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Very low hospital capacity in Ontario

A key result of low hospital funding (discussed in the previous post) is that Ontario has fewer beds than the rest of Canada and far fewer beds than other developed countries.

The rest of Canada has 27.4% more beds per capita than Ontario (i.e. a difference very similar to the funding difference with the rest of Canada).
If Ontario had the same beds per capita as in the rest of Canada, we would have 39,385 beds.That is an 8,489 extra beds.
In Windsor that would mean an additional 137 beds at Windsor Regional (500 beds reported x 27.4% = 137), 71 beds at Hotel Dieu, and 16 at Erie Shores for a total of 224 in Essex.
The 35 (mostly) rich nations in the OECD average 4.7 hospital beds per 1000 population.If Ontario had that level of capacity that would mean 66,347 hospital beds in Ontario, more than double the current number.For the three Essex hospitals, that would mean an additional 937 beds.[1]
What does this mean for Ontario? Bed occupancy is very high in Ontario as a result of the lack of…
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Under-funding of Ontario hospitals and health care

Hospitals typically benchmark against each other to determine care levels and efficiency.But when Ontario hospitals are bench marked against hospitals in other provinces, a pattern clearly emerges – under-funding and under-capacity.  This post will loo at under-funding, a later one will look at under-capacity

Provincial hospital funding per-capita is 28.3% higher in the rest of Canada than in Ontario — $404.09 more per person per year.



The gap between Ontario and the rest of Canada is a relatively new phenomenon. For decades we were in lock-step with the rest of Canada.We have fallen far behind since 2006.
Provincial health care funding as a whole is 14% higher per person in the rest of Canada compared to Ontario.That amounts to $561.08 higher per person, per year.The gap in overall health care funding between Ontario and the rest of Canada developed at the same time as the gap for hospital funding developed.Hospital under-funding accounts for almost three-quarters of health care under-…

Ford government promise falls far short of solving hospital hallway medicine problem

Tens of thousands of new Long-Term Care (LTC) beds needed just to offset aging
The new Progressive Conservative government in Ontario has promised 30,000 new long-term care beds over the next ten years, often connecting this to their promise to end hospital hallway medicine.  But how does this promise stack up with growing demand for these facilities?
Most people 85 and older live in collective dwellings (LTC facilities, seniors residences, multiple level of care facilities).  The setting with the largest number of elders 85 and older is LTC facilities, with about 35% of the population 85 to 89  years old and almost 40% of the population 90 to 94 years. Older people are even more likely to be in a LTC facility.
The population 85 and older is the main driver of the need for long-term care beds.
An additional thirty thousand LTC beds by 2028 will only partially offset the rapid growth in the 85+ population.  The ministry of finance projects 42.5% growth in the most relevant population (85 a…

Has the Financial Accountability Office over-estimated the deficit once again?

Buried in this week's Financial Accountability Office (FAO) report on the Ontario government books is a very quiet admission that Ontario ran a surplus of $700 million in 2017/18 (when using the government's accounting method for pension surpluses and hydro).  Just a year ago, the FAO claimed there would be a deficit of $500 million.

This $1.2 billion over-estimate is not surprising. The FAO has consistently cried wolf.   A year ago, they put the 2016/17 deficit at $2.8 billion (when using the government's accounting methods).   Now they put it at $1 billion with the same accounting methods.  

Towards the end of the 2015/16 fiscal year they overestimated the deficit for that year by $3.3 billion to $5 billion more than they subsequently admitted.  Even after that fiscal year ended, they put it at $2.2 billion more than they later admitted.

Now the FAO has changed its accounting methods (following the Auditor General) to claim a much higher deficit.  Accordingly it too forecas…

Budget underwhelms on health care. Bait and Switch is such a nasty term

Last year the government promised a 4.64% health care funding increase in 2018/19. Then, earlier this month, they announced they would deficit spend to improve hospitals, mental health, home care, and child care.   Three of the four items cited by the government for improvement were part of health care. 

As it turned out the government did in fact promise in today's Budget to deficit spend $6.7 billion. (Due to a $1 billion fall in expected revenue, the extra spend amounts only to an extra $5.7 billion for 2018/19 programs – but that is still a significant chunk of new found cash for program spending.)  
If health care had gotten even a proportionate share of this new $5.7 billion in program spending, it would have added an additional $2.4 billion to health care  --  in other words about another 4% increase.  

But all health care got -- despite the government’s health care rhetoric -- was an extra $284 million. That may sound like a lot but with a total health care spend of $61 bill…

Hospital funding announcement falls short

Bowing to public pressure and the over-capacity crisis in our hospitals, the Ontario minister of health and long-term care, Eric Hoskins, announced Friday hospital funding of $187 million to deal with next year’s flu season.
While this is significant it is inadequate for several reasons:
The funding is for the next fiscal year. In other words, the minister is merely leaking information that would normally be released with the Budget.Most of this is not new money. Following pressure from labour and the community, the minister announced  $100 million for hospitals last fall to fund 1,200 beds.  But the government also made clear that money may not continue in the next fiscal year starting April 2018 -- the continuation of the funding would depend on the "budgetary process".  So this announcement merely confirms that this money will continue at least one more year and, positively, that they will increase the annual funding for this hospital bed …

Government plans to take $400 annually from every employee -- and give it to employers

The government plans to cut employer Workplace Safety and Insurance Board (WSIB) premiums $2.4 billion per year.  This is funded by cuts to workers compensation, as discussed below.  Here's the plan to cut employer premiums laid out in the 2016 Budget documents:
The WSIB has taken significant steps to reduce costs, and its finances have been improved by growth in investment returns and insurable payrolls. After hitting a high of $14.2 billion in 2011, the unfunded liability was $6.8 billion as of the WSIB’s 2015 third quarter that ended September 30, 2015.  Due to progress made to date, employer premiums have not been increased for three years. In its ‘2015 Economic Statement,’ the WSIB estimated that when the unfunded liability component is removed from the premium rate, it will be able to deliver $2.4 billion annually in premium reductions. This would represent an average premium rate reduction of about 40 per cent, with the average premium rate declining from $2.46 per $100 of p…