Defend Public Healthcare

While Canada has achieved universal public healthcare coverage, that does not mean conservative forces have given up trying to erode that coverage and expand corporate care where it does not currently exist. The battle has become particularly intense in Ontario under the Ford Progressive Conservative government, which is implementing serious cuts to the level of care and moving to bring in for-profit mini-hospitals. Inadequate Staffing.   Less and less of hospital spending is on staff.   Employee compensation as a share of hospital expenditures has consistently shrunk in Ontario. This is not some immutable law of hospital development.  It is in stark contrast with the rest of Canada, where compensation has become a larger share and now accounts for 67.1%. Hospitals in provinces other than Ontario now have 18 percent more staff per capita than hospitals in Ontario. Overall, if Ontario had the same staffing capacity as the other provinces and territories, there would be another...

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...

Despite the current health care capacity crisis, the Ford government plans to cut health care service levels. Hospitals : The news  is bad for hospital services.  The new Financial Accountability Office (FAO)  report   on the government's health care funding plan reports the government plans 3,000 new beds over the next decade.  That’s about an 8.4% increase in nominal capacity.   Measured against need, however, this will mean a sharp decrease in service levels.   The public wants improved service levels, but the opposite is planned. That "increase" won’t come  even   close to covering off increasing demand for services due to population growth, which according to provincial government projections  will be about 15%. The demands on health care will be much more than this, however, due to a rapidly aging population.  Health care needs are very sensitive to age.  People 65 and over use most of our hospital bed days...

With as much fanfare as it could muster, the Ford PC government re-announced its Budget plan of $300 million for hospitals to deal with the backlog of surgeries and procedures caused by the COVID-19 shut down of hospital services.  Despite the (attempted) fanfare, the Financial Accountability Office (FAO) has reported that the government’s budgeted plan for dealing with the backlog will fall hundreds of millions of dollars short of what is required to clear the COVID-19 backlog over three and a half years . The government says it is not working with the FAO estimates (indeed) and declined to make an estimate of how long it would take to deal with the backlog. The government did, however, state that it will “closely monitor” surgical outputs and wait times and will “implement additional measures if needed”. The government claims the funding will enable hospitals to operate at 110-115% capacity. Operating room hours will be extended into the evening and weekends.  That's ...

The group that will do the best out of the recent provincial Budget are the doctors.  According to the just released Budget  Estimates , OHIP funding (which  goes overwhelmingly to physicians and practitioners) will go up $1.2 billion or 8% compared to last year's Estimates.  (Note -- this is a little different, and less accurate, than the comparisons with last year's interim amounts reported in the 2019 Budget and used elsewhere in this note.  It is the only comparison publicly available for OHIP as of the moment, however. The Financial Accountability Office has suggested that the actual OHIP spend last year would be less than in the Estimates by several hundred million. So the actual increase this year may be larger than $1.2 billion. We will know for sure when the Public Accounts finalize the books for 2018-19 in September.)   This large increase is likely due to the February 2019 interest arbitration award for doctors, an award that was praise...

Soon after the Budget, the government announced they would spend $27 billion on hospital infrastructure over ten years and create 3,000 more hospital beds. For a moment, it may have seemed that we had prized a small victory from the Ford government.  The movement did, after all, force them to run on a promise of ending hospital hallway healthcare, and squeezed out a bit more in-year funding for hospitals last fall.   Unfortunately, as with so much from this government, the rhetoric does not match the reality.  Here's why this is much less than it might appear on first blush. [1] While the government promises to “create” 3,000 more beds over ten years, they do not promise that the hospitals will operate 3,000 more beds than they currently do.  There is no promise to increase hospital bed capacity.   There isn't even a promise to have 3,000 more spaces for beds.  As our hospitals are aging, spaces for some existing beds will no longer be usab...