The Greens have the most aggressive fiscal position among the four Ontario political parties, insisting they can balance the budget by 2015 — two years earlier than that promised by the Tories and Liberals.
However, the party is also promising income tax cuts and cuts to small business taxes. They also want to freeze tuition fees at post-secondary institutions.
How they intend to carry off this feat of cutting revenues and balancing the budget early while making significant spending commitments is unclear.
The Greens say they will continue to increase health care spending, but then reiterate the nonsense claim that health care is on track to consume 80 per cent ofOntario’s budget if something isn’t done soon. What would that something look like?
The Greens, like every other party, say they will “make more efficient use of health care dollars.” While they point to new initiatives they’d like to fund – including more home care, transitional care, long term care and more family/community health clinics – there is little to indicate where the efficiencies would come from aside from the usual cuts to administration.
By omission it’s also easy to see where they wouldn’t spend health care dollars: hospitals. This is despite criticism of emergency wait times.
It is not clear what administration the Greens would like to do away with. Recent drivers towards more health care administration center around government initiatives to collect data on dozens of health indicators that purportedly assist with evidence-based decision-making. Patient and staff satisfaction surveys are also costly from an administrative point of view, but part of an increased trend towards more patient-centered care. And if the Greens want the LHINs to do a better job of consulting the public, they may need to pay for that.
The Greens are promising to deliver electronic health records by using best practices from other places. Given there are already more than six million Ontarians who presently have electronic health records, and that the current timetable is to bring all Ontarians on-line by 2015, it’s not clear whether the Greens would actually stop the present work to look for something it could buy off the shelf. While the Greens want electronic health records, they say e-Health is one place they could save money.
While the Tories want to do away entirely with the LHINs – and replace them with nothing – the Greens say they will “put communities back in charge of local health care decisions.” They say they will instead review the LHINs and see if they need to be fixed or replaced. Oddly, they say they would put strict limits on administrative and consulting budgets for the LHINs despite the fact that LHINs are essentially administrative and consulting bodies.
The Greens are committed to investing $1.6 billion over four years in Community Care Centres, Aboriginal Health Access Centres, Family Health Teams and practices that team doctors with nurses, dieticians, psychologists, counsellors, physiotherapists and others.
They would also spend $2 billion over four years to improve “affordable care for seniors.” That would include more home care, transitional care, assisted living, tax credits for family members staying at home with seniors, case managers to help seniors navigate the health care system, and more supports to long term care.
They say they will also establish a goal of providing 50 per cent of Ontarians with access to a family care team by 2016, rising to 90 per cent by 2020. The assumption is Ontarians would want to drop their local GP for team-based care. The question is, would they have a choice?
One local Green candidate may have been winging it when he told a community forum “other specialized workers, such as nurse practitioners, can help streamline care by taking on tasks now done by physicians, allowing those doctors to focus on medical care.” One has to wonder what kind of care a nurse practitioner would be delivering if it wasn’t medical care?
He may have been trying to articulate the party’s position regarding expanding the scope of practice for health professions, which would allow members of those professions to “practise to the full extent of their demonstrated competencies as verified by their respective regulatory bodies.”
For-profit nursing homes will love the Green Party promise to “reform the funding model for long-term care homes to increase flexibility and to encourage innovation and efficiencies.” At present the debate in the nursing homes is about limiting the transition of funding from the clinical envelope to the accommodations envelope. Operators are only allowed to take profit from the accommodations envelope, and therefore would like a more “flexible arrangement.” The Greens would make it much easier for the large for-profit nursing home chains to siphon money from direct clinical care into profit.”
Like the other parties, the Greens place considerable emphasis on preventative care, with a focus on the environment. They will spend $600 million over four years on various food programs and on tax credits for children and adult recreation programs.
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