Defend Public Healthcare

The proposed reforms through Bill 175 will privatize health care services, weaken public oversight, remove legislative protections, undermine home care working conditions, and unleash an untested, home care experiment. Chaos beckons.Bill 175 is permissive, allowing a laissez-faire framework for home and community care.  It repeals the more detailed Home Care and Community Services Act, 1994 and leaves most details to policy or regulation. Deviously, the government has made the Bill (Connecting People to Home and Community Care Act, 2020) little more than an empty shell that doesn't even establish a new home and community act.  So, for example, the Home Care Bill of Rights is not in the proposed legislation.  Instead, it may be put into regulation.  This approach removes the public accountability that comes with legislation.  Regulations and policies are changed with little public consultation.  One would think that in today’s world a Home Care Bill of Rights would not be removed fr…

As usual, the provincial government is under-spending its (revised) budget.  Based on figures for provincial expenditures for the the first nine months of the fiscal year, the government-funded Financial Accountability Office (FAO) estimates that the government will under-spend its budget by about $2 billion this year.
While that sounds like quite a bit -- it is actually less than usual.  Over the last ten years, the province has spent $3.3 billion less than budgeted on average.


Combined with the expected non-use of the government’s $1 billion "reserve" (the reserve is an amount set aside every year for unexpected expenses), the FAO estimates the deficit will be only $6.1 billion, almost $3 billion less than predicted in the government’s own, very recent third-quarter report. 
Health care expenditures are under-spent by $400 million (0.9%) through the first three quarters of the fiscal year, primarily due to under-spending on LHINs for hospitals, LTC, home care, etc. (0.5…

Ontario’s third quarter finances came out yesterday.  They confirm that although planned health care funding has increased $404.1 million since the 2019/20 Budget, no further increase has been achieved since November's Ontario Economic Outlook and Fiscal Review. 

While the lack of new progress since the fall is disappointing, the $404.1 million is a 0.64% funding increasefor health care since the Budget.  Total health care funding for 2019/20 is now planned to increase 3.1% since 2018/19.
Also notable: Total revenue is projected to be $157.2 billion in 2019–20, $3.1 billion higher than the 2019 Budget projection and $1.68 billion higher than expected in the fall 2019 Ontario Economic Outlook and Fiscal Review. Program expenses are $2.45 billion higher than in the 2019/20 Budget. The total increase for the year compared to last year is $3.9 billion (so far).  So, in the Budget, program funding was increased 0.91%, while, since then, program funding was increased a …

The Financial Accountability Office (FAO) Budget and Economic review has identified planned government spending savings that come via [1] announced program changes (program cuts like the government’s cut to OHIP+), [2] announced efficiency targets (identified areas where the government hopes it will find savings without service cuts), and [3] cuts that have not yet been announced by the government.
While the government has identified some spending cuts of type 1 or 2 above, the government’s spending plan needs billions of dollars in extra, unidentifiedand unannounced cuts to meet its savings targets according to the FAO (type 3 cuts, as above). For health care, this amounts to $5.2 billion in unidentified and unannounced cost savings needed for the government’s health spending plan to work in 2023-24.  Even though the cuts identified to date have been major and painful, $5.2 billion is many times more than the cuts announced and implemented to date. [1]
The unidentified and unannounced …

Attack on health care worker benefits: The Ontario Ford government has specifically targeted in the Budget health care worker compensation  through cuts in premium payments (e.g. shift payments), overtime, and sick leave. "Improving" scheduling is also part of the plan.  The stated goalis to cut $250 million annually through such changes by 2021-22.

This is squarely aimed at hourly paid employees. Managers don't get overtime and premium payments, and they are not likely to be targeted by attendance management programs or scheduling "improvements". 

With about half a million hourly paid employees working in health care a $250 million cut would mean about a cut of about $500 per employee per year.  

The Ford government claims in the Budget that this will have "no impact on patient care or front-line staff."

In fact, a $500 cut may be low -- as it will be especially hard to harvest such amounts from contracted, for-profit corporations (e.g. in home care).  T…

The group that will do the best out of the recent provincial Budget are the doctors.  According to the just released Budget Estimates, OHIP funding (which  goes overwhelmingly to physicians and practitioners) will go up $1.2 billion or 8% compared to last year's Estimates. 

(Note -- this is a little different, and less accurate, than the comparisons with last year's interim amounts reported in the 2019 Budget and used elsewhere in this note.  It is the only comparison publicly available for OHIP as of the moment, however. The Financial Accountability Office has suggested that the actual OHIP spend last year would be less than in the Estimates by several hundred million. So the actual increase this year may be larger than $1.2 billion. We will know for sure when the Public Accounts finalize the books for 2018-19 in September.)  

This large increase is likely due to the February 2019 interest arbitration award for doctors, an award that was praised as "fair" by Christine…