Defend Public Healthcare

Ontario government revenue is way up -- $16.6 billion higher than the forecast in the Budget just six months ago. That’s an average increase of $2.7 billion per month -- or up another 1.5% every month.  Revealingly, the quarterly increases in revenue reported have grown sharply: from a modest $1.2 billion in the first quarter report, to $5.8 billion in the second quarter report, on to a whopping $9.6 billion now in the government's new 3rd quarter report .  Yet the fact that the government was massively underestimating revenue was obvious right from the get go when the Budget was re-introduced in August.   The slow recognition of the extra revenue reduced pressure on the PC government to improve health care funding during a hospital capacity crisis. And not one extra penny was added for hospitals, despite the crisis.   It would be hardly surprising if more revenue is recognized in the final two reports for this fiscal year – the 2023 Budget and the Septembe...

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...

Hospitals in provinces other than Ontario have 18% more staff than hospitals in Ontario.  Much, but not all of this is due to low levels of inpatient staffing in Ontario.  In that area, hospitals outside of Ontario have 38.7% more staff.   Understaffing : Ontario hospital full time equivalent (FTE) jobs are reported at 189,519 in 2020/21. With a population of 14,740,102 at the end of 2020 this means there are 1.286 FTE hospital jobs per 100 population. Across the other provinces and territories (absent CIHI data for Quebec and Nunavut) the ratio is 221,917 FTEs for a population of 14,648,959, or 1.514 FTEs per 100 population.  In other words, there is 18% more hospital staff capacity in the other provinces and territories than in Ontario.  Put another way, if Ontario had the same staffing capacity as the other provinces and territories,  we would have another 33,778   full time positions  working in Ontario hospitals. ...

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 ...

The Ontario Financial Accountability Office (FAO)   says  that, with inflation, real wages in the public sector will decline 11.3% over the three year period  2021/2 - 2023/4 .  This would radically deepen the trend towards lower wages during the last ten years.   The FAO reports that since 2011, the average annual salary for the Ontario public sector employees (defined here as employees of schools, colleges, provincial government, provincial agencies, and hospitals) has increased by $10,385   -- or 1.6 per cent on average annually.  This is the lowest increase of all the sectors and lower than inflation, which averaged 1.8 per cent per year. Over the ten years that would be about a 2% pay cut.   The FAO reports that wage settlements were the lowest in the provincial public sector over the last decade:   Hospital Wages Especially Challenged: The FAO predicts hospital wages will increase even less than in the public sector  -- just ...

The Financial Accountability Office has released the Ford PC government's funding plans for the various health care sub-sectors .   The news is not good.   The funding plans for 2022/3 in several key line items are down compared to actual funding in 2021/2 :  Funding plans for long-term care services are down $26 million – or down 0.4% compared to last year's actual funding.  Overall funding to the Ministry of Long-Term Care (LTC service funding plus LTC Capital and Development funding) is down $315 million, with the LTC Capital line item down a full $376 million. The LTC Development line item was also completely unspent over the last five quarters. These are mysterious changes when there is a 38,000 person LTC wait list, a desperate shortage of LTC facilities that meet modern design standards, new legislation that forces hospital patients to move into LTC facilities they did not choose, and frequent claims by the government that it is quickly building new...

The Ford government re-released its spring Budget this week with a new first quarter fiscal and economic update  providing a little bit more information -- albeit from a government with a track record for wildly inaccurate Budget plans.    The increases in spending announced (e.g. for people with disabilities on a fixed income) are so insignificant in the scheme of things that they can be handled within government contingencies.  Overall program spending is still exactly as planned in April.  Total spending , which also includes the debt expense, is up a modest $105 million due to higher interest rates. As a result, the total spending plan is up by five one hundreths of one percent (0.05%).  They are not even writing down their $1 billion reserve by a few kopeks.  With increased revenues, the deficit is planned to be $1.1 billion lower and the debt to GDP ratio is also planned to be a full percent lower.  Keeping with the new health minister's (...