Skip to main content

Contracting for hospital services

Ontario proposes radical overhaul of hospital funding - The Globe and Mail

Attached is today's Globe story on the proposed system of compulsory contracting for hospital services that the Star reported on last week. Here's something from the hardly surprising department: they are already paving the way for the idea that the new funding model will not save money.

When a compulsory contracting model was introduced to home care, costs actually went up (to the market price, a government report rationalized). It also, of course, led to the wide-spread elimination of community-based not for profit organizations by for-profit corporations.

The tail end of the Globe story indicates that Ontario has the second lowest hospital costs per capita across Canada (just slightly higher than Quebec). But why not mess with a winner??

Even the OHA says the system wouldn’t work for smaller communities; that makes me think the government may make some attempt to mitigate the destabilizing impact of such a system in those areas.

Right or wrong, this story ties the new model to "HBAM" funding, which has been been proposed for a while. In the past, however, HBAM has not been tied to a system of compulsory contracting, or market based contracting, as far as I know.

I suspect the reference in the story to the University Health Network's pay for procedure is misleading – market-based systems do not work for highly complex or specialized procedures as there are too few potential providers.

Finally, note all the cash the government has found for some hospitals in recent months.


Popular posts from this blog

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 …

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…

Six more problems with Public Private Partnerships (P3s)

The Auditor General (AG) has again identified issues in her annual reportwhich reflect problems with Ontario health care capacity and privatization.   First, here are six key problems with the maintenance of the 16 privatized P3 ("public private partnership") hospitals in Ontario:
There are long-term ongoing disputes with privatized P3 contractors over the P3 agreements, including about what is covered by the P3  (or “AFP” as the government likes to call them) contract.The hospitals are required to pay higher than reasonable rates tothe P3 contractor for  maintenance work the contractor has deemed to be outside of the P3 contract. Hospitals are almost forced to use P3 contractors to do maintenance work the contractors deem outside of the P3 contract or face the prospect of transferring the risk associated with maintaining the related hospital assets from the private-sector company back to the hospitalP3 companies with poor perf…