Defend Public Healthcare

New hospital inpatient length of stay data published by the Canadian Institute for Health Information (CIHI) indicates [1] Ontario lengths of stay continue to decline, but the pace of decline has picked up, and [2] the gap between the Ontario and Canadian average length of stay is growing and has now hit startling levels. Since 2007/8, Ontario inpatients have 0.6 fewer days in hospital. This is a decline in length of stay of 8.7%. The Canadian average declined only 0.1 day (1.3%). The Ontario decline corresponds with the real funding cuts for Ontario hospitals in recent years. Much of this occurred in the last year -- Ontario inpatients had 0.3 fewer days in 2014-15, a decline of 4.6%. The Canadian average is now 1.2 days longer – or, put another way, Canadian patients stay 19% longer. This corresponds with the extra funding Canadian hospitals get compared to Ontario hospitals.  The trend is even more apparent if we look at “age standardized average length of stay...

There has been a general trend downwards in public sector employment in Ontario according to Statistics Canada. In the last two years, Ontario has lost 19,000 public sector workers, with most of the loss occurring in the last year. The downwards trend in Ontario contrasts with the upward trend across the rest of Canada.  While Ontario lost over the last two years, the rest of Canada gained 73,400. Over the last year the rest of Canada gained 65,300 public sector jobs, while Ontario lost 12,700 public sector jobs. This may understate the cuts in the Ontario broader provincial public sector (i.e. public sector workers, like health care workers, that are primarily funded by the province, excluding federal and municipal employees). Austerity has been much harsher for the Ontario government than the federal and Ontario municipal governments. So the Ontario broader provincial cuts may be softened by modest growth in the federal and municipal sectors. The level of pu...

Health care and hospital funding : Despite significant new revenue and lower than expected debt costs, health care spending is almost exactly identical to the amounts planned in last year’s Budget for 2015-2018.  The total health budget for 2015/16 came in (on an “interim” basis) basically the same as planned in the 2015 Budget (that is unusual, more often they under-spend the health budget).    For 2016/17 and 2017/18, they plan to keep basically to the targets set out in the 2015 budget (plus a small increase of $100 million in each of those two years -- an extra 0.2%).  Overall, health is planned to increase 1.97% in 2016/17 and 1.93% in 2017/18. That will see health expenditures fall again as a percentage of the economy but is a little bit higher than the planned all-program expense increase (of 1% in 2016/17 and 1.7% in 2017/18).  That is far short of costs pressure due to increased utilization, aging, population growth, and inflation....

Federal Health Cash Transfers  ("CHT") to the Ontario government will rise 5.94% in 2016/17, or by $778 million. This, in itself, would pay for a 1.5% increase in Ontario health care funding even without a single extra penny from Ontario tax revenues.  This follows a $736 million increase (5.96%) to federal health care cash transfers to the province of Ontario for this year. Despite this, the Canadian Institute for Health Information (CIHI) estimates that total health funding by the Ontario government is only going up by about $352 million this year -- or about 0.7%. This falls well short of aging, inflation, utilization, and population growth cost pressures and deepens  the trend in recent years to reduce health care and hospital funding in real terms.  So far, there are precious few signs that the government will reverse its policy of health care austerity in its upcoming 2016/17 budget. Likely, Ontario funding will fall far behind federal health care fund...

The litany of health care problems identified by the Auditor General  in her 2015 report is frightening. Here's thirty-seven of them dealing with LHINs, LTC, EMS, Rehab Hospitals, Health Infrastructure, Home Care, and Health Human Resources. Local Health Integration Networks (LHINs): A Lot of Problems LHINs have not met performance expectations. "Most LHINs performed below expected levels in the year ending March 31, 2015. In that year, LHINs on average achieved their respective local targets for six of the 15 performance areas".  Also: "Based on the provincial results that include all 14 LHINs, only four of the 11 provincial targets that measure long-term goals for LHINs were met." Performance has not improved. "While province-wide performance in six of the 15 areas measured has improved between the time the LHINs were created and 2015, in the remaining nine areas, performance has either stayed relatively consistent or deteriorated since 2010 or...

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...