Defend Public Healthcare

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 a lot

Ontario's Financial Accountability Office (FAO) reports that the nominal health care funding increases planned by the Ford PC goverment between 2019/20 to 2029-30 fall well short of the nominal increases over the previous nine years (2010/11-2019/20, the period of public sector austerity that followed the last recession). Indeed, as the increase planned on a go-forward basis (between this year, 2021-22, and 2029/30) amounts to only 2% annually , we are looking at significantly harsher austerity than the 2010/11-2019/20 period , where funding increased 3.2% annually. As the FAO notes, the health care austerity imposed over 2010-20 "included a number of significant spending restraint measures, including: freezing base operating funding for hospitals from 2012-13 to 2015-16; reducing physician payment rates in 2013 and 2015; and limiting investments in new long-term care beds, with only 611 new beds created between 2011 and 2018."   This time around the plan is to impose h

The pandemic led to a brief reprieve from the austerity that has bedevilled Ontario hospital care since the great recession. After decades of being on par with other provinces, hospital funding fell far behind the rest of Canada. At the start of the pandemic the Ontario government was obsessed with the lack of capacity in Ontario hospitals, tragically compounding the crowding in long-term care by ordering hospitals to discharge patients to long-term care.  Despite the mass death in long-term care, very few sick or dying resients were transferred for treatment in hospital. They died in their homes.   But the government also moved to increase hospital funding in 2020-21 -- increasing it by more than ever before. That new money is temporary, however.   Cuts are coming: The government established a budgeting system in 2020-21 which would see much of the COVID-related funding budgeted under special funds distinct from the normal ministry line items. So, much of the increased funding for th

Health Care: To ease future cuts, the government established a budgeting system this year which would see much of the COVID-related funding budgeted under special funds distinct from the normal ministries. So much of the increased funding for the Ministry of Health or Ministry of Long-Term Care is not reflected in their line items but instead through special funds that are then later allocated to a ministry. So first the good news: The health and LTC  special COVID funds  are “budgeted” to continue for a couple of years.  An additional $4 billion in 2021–22 and $2 billion in 2022–23 is currently planned to help the health sector address COVID-19.   The bad news, however, is that even with that continuation of special COVID funds, overall health care and LTC funding is budgeted to go down -- by $1.9 billion in 2021/22 and another $500 million in 2022/23. That's a lot of cutting.  Of course that is “down” after a major increase this year.  Including the special funds, $72.8 bil

In the 2019/20 Ontario budget health care was budgeted at $59.97 billion.  That was subsequently increased by over $450 million to $60.42 billion, mostly through Supplementary Estimates late in the fiscal year. The Financial Accountability Office (FAO) now reports (based on current, but not yet final figures) that actual health care spending was  $59.96 billion – in other words, $466 million less than the revised health care budget.  So, despite increasing the health care budget by $453 million late in   the fiscal year, the government s pent $13 million less than it first budgeted.  That is about a 0.8% reduction compared with the revised budget plan.  It's a little hard to take Ford's protestations that he has no money for pandemic pay, and won't pay for more time to care, when he spends $466 million less on health care than he budgeted. One area with lower than  projected expenditures was the line item for local health agencies.  This is odd as public health is rather

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 of Rights would not be re

As usual, the provincial government is under-spending its (revised) budget.  Based on figures for provincial expenditures for the the first nine months of the fiscal year, the government-funded Financial Accountability Office (FAO) estimates that the government will under-spend its budget by about $2 billion this year. While that sounds like quite a bit -- it is actually less than usual.  Over the last ten years, the province has spent $3.3 billion less than budgeted on average. Combined with the expected non-use of the government’s $1 billion "reserve" (the reserve is an amount set aside every year for unexpected expenses), the FAO estimates the deficit will be only $6.1 billion, almost $3 billion less than predicted in the government’s own, very recent third-quarter report.  Health care expenditures are under-spent by $400 million (0.9%) through the first three quarters of the fiscal year, primarily due to under-spending on LHINs for hospitals, LTC, h