Skip to main content

Under-funding of Ontario hospitals and health care

Hospitals typically benchmark against each other to determine care levels and efficiency.  But when Ontario hospitals are bench marked against hospitals in other provinces, a pattern clearly emerges – under-funding and under-capacity.  This post will loo at under-funding, a later one will look at under-capacity

 Provincial hospital funding per-capita is 28.3% higher in the rest of Canada than in Ontario — $404.09 more per person per year. 

Hospital funding 2004-2018


The gap between Ontario and the rest of Canada is a relatively new phenomenon.  For decades we were in lock-step with the rest of Canada.  We have fallen far behind since 2006.

Ontario and rest of Canada provincial hospital funding 1975-2018
Provincial health care funding as a whole is 14% higher per person in the rest of Canada compared to Ontario.  That amounts to $561.08 higher per person, per year.  The gap in overall health care funding between Ontario and the rest of Canada developed at the same time as the gap for hospital funding developed.  Hospital under-funding accounts for almost three-quarters of health care under-funding.





In fact, Ontario provides the least health care funding per person of any province.  Below is a chart with the provincial government per person dollar funding since 2008 in real dollars (using constant 1997 dollars).  In 2017, real funding per person was still less than in 2008 — although the Ontario economy was about 17% larger than it was in 2008 in real terms.  The hysteria about the runaway health care cost is just that — hysteria.



 Two-thirds of this dollar cut came from cuts to hospital funding.  Between 2010/11 and 2017/18 real provincial hospital expenditures were cut 8.3%.



 That is a cut of $81 per person per year in constant 1997 dollars since 2010, or $128 per person in today's money.

 In fact, real provincial expenditures on hospitals are lower than they were in 1991 — despite very significant economic growth per-capita, an increase in the median age in Ontario from
33.3 years to 40.6 years, and a doubling of the population over 65 (with even bigger increases in the population over 85).

 Hospital costs per patient also going down:

All provinces hospital costs per standard patient

 In the four years from 2012/13 to 2016/17, standardized costs for a hospital stay (adjusted for differences in the types of patients) have fallen 2.6% in Ontario.  Ontario has the lowest cost for a standardized hospital stay of any province.


Ontario hospital expenditures are a lower share of the economy than 25 years ago:  Ontario provincial government hospital expenditure as a share of the economy has declined — not just since 2009, but since 1991.
Ontario health costs as percent of GDP

 Ontario has been through a period of health care austerity since the 2008 recession — ten years.  There are signs that the public believes it has put up with enough cuts.  Another period of cuts is not likely to be received well by the population.  
Labels:

Comments

Post a Comment

Popular posts from this blog

More spending on new hospitals and new beds? Nope

Hospital funding:  There is something off about the provincial government's Budget claims on hospital capital funding (funding to build and renovate hospital beds and facilities).    For what it is worth (which is not that much, given the long time frame the government cites), the province claims it will increase hospital capital spending over the next 10 years from $11 billion to $20 billion – or on average to about $2 billion per year.   But, this is just a notional increase from the previous announcement of future hospital capital spending.  Moreover, even if we did take this as a serious promise and not just a wisp of smoke, the government's own reports shows they have actually funded hospital infrastructure about $3 billion a year over the 2011/12-2015/16 period. So this “increase” is really a decrease from past actual spending. Even last year's (2016-17) hospital capital funding increase was reported in this Budget at $2.3 billion - i.e. about 15% more th
Post a Comment
Read more

Ford government fails to respond to 72% increase in COVID inpatient days, deepening the capacity crisis

COVID infections continue to drive up hospital costs and inpatient hospitalizations in Ontario. For the most recent fiscal year (April 1, 2022- March 31, 2023) hospital stays related to COVID cost $1.221 billion, according to new CIHI data.   This is about 4% of total hospital spending, creating a very significant new cost pressure beyond the usual pressures of population growth, aging, inflation, and rising utilization.   Costs for COVID related hospitalizations increased 22.2% in Ontario in 2022/23 from the previous fiscal year, rising from $999 million to $1.221 billion.  That rise is particularly notable as the OMICRON spike of late 2021 and early 2022 had passed by the the 2022/23 fiscal year.   The $222 million increase in COVID hospitalization costs came in the same year as the Ford government cut special COVID funding and, in fact, cut total hospital funding by $156 million.     In total, there were 60,653 COVID hospitalizations in Ontario in 2022/3, up from 47,543 in 2021/2. 
Post a Comment
Read more

Paramedic Services in Canada: Structure, Privatization, Unionization and other issues

Governance and Funding :  While police and fire services are usually municipal services, Emergency Medical Services (EMS) are typically controlled by provincial governments.  In Ontario, regional municipal governments have responsibility for delivering and funding EMS.  But even in Ontario the province plays a key role, strictly regulating EMS, providing funding for 50% of the approved land ambulance costs, and paying 100% of the approved costs for air ambulance, dispatch, base hospitals, First Nation EMS, and for territories without municipal government. Delivery :  Like police and fire services, EMS is predominantly a publicly provided service in Canada.   But businesses have now made some significant in-roads into EMS, primarily  Medavie,  a private corporation based in the Maritimes that describes itself as not-for-profit.  Medavie goes back over 70 years, with its roots in health insurance.  It still operates Medavie Blue Cross with 1,900 employees.  It now a
Post a Comment
Read more