To the Editor:
$196.1 billion over ten years, including $46.2 billion in new funding is a lot of money but it’s not enough to revamp our health care system to meet the growing challenges of an aging population, recurrent pandemics, poverty and homelessness.
The last time the Liberals threw ‘transformative’ money at the system was in 2004 when Martin reached an ‘Accord’ with the provinces for $18 billion over six years with annual bump-ups of 6%.
Guess what the major issues were that the 2004 Accord was supposed to solve: lengthening wait times for surgeries and procedures; commitments from the provinces for a national home care program with agreement on what services it would provide; and comparable standards of care.
Sounds familiar, eh? The Conservatives under Harper didn’t help matters by reducing the bump-up to 3% a year and not following through with the goals of the Accord.
Trudeau’s deal will increase the annual bump-up to 5% and will negotiate terms of the deal with individual provinces, mostly for the sort of things the 2004 Accord was supposed to deliver. We’re still a long way from adequate funding for the single-payer universal health care system envisaged by Tommy Douglas.
And it doesn’t help that Ontario has underspent on services by some $7.5 billion, according to the Financial Accountability Office. Ontario will likely post a surplus next year, but it will be at the expense of health (where Doug Ford has underspent by $5 billion) and education (underspent by over a billion).
Let us not forget that the crisis in health care is not in infrastructure (there are enough operating rooms). It’s in staffing. Chronic underfunding and the pandemic have prompted over-stressed doctors and nurses to leave Ontario or abandon their professions entirely.
Private surgeries bleed staff from public hospitals. And many nurses and PSWs have signed up with private hiring agencies who charge hospitals and long-term care homes two or three times what in-house staff would cost.
There are things that can be done to meet the challenges of today, and save money …
- Repeal Bill 124 that hold nurses (and other public employees) to a 1% increase a year. Ontario courts have found it illegal, but Ford is appealing that decision. Repealing it and paying health care heroes what they are worth will save money compared to what temp agencies are charging.
- Fast-track professionals with foreign training to work in Ontario.
- Ramp-up home care services, especially for the elderly. That will relieve pressure on hospitals and provide care where 90% people have said they want it – in their homes.
- Fund more Community Health Service clinics which have proven to be cost-effective, and are able to provide a suite of diagnostic and treatment services. Everyone should have access to primary care.
- Educate and hire more nurse practitioners and deploy them in rural CHCs.
- Designate some hospital operating rooms for surgeries that don’t require the staff and equipment that more complicated procedures do. This has been done in the London Health Sciences Centre and it cuts wait times for orthopedic surgeries (for example) in half while maintaining public funding.
- Negotiate lower drug prices through a nation-wide pharmacare plan.
- To help us afford the health care Canadians deserve, increase the low rate at which corporations are taxed. The corporate tax rate is now about 26%, but some have become expert at lowering that even further. The corporate tax rate used to be two and three times that before trickle down economics took hold of conservative governments in the late 1980s.
All of this takes more political will than money. It’s a whole lot easier hand over the whole mess to the private sector take over as Ontario is doing. Trouble is, the research shows, the private sector doesn’t save us money and it delivers second rate care.
The other problem is that the provinces have, for decades, spent less on health care than the feds have given them. They’ve moved the money into other areas – building expressways, perhaps, or cutting corporate taxes, or bringing down their deficits. Successive Liberal and Conservative federal governments have not held the provinces to account.
Note: David McLaren is an award-winning writer. He has worked in government and the private sector, with NGOs and First Nations in Ontario. He is currently writing from Neyaashiinigamiing on the shore of Geogian Bay in the Bruce Peninsula.
Articles of Interest
- PM and premiers haggle over billions — but the future of health care needs more than money https://www.cbc.ca/news/politics/trudeau-premiers-health-care-wherry-analysis-1.6740580
- Looking forward into the past: Lessons for the future of Medicare on its 60th anniversary https://theconversation.com/looking-forward-into-the-past-lessons-for-the-future-of-medicare-on-its-60th-anniversary-196866
- Working together to improve health care for Canadians (Gov’t press release 7 Feb 23) https://pm.gc.ca/en/news/news-releases/2023/02/07/working-together-improve-health-care-canadians
- An idea to streamline the operating room got patients into surgery sooner https://www.cbc.ca/news/health/surgicentre-operating-room-1.6623980
- As surgical wait lists grow, Canada’s private clinics cash in 10 Feb 23 https://www.cbc.ca/news/health/private-surgery-hip-knee-replacement-1.6741461
- ‘Show me the money’ is only Act 1 of Canada’s health-care drama 13 Feb 23 https://www.nationalobserver.com/2023/02/13/opinion/first-ministers-meeting-health-care-funding
- Temp agency fees eating up government funds amid nursing home staffing crisis 14Feb 23 https://www.thestar.com/news/canada/2023/02/14/temp-agency-fees-eating-up-government-funds-amid-nursing-home-staffing-crisis.html
- For-profit nursing homes have four times as many COVID-19 deaths as city-run homes, Star analysis finds https://www.thestar.com/business/2020/05/08/for-profit-nursing-homes-have-four-times-as-many-covid-19-deaths-as-city-run-homes-star-analysis-finds.html
- In the US: How Wall Street Profits Off Of The Sick And Elderly https://www.levernews.com/how-wall-street-profits-off-of-the-sick-and-elderly-private-equity-nursing-homes/
- COVID-19 excess mortality among long-term care residents in Ontario (2021 study) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8775534/
- https://www.ontariohealthcoalition.ca/index.php/release-ford-government-is-awarding-thousands-of-long-term-care-beds-to-for-profit-chains-with-ghastly-records-of-death-and-suffering-new-coalition-report/ Ford Government is Awarding Thousands of Long-Term Care Beds to For-Profit Chains with Ghastly Records of Death and Suffering: New Coalition Report