Skip to main content

Declining Health Care Funding in Ontario


Federal Health Cash Transfers ("CHT") to the Ontario government will rise 5.94% in 2016/17, or by $778 million. This, in itself, would pay for a 1.5% increase in Ontario health care funding even without a single extra penny from Ontario tax revenues.  This follows a $736 million increase (5.96%) to federal health care cash transfers to the province of Ontario for this year.

Despite this, the Canadian Institute for Health Information (CIHI) estimates that total health funding by the Ontario government is only going up by about $352 million this year -- or about 0.7%. This falls well short of aging, inflation, utilization, and population growth cost pressures and deepens  the trend in recent years to reduce health care and hospital funding in real terms.  So far, there are precious few signs that the government will reverse its policy of health care austerity in its upcoming 2016/17 budget. Likely, Ontario funding will fall far behind federal health care funding once again:



Health Care and Hospital Funding Declining as a Share of the Economy: As a percentage of the total economy, Ontario government health spending has declined consistently since 2009-2010, when it is was at 7.6% of Gross Domestic Product. Last year it was at 7.15%, and this year it is 6.91%.  


hospital funding in Ontario - chart

  


Ontario health cafe funding declines as percentage of GDP

The current Budget plan is to increase Ministry of Health and Long-Term Care funding by 1.8%  (to $51.7 billion) in 2016/17 and by 1.9% (to $52.7 billion) in 2017/18. With nominal GDP expected to go up at a much quicker rate, health care funding would continue to decline as a percentage of the economy.

Hospital funding is also declining as a percentage of the economy:


Ontario hospital funding declines as percentage of GDP

CIHI figures  indicate that (contrary to widespread suggestions) Ontario provincial health care funding has been falling as a percentage of total provincial government program spending.

health spending declines in Ontario

According to data in the 2015/16 Ontario Budget, this trend continues with Ministry of Health and LTC funding falling from 38.8% of total program spending last year to 38.5% this year.  This directly contradicts claims by many that health care would assume a much larger portion of program spending.  

But this squeeze on hospital and health care funding comes with consequences. Here's two:

Nursing: Ontario has far fewer nurses working in hospitals than the rest of Canada according to CIHI data.

more nurses in rest of Canada compared to Ontario




Most (but not all) of this is driven by fewer practical nurses in Ontario hospitals compared to the rest of Canada:


More practical nurses in rest of Canada than Ontario

Currently, Ontario has 1.11 practical nurses working in hospitals per 1000 population while the rest of Canada has 1.74 practical nurses. In other words, the rest of Canada now has 57% more practical nurses working in hospitals per capita than Ontario does.

This lack of resources results in significantly fewer nursing hours per patient in Ontario according to CIHI data:

Hospital inpatients with the same condition can expect to receive 16.6% more nursing care if they are treated at a typical Canadian hospital than if they are treated at a typical Ontario hospital. 

Re-admissions: Coinciding with the cuts is a large increase in hospital re-admissions. Canadian Institute for Health Information indicates that across Ontario the number of all patients readmitted to hospital has increased since 2009-10 through 2013-14 from 8.3 per 100 patients to 9.1 per 100 patients. This is an increase of 9.6% over just four years. In other words an extra 9,000 patients have to be readmitted to hospitals each year compared to four years earlier. Moreover, Ontario has gone from having below average re-admissions to above average re-admissions compared with Canada as a whole:

Ontario hospital readmission now higher than rest of Canada



To deal with these problems the Ontario Council of Hospital Unions has called for:
  •          Significant ongoing increases to hospital, LTC and home care funding to offset population growth, aging, and inflation, as well as  increases to offset the funding lost in the last several years
  •         Ontario, as a relatively wealthy province, should aim to fund and provide care at the same level as the other provinces or better.


Popular posts from this blog

Deficit? Public spending ain't the cause. Revenue, however...

With the election over, pressure to cut public programs has become quite intense. In almost all of the corporate owned media someone is barking on about it.

Another option -- increasing revenue from corporations and the wealthy is not mentioned.  However, data clearly indicates that Ontario does not have an overspending problem compared to the other provinces.

Instead, it indicates Ontario has very low revenue. 
Ontario has the lowest public spending of all the provinces on a per capita basis (see the chart from the 2014 Ontario Budget below).  So there is little reason to suspect that we have an over-spending problem.  If anything, this suggests we have an under-spending problem.







The Ontario government has also now reported in the 2014 Budget that Ontario has the lowest revenue per capita of any province.  This is particularly notable as other provinces are quite a bit poorer than Ontario and therefore have a much more limited ability to pay for public spending.  (Also notable in this…

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…

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 …