health care will be much more than this, however, due to a rapidly aging population.  Health care needs are very sensitive to age.  People 65 and over use most of our hospital bed days...

Women's wages caught up to male wages when broader public sector (BPS) wages grew but when BPS wages were suppressed, the wage gap grew.  Women comprise 74% of the Ontario education, health care, and social assistance workforce.   A strong female majority is present in all three of these sectors but is especially marked in health care and social assistance, where 762,800 women work.   These three industries account for 31% of all women employees in Ontario. So what happens to these workers has a big impact on women. For men, it's a different story -- education, health, and social assistance account for only 9.89% of all male employment in Ontario. So, overall, males are much less affected by what happens in these sectors. Source:  Statistics Canada.  Table  14-10-0022-01  Labour force characteristics by industry, monthly, unadjusted for seasonality (x 1,000) These three industries are the great bulk of the provincial broader public sector or ...

By 2027 the PC health care funding plan falls $21.3 billion short, their hospital bed plan falls 500 beds short, their plan to free up hospital capacity by moving hospital patents to long-term care is unlikely to work, and their nurse and PSW staffing plan will fall 33,000 short according to the Financial Accountability Office ( FAO ).  Important and appalling news. But the human problems are actually much worse. The FAO focuses on measuring the gap between the government's stated plans and the government’s stated aspirations.  The bigger -- and much more important -- problem is that the government aspirations fall so very far short of actual human needs. So, on staffing, the FAO makes no claim that government aspirations are adequate to human need. Indeed, their staffing projections do “not reflect an assessment about the quality of services that should be provided by these programs.” As a result, the FAO estimates the government aims to add 1,000 hospital beds between no...

Actual provincial program spending is much less than "planned" Provincial Spending was $6.4 billion less than planned over the first 9 months of the fiscal year 2022/3 according to the Financial Accountability Office (FAO). That is 5.0% less than budgeted. After the first half of the year, the FAO had reported that the government had underspent its budget by 4.1% ($3.5 billion).  Health was underspent by $1.25 billion – or 2.3% less than planned. This is an increase from an underspend of $859 million reported by the FAO after the first half of the year.   The news of the $1.25 billion underspend on health comes just as the province scooped up another $776 million from the federal government for health care to deal with urgent health needs like the hospital crisis.  But, instead of dealing with urgent hospital needs, it looks like the province will bank the cheque and underspend the health budget it set last March.      Despite the health underspend...