Category Archives: Health System

Wealth, age and geography should be significant factors in “ranking” LHIN performance

According to the Hamilton Spectator, the three wealthiest regions of the province have the best health results despite the lowest per capita health funding, a blatant reminder of the link between income and health.

These three LHINs also happen to be adjacent to Toronto, where many patients cross LHIN boundaries to seek care.

It also tells us that tackling poverty could have a substantial impact on public health care costs.

Does that make these three regions the best run LHINs? Not necessarily.

Unfortunately, the newspaper’s ranking of the 14 Local Health Integration Networks may not be entirely fair given the emphasis on population health in those standings.

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Health and education vs. sports executive boxes

It’s no surprise that the root cause of the recent recession would be eventually reinterpreted to blame the public sector.

Now that the bankers and the auto industry have now renounced their brief flirtation with socialism, it seems we are told our problems stem from us little people having it too good when it comes to health, education and other public services.

Even the ever apoplectic Rex Murphy blames Premier Dalton McGuinty for the sudden state of the province’s finances, and not the bankers who crashed the economy and suddenly put a big hole in Ontario’s gross domestic product (GDP).

Federal Finance Minister Jim Flaherty, blowing harder than usual these days, says Ontario has fundamental budget problems – “major spending problems that they’ve built up over the course of eight years.”

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Hudak flip flops on health care issues

Have the Ontario Tories ditched some of their long-standing health care issues in the wake of the Drummond report?

On the one hand, Hudak likes Drummond’s idea for even larger Local Health Integration Networks, on the other hand, he remains silent on Drummond’s call to hold the line on new long-term care beds. During the election Hudak called for the elimination of the LHINs and pledged to create 5,000 new long-term care beds and renovate 35,000 more.

While PC Leader Tim Hudak has accused Premier Dalton McGuinty of cherry picking the report, he himself has been all over the map, one day insisting the Premier implement it, the next day carving out his own exceptions from the 362 recommendations.

“If the Premier takes a single one of them off the table he must specify an alternative approach,” Hudak said. And then Hudak himself began taking them off one by one, starting with his call to protect $340 million in revenue from slot machines shared with the horse racing industry.

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Windsor hospital CEO defends women’s wages – we think…

Our friend David Musyj is mellowing.

The CEO of Windsor Regional Hospital, once a vocal advocate for wage freezes, now says either freeze all wages or none at all.

Musyj told the Windsor Star that it’s a morale breaker when the government freezes wages for just one group.

He says the impact of extending the freeze will be negative because further penalizing this group for “political gain” is grossly unfair.

We agree. As public sector workers, it is a morale breaker to see calls for more austerity when our wage increases are already well below the private sector.

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New funding formula abandons patient-centered care for payer-centered care

In Ontario, when a health policy fails, it appears you expand it.

For four years Ontario has been attempting to use payment-for-results (P4R) funding to improve ER wait times. As we reported recently, only about a fifth of the P4R money allocated to hospitals in the Central East region was distributed this quarter, the rest – more than $4 million – was returned to the Ministry of Health. The hospitals couldn’t reach the targets set for them.

Sending more than $4 million back to the Ministry of Health will not help them reach those targets any faster.

Queen’s Park is fixated with the idea that only competition for cash can lead to improved wait times. On the other hand, they expect the system to integrate with more cooperation between providers.

These are not compatible ideas.

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Health care hasn’t squeezed out funding for higher education – prof

There’s no question that there has been a concerted effort to portray health care as eating everyone else’s lunch when it comes to funding.

While health policy experts have repeatedly pointed out that this is not true, few outsiders have acknowledged this reality.

In today’s Toronto Star, York University professor George Fallis notes that funding for higher education has kept pace with health care over the last decade.

He writes: “Contrary to what many believe, the growth in health spending over this period has not squeezed out spending on higher education. Ontario has one of the best systems of higher education in the world, highlighted by its achievements in providing access to higher education.”

Fallis notes that over the last 10 years university enrolments have grown by 50 per cent and college enrolments by 23 per cent.

The professor argues the baby boom “echo” has reached its peak, and changing demographics will likely reduce demand for higher education.

Quebec proving two-tier health has a dramatic impact on access to public care

Advocates for two-tier health care fail to acknowledge that a second tier comes with a significant cost to the first.

Waits for colonoscopies in Montreal are averaging between two to three years in the public system for patients considered to be at average risk.

The city’s Royal Victoria Hospital has stopped accepting new patients for colonoscopies – at least until the backlog can be resolved.

One family physician has contacted the Montreal Gazette to suggest the long waits are all about forcing patients into private clinics, especially when the gastroenterologists are working both the private and public side of the system.

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Did The Scarborough Hospital hide its near insolvency from the LHIN?

The merger between the Scarborough and Toronto East General hospitals may be off, but the Central East Local Health Integration Network certainly took note of one of the report’s statements – The Scarborough Hospital is near financial insolvency.

This may be the main reason why the Toronto East General Hospital backed off from a proposed merger, or as the consultant’s report states, was a “potential show stopper.”

The LHIN has since released a statement March 1st that suggest The Scarborough Hospital’s financial predicament may have been previously misrepresented.

“The report makes a number of observations related to the financial sustainability of The Scarborough Hospital that are not substantiated by evidence or data previously submitted by the hospital to the LHIN which will require some clarification by the hospital,” the LHIN release states.

Or in more common parlance, TSH CEO Dr. John Wright may have some explaining to do.

The LHIN also raised issues about how the merger talks had evolved, noting that the process lacked a transparent explanation of the vision, aims and scope of an integration, a clear understanding of the benefits to the community, nor an appropriate community engagement plan.

The Scarborough Hospital is expected before the LHIN on March 28th to outline its plan on how it will “move forward.”

Who’s behind the attack on Canada’s public health system?

Where you buy your groceries, which newspaper you subscribe to, or where you do your banking may contribute to funding the attack on public health care in Canada.

The explosive growth of right-wing think tanks across Canada has been supported by some of our largest corporations to promote their own private interests. The question is, are these legitimate research institutes or business lobbyists?

While the media continually treats reports from these organizations as gospel, they seldom ask who provides the funding?

The irony is not lost on us, especially given the Montreal Economics Institute’s campaign to make unions open their books to the public while they themselves refuse to divulge who their funders are.

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Owen Sound media insists down is really up

Ah, reporters.

We recently contacted a writer from the Owen Sound Sun Times regarding her story about the Drummond Commission recommendations. In it, reporter Tracey Richardson states:

“About 100 of those recommendations were devoted to the $47-billion health care industry, which eats up about 43% of the provincial budget and is growing.”

We pointed out that in the most recent budget health care made up 42 per cent of provincial program spending, and that it has recently been as much as 46 per cent of program spending (2010-11 budget).

How could this be construed as “growing” as a percentage of government spending? 42, after all, is less than 46.

Ms. Richardson replied to our e-mail complaint about the inaccuracy in her story. She said health care spending was somewhere between 42 and 43 per cent, depending on your “political leanings.” She didn’t offer to explain how this could be more than 46 per cent, but that we were free to write a letter to the editor if we had “strong opinions.”

Sorry Tracey – but you were plain wrong. You accepted Don Drummond’s word as fact, and evidently never looked at the actual provincial budget documents. When we attempted to correct your error, you suggested it was opinion.

For the record, this is what the provincial budgets actually forecast health care spending to be:

  • 2009-10: 43 per cent of program spending
  • 2010-11: 46 per cent of program spending
  • 2011-12: 42 per cent of program spending

In 2010-11 the actual spending on health care came in $454 million below what was forecast. Yes, below.

The government explained in last spring’s budget “health sector expense is projected to decrease by $454.0 million, primarily due to revised Electronic Health Record project plans, lower-than-expected uptake in vaccine and assistive devices programs, and the extended deadline for short-term stimulus projects.”

Ah, the facts. They have a way of messing up a pretty good story.

Oh, and the $47 billion health “industry?” It’s actually a lot bigger than that. Only about two-thirds of Ontario’s health care expenditures are public. The rest? You pay it out-of-pocket or through private insurance. Costs are rising there too, but Don Drummond has no recommendations on that front.