Memo: To the Honourable Kathleen Wynne, Premier, Province of Ontario
From: Your new pals at OPSEU Diablogue
Dear Premier Wynne –
Imagine our surprise when we discovered in today’s newspaper that the public sector unions are in fact running government. We have to give thanks to PC Leader Tim Hudak for pointing this out, because we had no idea this had taken place.
Anybody who reads our BLOG will note that we have had many recent differences, ranging from your government’s addiction to costly private-public partnerships to the present round of deep cuts to our public hospitals. We know, you don’t call them cuts, you call it restructuring (now that we’re friends perhaps you’ll let us know where this work is being restructured so our members can pursue jobs there).
We thought we would start off with a basic principle – public is better.
Here’s the proof: at the dawn of Medicare in Canada, we spent about the same percentage of our economy on health care as the United States. That percentage has since gone up for both of us, but at a much faster rate in the United States where the majority of health care delivery is in private hands.
In 2010, the most recent year we have comparable international data, the U.S. was spending 17.6 per cent of its economic output on health care – both public and private. In Canada we spent 11.4 per cent. While we could do a lot better, our spending is comparable to countries such as France, Switzerland, Germany and the Netherlands. Incidentally, for all the panic about rising health care costs, Canada also spent 11.4 per cent of its economic output on health care in 2009.
Despite the considerable difference in spending between the two, Canada actually does better on the big outcomes such as life expectancy and infant mortality. In a 17-country comparison of health outcomes done by the Conference Board of Canada, Canada ranked 10th, the U.S. dead last at 17th.
One of the reasons we don’t do as well as other countries is that a lot of our health care still looks like the inefficient United States’ system. Nationally about 30 per cent of our health system remains private. In Ontario it’s closer to a third.
As we stated last week, Canada remains an outlier when it comes to universal pharmacare coverage. Premier Wynne — you could go down in history as the next Tommy Douglas by expanding the Ontario Drug Benefit Plan to cover everyone. While it would come with a price tag, it would be considerably offset by costs presently associated with the 10 per cent of Ontarians who cannot afford their prescriptions and subsequently wind up in hospital. It would also give you more leverage with the drug companies and reduce administrative costs dramatically. Even at 25 per cent of brand name costs, Ontarians still pay among the highest generic prescription costs in the world. We could do better under universal pharmacare. If Ontario went first, you can bet that the other provinces would follow – just like Medicare. Some day CBC may even run a program in which you could be voted “the greatest Canadian.” Please, think about it.
Aside from the one-third of the health system that is private, Ontario has also gone down a very wrong road with the private provision of public health care services. Ontario stands out as having the highest levels of both home care and long-term care beds in private for-profit hands. Now we are now seeing the rise of for-profit diagnostics. There is a cost to all this. In home care administrative costs are conservatively estimated at 30 per cent. For-profit long-term care homes in Ontario cost the same as the not-for-profits and public nursing homes but have less staff. With private health you have to incent this, incent that, to achieve your aims. When it’s public, you just get to decide what’s best for Ontarians.
We’re happy that after a decade of advocacy your government has finally listened to us with regards to competitive bidding in home care. We left our nifty music video up anyway because we like the song. We’re happy to see Community Care Access Centres directly hire nurses to do community-based mental health work with children. We see this as a good direction. Please – more of the same.
We’re so glad Tim Hudak has let us know about your change of heart towards public sector unions.
As we develop this new wonderful friendship, we’ll be sure to give you plenty more good ideas to get Ontario back on track.