June 18, 2012
Ontario health care under the scalpel
Reuel S. AmdurMore by this author...
"Premier McGuinty's fight with the doctors is a master stroke. It takes the spotlight off what is being done to health care in the budget."
That was the analysis of the situation put forward by Marlene Rivier at a public meeting called by the Ontario Health Coalition in Ottawa on May 26. She is a psychologist at the Royal Ottawa Hospital and chairman of the Ottawa branch of the coalition.
McGuinty’s health care budget will cut $1 billion from hospitals in the next two years. OHIP is set to take a $2.05 billion haircut in the same period. These cuts occur while Ontario already under spends on health in comparison with the rest of Canada.
In 2010, Ontario sent $3,911.70 per person, compared with an average of $4,351 for the rest of Canada. Only British Columbia and Quebec spent less than Ontario. And as a percentage of all Ontario government spending, health care spending has been continually declining.
Hospital bed occupancy rates are also an issue. The Ontario Health Coalition states that experts set the optimal maximum hospital bed occupancy rate at 85%, to avoid blockages. In Ontario it is 97.5%.
Ontario is the lowest among the provinces in bed ratio staffed and in operation, 2.5 beds per 1,000 population. (Quebec information is lacking.) The financial constraints imposed on hospitals result in cuts to services, abandoned at times to for-profit, fee-charging alternatives in the community.
The picture for alternative care is not much brighter. According to the Ontario Association of Non-Profit Homes and Services for Seniors (OHNSS), the demand is increasing, “outstripping supply. Wait lists are growing and there are virtually no beds available,” with a 5.1% increase from the previous year.
Then there is home care. The provincial Auditor General found 10,000 people on waiting lists, with waits up to 262 days. And costs for alternative care are increased due to privatization, with most home care services and long-term facilities in the private sector.
At the same time, low pay for workers in the facilities results in high turnover rates and many staff lacking in training and experience. We have heard this tune before, when deinstitutionalization of the mentally ill was supposed to be dealt with by services in the community, but the services were never funded. So it is with movement of services from hospital to the community for services for the elderly.
McGuinty cries that health care costs are bleeding the government’s coffers. Quite right, but what is the real problem? The sad state of the government’s exchequer is due to massive and continuing tax cuts. “Without the recession–at full economic potential–the impact of the tax cuts is a revenue reduction of $18 billion per year, more than the entire provincial deficit.” (Ontario Health Coalition. “First Do No Harm” Feb. 10, 2012) These cuts are overwhelmingly to corporations and high-income earners, very little if any for other Ontarians.
We are told that the cuts are to encourage business to come to Ontario. As a result Ontario has among the very lowest tax rates in North America. Yet this strategy has simply failed. The McGuinty answer is simply more of the same, while what is needed is a real new economic strategy.
Dennis Howlett, of Canadians for Tax Fairness, identified poverty as a major factor in poor health, worse than smoking. Another way of looking at it is to see that poverty is expensive, consuming health care dollars.
If a child is raised in poverty, even if the poverty is overcome later in life, health outcomes are still affected. Yet, McGuinty has done absolutely nothing to reverse the 21.6% cut in welfare rates brought in by Harris. Subsequent increases have only addressed increases in cost of living since the cut. Incidentally, the cut also appears not to be on the NDP’s radar.