Defend Public Healthcare

Shocker.  The Ontario government is forecasting that it will beat its deficit forecast -- for the seventh year in a row . The deficit for this year is forecast in t he province's Fall  Economic Outlook and Fiscal Review  to be $1 billion less than forecast in the spring 2015 Budget .  The forecast for next year is already $300 million less than in the 2015 Budget.  That would make eight years in a row. For this year, the decline in the deficit was driven by higher than expected revenue ($1.245 billion more revenue,  primarily due to an underestimation of revenue from the Hydro sell-off and $600 million higher than forecast revenue from personal income and land transfer taxes).  Lower than expected interest expense on debt ($140 million) has also helped.  Program spending however is $397 million higher than expected.   The major in-year increases in spending compared with the 2015 Budget are in two areas, the Hydro privatization and the new Green Investment Fund:

Provincial government per capita expenditures on hospitals continue to decline.  This is the third year of absolute decline according to Canadian Institute for Health Information (CIHI) data. Of course hospital services are also affected by inflation, like other services.  One way to measure this is the total health care price index.   CIHI  reports the health care implicit price index over this three year period has increased by approximately 8.3% (160.9/148.6). That is equal to about 2.7% per year. This inflation means the 2012/13 per capita hospital funding  would have to increase to $1,534.95 in 2015/16 just to keep up with increasing health care prices.  Instead the government expended just $1395.73. In other words, in three short years, the government has reduced real spending on hospital services by 9.1% per person ($1395.73/ $1534.95). If we considered the impact of an aging population on hospital costs (usually put at about 1% per year in extra costs), the

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 OCH

Canadian Institute for Health Information (CIHI) hospital data indicates big changes in hospital activity, particularly in the most recent four years reported. Ontario, especially, is experimenting with hospital cuts and restructuring.   Hospital inpatient days are now dropping rapidly in Ontario – with a drop of 13.4% in inpatient days over the last four years. This has occurred even as inpatient days continue to increase in the rest of Canada (note: Quebec is excluded from the CIHI report as the data for that province is under review).  The data suggests a sharp fall in Ontario in 2013/14 compared to 2012/13 (8.9%), a less sharp decline over the previous 3 years, and significant growth over the previous five year period. Over the 15 years of data reported (1999/00 through 2013/14), Ontario inpatient days have increased 4.6%  -- even while population has increased at almost four times that rate (17.8 %) and the median age increased 4 full years (from 36.2 to 40.2 years). T

The suggestion that Ontario has a deficit because its public sector is too large does not bear scrutiny. Consider the following.  Public sector employment has fallen in the last three quarters in Ontario.  Since 2011, public sector employment has been pretty flat, with employment up less than 4 tenths of one percent in the first half of 2015 compared with the first half of 2011. This contrasts with public sector employment outside of Ontario which has gone up pretty consistently and is now 4.7% higher than it was in the first half of 2011. Private sector employment has also gone up consistently over that period. In Ontario, it has increased 4.3% since the first half of 2011, while in Canada as a whole it has increased 4.9%. As a result, public sector employment in Ontario is now shrinking as a percentage of the private sector workforce.  In contrast, in the rest of Canada, it is increasing. Moreover, public sector employment is much higher in the rest of Canada