Last year the government promised a 4.64% health care funding increase in 2018/19. Then, earlier this month, they announced they would deficit spend to improve hospitals, mental health, home care, and
child care. Three of the four items cited by the government for improvement were part of health care.
As it turned out the government did in fact promise in today's Budget to deficit spend $6.7 billion. (Due to a $1 billion fall in expected revenue, the extra spend amounts only to an extra $5.7 billion for 2018/19 programs – but that is still a significant chunk of new found cash for program spending.)
As it turned out the government did in fact promise in today's Budget to deficit spend $6.7 billion. (Due to a $1 billion fall in expected revenue, the extra spend amounts only to an extra $5.7 billion for 2018/19 programs – but that is still a significant chunk of new found cash for program spending.)
If health care had gotten even a proportionate share of this new $5.7 billion in program spending, it would have added an additional $2.4 billion to health care -- in other words about another 4% increase.
But all health care got -- despite the government’s health care rhetoric -- was an extra $284 million. That may sound like a lot but with a total health care spend of $61 billion, it is not so much. Health care spending is now set to increase 5.14%, a (measly) half percent more than they planned in the last Budget.
Meanwhile program spending for all ministries and programs will increase 6.1%, almost a full percent more than health care. Indeed, the total increase for programs outside of health care is actually 6.8%. So, once again, health care will get less than overall program spending and shrink as a proportion of total program spending!
The suggestion that the new deficit spending was primarily to improve health care was not accurate. Health care will get only a very small part of the new deficit spending -- less than one-twentieth of it in fact.
But all health care got -- despite the government’s health care rhetoric -- was an extra $284 million. That may sound like a lot but with a total health care spend of $61 billion, it is not so much. Health care spending is now set to increase 5.14%, a (measly) half percent more than they planned in the last Budget.
Meanwhile program spending for all ministries and programs will increase 6.1%, almost a full percent more than health care. Indeed, the total increase for programs outside of health care is actually 6.8%. So, once again, health care will get less than overall program spending and shrink as a proportion of total program spending!
The suggestion that the new deficit spending was primarily to improve health care was not accurate. Health care will get only a very small part of the new deficit spending -- less than one-twentieth of it in fact.
Hospital spending was increased as announced earlier, 4.6%. That is better than recent years, but still not at actual cost pressures.
Long-term care homes are supposed to get an extra $50 million to start the implementation of the LTC staffing increase announced earlier.
This takes them about one-tenth of the way to their goal of an extra 15,000,000 hours of staffing. (In fact even that may be high as they emphasize increasing Registered Nurse staffing this year -- i.e. one Registered Nurse in every home. So the $50 million may end up buying fewer hours than might otherwise be expected as RNs are highly skilled and so naturally cost more than most other staff.) In any case, the government is starting the process of getting to 15 million hours slowly. Very.
LTC increases planned for the following two years are not all that great either (they promise a total of only $300 million over three years). So if they are going to meet their goal of 15,000,000 hours annually (which will cost about $500 million annually) they are going to have to come up with a massive increase in the fourth year of their mandate!
This is going to be tricky as the big spending increases come to an end right after the election. This year’s overall program spending increase of 6.1% will be cut in half to 3.1% in 2019/20, before rebounding slightly to 3.6% in 2020-21 and then going down to 2.4% in 2021-22 (just when they will have to come through with a big increase for LTC!). They will then bottom out at 2% in 2022-23.
This takes them about one-tenth of the way to their goal of an extra 15,000,000 hours of staffing. (In fact even that may be high as they emphasize increasing Registered Nurse staffing this year -- i.e. one Registered Nurse in every home. So the $50 million may end up buying fewer hours than might otherwise be expected as RNs are highly skilled and so naturally cost more than most other staff.) In any case, the government is starting the process of getting to 15 million hours slowly. Very.
LTC increases planned for the following two years are not all that great either (they promise a total of only $300 million over three years). So if they are going to meet their goal of 15,000,000 hours annually (which will cost about $500 million annually) they are going to have to come up with a massive increase in the fourth year of their mandate!
This is going to be tricky as the big spending increases come to an end right after the election. This year’s overall program spending increase of 6.1% will be cut in half to 3.1% in 2019/20, before rebounding slightly to 3.6% in 2020-21 and then going down to 2.4% in 2021-22 (just when they will have to come through with a big increase for LTC!). They will then bottom out at 2% in 2022-23.
Welcome back austerity.
The government claims they will increase home care funding by $650 million over three years. If we assume that the $650
million increase is phased in at the same percentage increase each year, then the increase would be roughly 3.6% per year (on a $3 billion spend). Not too much for a sector that is supposed to be growing.
Other points of note:
- They make a fairly vague, but interesting, promise to increase home care compensation with a new investment of $45 million. More will have to be determined on this.
- They promise the establishment of Tax Free Savings Accounts for home care Personal Support Worker (PSW) retirements -- $65 million over three years. They promise to work with the “employers” on this, but also hint they may consult more broadly. This too will have to be investigated. (These last two items are not it seems for LHIN employees who oversee home care – but rather for employees delivering a home care service.)
- $38 million for education for new and existing home care PSWs
The good news? The funding increase for hospitals and health care is significantly better than it has been. Moreover, health care got (by far) the biggest in-year funding increase -- $357 million extra for hospitals and home care in 2017/18 -- about a 0.6% in-year increase (i.e. more than 0.5% bump health care got after all that deficit spending hoopla). That in-year win raised the total health care increase to 4.2% for 2017/18 -- significantly better than recent years. So labour and community campaigns for public health care have helped lead to some improvements -- we now have to set our sites on more for health care this coming year.
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