Defend Public Healthcare

The BC Health Coalition has released a report showing that for-profit clinics are charging patients extra to jump the queue for services covered by public health care:  "Research conducted over three months (June – August, 2010) by BCHC staff has revealed that for-profit clinics across the province continue to openly charge patients additional fees to jump the queue for services that are publicly insured. " The BC Health Coalition’s report can be found here.   Also this week, the BC government announced extra funding for 'patient focused funding' (aka price based funding), a funding model that has some similarities to 'fee for service' funding used in the US.   BC is   reported to be increasing this form of funding to 20% of hospital funding by 2012-13.  The NDP has called on the government to audit private clinics as they could be getting a share of 'patient-focused funding' for surgeries and MRIs. BC Health Services Minister Kevin Falcon has ...

Competitive bidding is coming back. Or so it seems.  As of yesterday, the Ontario Association of CCACs had on their web site a link to a letter reporting that competitive bidding for home care services will come to four communities between October and December of 2010. As of today, however, the link to the letter is no longer to be found.  But while the link has disappeared, the web page still works. The letter, dated August 13, indicates these plans only reflect "the current planning  among CCACs and is dependent on the issue of MOHLTC Directives for CCAC procurement."  The Conservative Harris government introduced this model to home care in 1996: it requires Community Care Access Centres to contract out all home care services.  As a result, for profit corporations have taken over many of the home care services provided by nurses and personal support workers in the province.  There has been major pr...

Starting September 21, the Ontario Health Coalition  (OHC) is sponsoring summits in six cities around Ontario dealing with significant changes proposed for Ontario’s hospitals. The provincial government is moving towards a type of fee-for-service hospital funding (usually referred to by the government as "patient based funding", and by critics as "price based funding").   This is a potentially revolutionary change. The OHC notes that this funding system will encourage: - Major hospital restructuring and cuts - Centralization of services into fewer towns & pressure on the workforce - A host of new administrative costs - The end of community hospitals as we know them This system has already been tried in the United Kingdom. There, it resulted in: - Near-bankruptcies in large hospitals - ballooning administrative costs - instability - privatization - major cuts - demoralized staff - chaotic health planning and the undermining of t...

The Globe and Mail is raising concerns in its lead news story today about rapidly increasing payments to physicians.  OCHU/CUPE had raised similar concerns several months ago, uncovering a 57.6% funding increase for doctors between 2004-5 and 2009-10. Notably, the Globe also ties the rapid increase to the development of wait time funding by the Ontario government.  OCHU / CUPE has also raised concerns about wait time funding as it is a form of price-based funding that opens the door to privatization and a market for health care. Judging from the Globe's account, the market has resulted in handsome increases for some doctors, with 259 now billing over $1 million annually. One group of docs that have benefited in particular is the opthamologists who do cataract surgeries through the wait times programs (sometimes at clinics like the new Kensington Eye Clinic in Toronto rather than at hospitals).  The Globe notes that health-care experts say the fe...

The Regina Health Region has started to privatize dental and knee arthroscopy surgeries, turning procedures over to a private clinic.  The rationale?  To reduce surgical wait times.  Oh, and the government claims the knee surgeries will cost $1,500 apiece, $179 cheaper than in the public sector. The Saskatoon Health Region is also exploring providing surgeries in a private facility. This from a province that until recently was a model of public health care delivery. The Ontario Conservatives raised the same idea in the last election, with a similar rationale.  But the claims were shot down (as were the Conservatives).  But the Ontario Liberal government had opened the door to this by introducing "patient based funding"  -- something that could be better described as "price based funding" or "fee for service".   Again, part of the rationale was specialized funding to reduce wait times for surgerie...

As it turns out, the new (and much ballyhooed) emergency room wait time funding will not go to any ER with less than 30,000 ER visits per year.    This is just the latest in a series of Liberal government hospital policies that discriminate against smaller towns and cities (remember, for example, the ER closures in Niagara?). Lake of the Woods Hospital, a reasonably large hospital in Kenora, falls 4,000 short of the 30,000 visit minimum. But its June wait time figures are 9.1 hours for high acuity and 5.2 hours compared to provincial expectations of eight and four hours, respectively. Local hospital president Mark Balcaen showed some guts, took this on, and defended his community: "The public sees ER wait times the same whether they are in a small, rural, isolated community or are in a large metropolitan area....A long ER wait is still a long ER wait no matter the size of the community or hospital. The people of Kenora complain just as m...

Complaints are already emerging about government control of the new Emergency Room wait times funding.  Here's the conclusion of today's Cornwall Standard Freeholder editorial: The ministry, at least in Cornwall's case, is putting the cart before the horse with the $800,000 incentive. The money should be used to open up more long-term care beds. This would move more people out of acute care beds and go a long way in reducing unacceptable wait times. (The full editorial is here .) This isn't just in Cornwall's case.  Queen's Park in Toronto has all the control and so local hospitals (and local communities) cannot fashion local solutions that actually meet local needs. dallan@cupe.ca

Well, we found out a little bit more about where the government's hospital funding is going with the announcement of $100 million for 'payment for results' funding yesterday.  And it pretty much summed up what's wrong with this approach. First: unlike global funding (set at a mighty 1.5% or less ) this funding is centrally controlled.  Local hospitals have to spend it as directed by the central government, whatever local needs actually are.   Second: the government (and local Liberal MPPs) primarily see these announcements as a media opportunity, parading it to the media as their latest accomplishment.  If you keep everybody guessing where the money is going and when it is coming, you can always manufacture a media story.  Think of a manipulative and stingy Santa Claus.  Moreover, this model favours whatever item is politically expedient at the moment.  How can the government get headlines?  So much for a rational proc...

BC is introducing a system of price-based funding for specific hospital procedures.  It sounds similar to the model that Ontario plans to introduce. The BC Health Minister now admits their model could see private clinics competing with hospitals to provide publicly funded surgeries.  He claims they will ‘be a pretty small piece of the pie’.  CUPE has long claimed price based funding would open doors to privatization -- even while the Ontario government disimissed such concerns. The for-profits are delighted by the BC Minister's announcement. BC is aiming to have 20% of acute services paid for by price based funding in 2012-3.   While Ontario is not moving as fast (an election is upcoming, after all), there are reports that the province is aiming for 40% of services funded through price-based funding. And like BC, Ontario is starting the new funding system with the bigger hospital...