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Showing posts from December, 2012

The future for long-term care looks grim: Mass privatization

As with hospital beds, the government and other proponents of  the near freeze in new long-term care beds suggest that home care can take up the slack.

Does this stand up?  Well, let's take even a very aggressive version of this theory.  Say that 25% of all people in LTC could be dealt with through home care.   (Currently, that would mean evicting 19,250 LTC residents, which is hardly realistic!)

As noted in the previous post, the demographics of the province are rapidly changing, with huge growth in the elderly population, now and into the years ahead.

A 2011 study the Conference Board concludes "based on Statistics Canada‘s reported utilization rate by age and the Government of Ontario‘s population projection, it is estimated that by 2035—when boomers are 71 to 89 years old— 238,000 Ontarians will be in need of long-term care."  That is 161,000 more than the 77,000 LTC beds existing now.  

If we somehow can subtract 25% from 238,000 we still need 178,500 LTC beds.  T…

Long-term care beds falling well short of need

The Auditor General reports that the stock of long-term care beds in Ontario has grown only 3% since 2004-5.  Over seven years (until 2011-12) that means an annual average growth rate of  0.42% (or about 319 beds per year).

That falls well short of population growth.  But much more important, it falls far short of the growth of the relevant population - the elderly.  Or as the Auditor General demurely states:  "An increase in the number of LTC home beds of 3% during that period has not kept pace with the rising demand from an aging population."

Ontario Ministry of Finance figures indicate that in the five years between 2006 and 2011 the number of people 85 and over increased 34%.  By 2016 the plus 85 set will have increased by 67% over 2006 -- and the ratio of those 90 and over compared to those between 85 and 90 will have increased from about 50% to 70%.

With a 1.5% annual increase in the number of LTC beds, the Conference Board estimates Ontario would be 127,000 beds short of…

What's $1.4 B? Well, it all depends who you are...

The $1.4 billion in, mostly corporate, taxes that the Ontario Liberal government plans to walk away from (according to Auditor General), is exactly equal to the amount of money Finance Minister Dwight Duncan claims he absolutely has to save in the first year of the so called "provincial compensation framework".   That's the government policy announced in July that led to Bill 115, the attack on free collective bargaining in the broader public sector (and, to a large extent, the end of the McGuinty government).

Duncan and McGuinty practically declared the War Measures Act to get their "wage freeze" -- even though some unions started bargaining by proposing a wage freeze.

But corporate taxes? Fahgettaboudit!

Should we tolerate secrecy for public health care?

It's amusing to review the course of events that led to the revelation of the secrecy concerning the problems at private surgical and diagnostic clinics.  

The doctors lobbied to move surgical and diagnostics work from the hospitals.  The government let the emerging industry slip free of public reporting and oversight.  

Subsequently, after a death (and a coroners report), the government required the industry to face some modest oversight in 2010 -- not by a public authority, but through self-regulation by the docs . (Remember, the doctors had lobbied to expand the industry in the first place.)

Then in the fall of 2011, following disclosure that 6,800 patients would have to be notified that faulty infection control procedures at a private clinic could have exposed them to HIV or hepatitis, Health Minister Deb Matthews declined to introduce oversight by a public authority, despite public pressure.  Instead she comments,  "Government can't do everything.  A professional (regul…

More cuts to Ontario deficit coming in January

The Ontario government's recent Fall Economic Statement retroactively confirmed that the 2011-12 deficit was $2 billion less than set out in the 2012 provincial budget. It also lopped $400 million off the 2012-13 deficit.

Our economic elites thought this was no big deal -- there was a "lack of significant progress" the TD Bank said. (See TD's report here and the chart "Fiscal profile largely the same for the Ontario government" )

But just those cuts in the deficits are equivalent to $1 billion more than the $1.4 billion the government hopes to save through the first year of its  "provincial compensation framework" announced in July.

The   $2.4 billion reduction in the Fall Economic Outlook is just the latest in a long series of reductions since the 2010 Budget -- $13.5 billion in total.
Deficit (in billions of dollars) 2009–10 2010–11 2011–12 2012–13 Total 2010 Budget 21.3 19.7 17.3

Liberals prevent public reporting of failed private clinics

Yesterday I fumed about the gall of one academic who claimed that privatized P3s (public private partnerships) had actually increased public transparency.

Even more evidence came today that privatization leads to a lack of transparency.  Not only is the Ontario government turning more surgeries and procedures over to private clinics, they have contracted out the oversight of these outfits to the College of Physicians and Surgeons.

Today, the Toronto Star reports that the College of Physicians claims that legislation passed by the Liberals putting the College in charge of inspections of these clinics, also prevents the College from actually telling the public which clinics are providing sub-standard care!  "We are not allowed to discuss the failed premises" says the College president, Dr. Bob Byrick.  As a result, we do not even know where the clinics are located. It remains unclear if even the Ministry of Health & LTC is told which clinics are failing.

Of the 251 clin…

P3 transparency? Hardly: private profit prefers privacy

The corruption scandal rocking a public private partnership (P3) hospital project in Quebec has raised some significant doubts about P3s in Canada.

Over the weekend even the normally pro-privatization Financial Post ran a story considering such doubts. They allowed that the size and scope of P3 projects may make the projects a magnet for greed.

The Financial Post was, however, able to dredge up an academic to claim that P3s had improved public transparency.

This is pretty galling.  In fact OCHU/CUPE, several other unions, and the Ontario Health Coalition (OHC) had to go to extraordinary lengths to get any significant information about P3s. Even with the assistance of a very expensive legal challenge we were only able to get information for very restricted purposes, and only after much to do.

"Commercial confidentiality" requires privatization to proceed under a cloak of secrecy.  The corporations don't want to let anyone know their secrets -- not their opponents in the…