The Ontario Budget: Hard Times Ahead

Health Care: To ease future cuts, the government established a budgeting system this year which would see much of the COVID-related funding budgeted under special funds distinct from the normal ministries. So much of the increased funding for the Ministry of Health or Ministry of Long-Term Care is not reflected in their line items but instead through special funds that are then later allocated to a ministry. So first the good news: The health and LTC  special COVID funds  are “budgeted” to continue for a couple of years.  An additional $4 billion in 2021–22 and $2 billion in 2022–23 is currently planned to help the health sector address COVID-19.   The bad news, however, is that even with that continuation of special COVID funds, overall health care and LTC funding is budgeted to go down -- by $1.9 billion in 2021/22 and another $500 million in 2022/23. That's a lot of cutting.  Of course that is “down” after a major increase this year.  Including the special funds, $72.8 bil

Health care funding $466 million less than budgeted

In the 2019/20 Ontario budget health care was budgeted at $59.97 billion.  That was subsequently increased by over $450 million to $60.42 billion, mostly through Supplementary Estimates late in the fiscal year. The Financial Accountability Office (FAO) now reports (based on current, but not yet final figures) that actual health care spending was  $59.96 billion – in other words, $466 million less than the revised health care budget.  So, despite increasing the health care budget by $453 million late in   the fiscal year, the government s pent $13 million less than it first budgeted.  That is about a 0.8% reduction compared with the revised budget plan.  It's a little hard to take Ford's protestations that he has no money for pandemic pay, and won't pay for more time to care, when he spends $466 million less on health care than he budgeted. One area with lower than  projected expenditures was the line item for local health agencies.  This is odd as public health is rather

Ford government plans to deepen privatization of hospital and home care services: Bill 175

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 re

Ford government will not spend $2 billion of its budget -- deficit on track to fall $3 billion

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, h

Ontario revenue up $1.5 billion since November - but no new health care spending announced

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 increase   for 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 fundin

PC Government Plans Many More Health Care Cuts

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, unidentified and 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 unidentifie

Ford Plans to Cut Health Care Worker Benefits by $250 million

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 goal   is to cut $250 million annually through such changes by 2021-22. This is squarely aimed at hourly paid employees. Ma nagers 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 i t will be especially hard to harvest such amounts from  contracted , for-profit corporations (