Defend Public Healthcare

Premier Ford wants for-profit surgical clinics -- but that is just one area where his government is privatizing hospitals.  Unfortunately, there is so much more.    The privatized American heath care disaster is on full display right on our doorstep. According to the US government 31.6 million Americans have no health insurance whatsoever, including 3.7 million children.  Many millions more have inadequate health insurance.  A recent survey indicates that f orty-three percent of working-age adults were inadequately insured in 2022.  Twenty-nine percent of people with employer coverage and 44 percent of those with individual coverage were underinsured.   Forty-six percent of respondents said they had skipped or delayed care because of the cost, and 42 percent said they had problems paying medical bills or were paying off medical debt.  Medical bills hit African Americans and Latinx/Hispanics especially hard. US health care costs per capita are...

The Ford government suggests it must reduce the real wages of hospital workers via Bill 124, and now even proposes to appeal the court decision that found the legislation unconstitutional.  However, no such need exists - quite the opposite. Spending on compensation has been shrinking as a portion of hospital budgets for many years.  The result of this shrinkage? The short staffing, workplace violence, staff burn-out, and falling real wages that are currently hobbling hospitals. Spending on compensation has consistently declined as a percentage of total hospital spending in Ontario:  Data source: CIHI,  Provincial/territorial hospital spending by type of expense, province/territory and Canada (excluding Quebec and Nunavut) ,  The decline in compensation is not something intrinsic to modern hospitals.  The experience in Ontario is in stark contrast with the experience in  the rest of Canada. For provinces and territories other than Ontario, compensation ...

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 proposed reforms through Bill 175 will privatize health care services, weaken public oversight, remove legislative protections, undermine home care working conditions, and unleash an untested, home care experiment. Chaos beckons. Bill 175 is permissive, allowing a laissez-faire framework for home and community care.  It repeals the more detailed Home Care and Community Services Act, 1994 and leaves most details to policy or regulation. Deviously, the government has made the Bill ( Connecting People to Home and Community Care Act, 2020 ) little more than an empty shell that doesn't even establish a new home and community act.  So, for example, the Home Care Bill of Rights is not in the proposed legislation.  Instead, it may be put into regulation.  This approach removes the public accountability that comes with legislation.  Regulations and policies are changed with little public consultation.  One would think that in today’s world a Home Care Bill ...

The Auditor General (AG) has again identified issues in her  annual report   which 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 to the 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...

For many years, OCHU/CUPE has been concerned the Ontario government would transfer public hospital surgeries, procedures and diagnostic tests to private clinics. CUPE began campaigning in earnest against this possibility in the spring of 2007 with a tour of the province by former British Health Secretary, Frank Dobson, who talked about the disastrous British experience with private surgical clinics. The door opened years ago with the introduction of fee-for-service hospital funding (sometimes called Quality Based Funding). Then in the fall of 2013 the government announced regulatory changes to facilitate this privatization. The government announced Request for Proposals for the summer of 2014 to expand the role of "Independent Health Facilities" (IHFs).  With mass campaigns to stop the private clinic expansion by the Ontario Health Coalition the process slowed.   But it seems the provincial Liberal government continues to push the idea.  Following a recent second...

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 Medav...