Tag Archives: health care

Two-thirds of Ontarians would vote for a strong health care platform — Nanos

It was a curious decision by the media conglomerate putting on the Tuesday’s leaders debate. Limiting viewer questions to six, you’d have thought one of them would have dealt with Ontario’s struggling health care system.

As it was, health care was raised only by NDP leader Andrea Horwath, when she noted the NDP’s wait time pledge in her final summary.

The Ontario Medical Association and Nanos suggest Ontarians were dealt a disservice by the way the conglomerate produced the program. According to a poll taken between May 22-26, more than two-thirds of Ontarians (67.6%) said a strong health care platform would have an impact on their vote.

Further 87.9 per cent said that health care is an important issue to them personally.

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September rally to demand health care commitments

Public health care usually ranks at the top of voter priority issues. It is also an issue that politicians are reluctant to talk about during the heat of an election. All three parties carry health care baggage from their time in government.

The Rae NDP government accelerated the privatization of community labs and created Rae days which increased overtime costs in hospitals. The Harris/Eves Tory government froze health care funding and introduce the disastrous policy of competitive bidding to home care. The McGuinty Liberals have closed ERs and pressured hospitals to empty hospital beds without providing sufficient alternate care in the community.

The Liberals and Tories are now promising to reduce health care spending increases to three per cent per year. Tim Hudak wants to eliminate the LHINs but offers no replacement for planning, funding, and community consultation. He also wants to contract out support services in our hospitals. The NDP have yet to reveal their health care platform. All this is taking place as governments prepare for a new age of austerity.

Regardless of the baggage they carry in to the election, voters need to demand a vision of where health care is going from all parties. It’s not just about shovelling funding into the system.

The Ontario Health Coalition is hoping that enough people show up in the streets of Toronto September 13th to send a message that political candidates cannot ignore. During this election we really do want to talk about health care.

The rally to safeguard public health care is being scheduled at Queen’s Park on Tuesday, September 13 at 12 Noon. While most rallies are aimed at the government of the day, this rally is a message to all parties that it is time for improved and equitable access to comprehensive health care across all of our communities.

Health care workers may want to schedule their shifts to be able to come to Toronto on that date. For workers along University Avenue and near Queen’s Park, the rally offers an ability to come out during lunch time and cheer the rally on.

Watch for more details in the coming months.

Meanwhile, please download the attached rally poster and share it with anyone you know who is interested in defending our public Medicare system.

Statistical recovery, human recession — McNally

We are in a statistical recovery but a human recession, says author and academic David McNally, speaking May 28 at the Students for Medicare conference in Toronto.

While the statistics show economic growth, jobs, personal income and public services are failing to recover.

“Medicare and public health care are one of the key social justice issues of our age,” says McNally. “We are in an entirely new historical moment.”

He says there is a more subtle set of strategies to undermine public health care, including privatization. It comes at a time when we need health care the most.

According to the Ontario Medical Association, Canadians are spending less on food, exercise and pharmaceuticals – three areas that will impact on the delivery of public health care.

McNally said that public services are now under one of the most unrelenting attacks in several generations, leading to what some are labelling “the age of austerity.”

These attacks on public services are having an impact on countries such as the UK where they are about to fall back into recession.

Whereas government had previously told us that programs such as universal child care or national pharmacare were not possible, it suddenly became possible to use enormous sums of money to bail out banks and other corporations, he says.

McNally estimates that the worldwide cost of the bailouts and stimulus – largely to construction firms – is $21 trillion, or about a year and a half of the entire economic output of the United States.

“When it comes to bailing out capitalist institutions, the cupboards are not bare,” he said.

“It tells us a lot about global elites and their governments.”

The age of austerity effectively found its beginnings at the Toronto G20 summit, where governments decided to direct belt tightening at public and social services. That belt tightening does not apply to police, military and prison building, tools governments will use to stifle unrest from these policies.

McNally says the process has already begun, pointing out that Latvia has fired 30 per cent of its teachers, Ireland has cut public sector wages by 15 per cent. Greece has cut public pensions. In the U.S. the State of Michigan has closed half of its schools, taking the average class size up to 60 students. California has cut health insurance for 900,000 children. Arizona scrapped all public health insurance for children.

Ontario is not exempt, noting the province has already cut the special diet program for individuals on social assistance.

While this is taking place, corporate taxes are being cut internationally.

McNally points to Mervyn King, Bank of England Governor, who has expressed surprise that there is not greater anger over the price of the economic crisis being paid for by the very people who did not cause it.

Instead governments are creating myths about out of control costs, blaming public employees.

This statistical recovery overlooks an unemployment and underemployment rate in the US that is more than 17 per cent. Among black and Latinos, it is between 24-25 per cent.

“Half of U.S. school –age children will be reliant on food aid at some point in their childhood, and among African-American children it will be closer to 90 per cent.”

The “Great Recession” has driven 64 million more people into poverty world-wide, many affected by spiking food prices created by speculators. 47 million will be driven into conditions of absolute hunger.

McNally says we are only in the first phase of this new age. Quoting Naomi Klein, he says governments are using the shock doctrine to push through this roll back of social programs.

The goal, he says, is a lower wage economy, low tax, and a low cost investment climate.

McNally compares the present era to the 1930s. People forget that while there were great changes in the 1930s, these didn’t happen until the latter half. Under Canadian Prime Minister “iron-heel Bennett” life was miserable for many Canadians until a coherent social movement forced changes.

He says there is hope in social movements, but this is a process that will take time.

“We need to think about a longer horizon that next week or next month,” he says, certain that the “last laugh will not belong to the Stephen Harpers and Rob Fords of this world.”

David McNally is author of Global Slump: The Economic and Politics of Crisis and Resistence. He teaches at York University in Toronto.

David McNally speaking at the Students for Medicare conference May 28.

A bad month for transparency and accountability

Private member bills seldom get passed at the legislature. Perhaps it was for that reason Bill 183 received little attention after the Liberal majority defeated it May 5th.

The NDP authored Bill was intended to expand the scope of the Ombudsman to include universities, colleges, hospitals, long-term care homes, school boards, children’s aid societies, and retirement homes. The Bill would have also given the Ombudsman an oversight role over the independent police review director.

Ontario is unique in barring the ombudsman from investigations into these sectors.

The Liberals argued in the legislature that these bodies already have sufficient oversight. In the case of hospitals, they argued hospital boards and LHINs provide this role. However, hospital boards and LHINs are decision-makers, and as such, have an interest in defending those decisions.

In fact, most LHINs have a staff of about 30 or slightly more. They also have about 200 health care providers to which they negotiate and sign accountability agreements. They are responsible for community engagement, funding, integration decisions, managing projects, as well as collecting and assessing key health care indicators. They are responsible for developing integrated health service plans for their regions. The thought that they could do all this and provide reasonable oversight to investigate complaints by individuals into hospital or long term care homes is absurd.

Surely the Liberals understand this.

However, the McGuinty government has been stung by a number of scandals, many of them health-related. Let’s not forget e-Health. The Ombudsman’s report on the LHINs, “The LHIN Spin,” was undoubtedly fresh in their mind as they contemplated this private member’s bill.

Together with Schedule 15 of Bill 173 (see related articles), it has not been a good month for transparency and accountability in the province of Ontario.

For the record, these were the MPPs in the legislature who voted down Bill 183:

Laura Albanese, Wayne Arthurs, Bas Balkissoon, Lorenzo Berardinetti, Margarett Best, Laurel Broten, Vic Dhillon, Kevin Flynn, Helena Jaczek, Kuldip Kular, Monte Kwinter, Amrit Mangat, Reza Moridi, Leeanna Pendergast, Gerry Phillips, Shafiq Qaadri, Khalil Ramal, Lou Rinaldi, Tony Ruprecht, Liz Sandals, Mario Sergio, and Charles Sousa.

Second Opinion debuts

The Ontario Health Coalition has launched a new quarterly magazine – Second Opinion. 

The Spring 2011 edition debuted last week, featuring stories on legal challenges to private clinics, privatization, debunking spending myths and building a social movement around health care.  20,000 copies of the magazine are being distributed across Ontario.

Copies of the magazine are being sent out to OPSEU’s 22 regional offices next week.  While quantities are limited, any locals wishing bulk copies should e-mail Rick Janson at rjanson@opseu.org

Federal campaign health care platforms: Conservative, Liberals, NDP and Greens

Health care was supposed to be the number one issue for Canadians coming into the Federal election. Within days, all the parties had committed to some level of renewal of the Health Accord, set to expire in 2014. Under that accord provinces have been receiving a so-called “escalator” that automatically increases Federal transfers to the provinces for health care by six per cent per year. By the last year of the accord that transfer should amount to about $30 billion. This was part of what officials once called an agreement to fix health care for a generation. Given the concerns that Canadians have been expressing during the election, they haven’t exactly met that expectation.

The Federal party platforms vary considerably, from the 98-page Liberal Red Book, to the 66-page Conservative “Here For Canada” platform, to the 12-page Green Party Platform. While the NDP features a brief point-form platform on their web site, there is no book.


In his opening message to the Conservative platform, Stephen Harper doesn’t actually use the word health, although one of the top five priorities, to support families, includes a promise of more support for seniors and caregivers.

That reference is to a $2,000 Family Caregiver Tax Credit for those who care for “infirm loved ones at home.” The tax credit would apply to those caring for an infirm spouse, common-law partner, and children of minority age.

The Conservatives have said they will work collaboratively with the provinces and territories to renew the Health Accord and to continue reducing wait times. A separate agreement would be negotiated with Quebec.

With little accountability embedded in the first Accord, the Conservatives say in their “discussions” they will “emphasize the importance of accountability and results for Canada.” However, they also state in the next paragraph that they “will respect the fact that health care is an area of provincial jurisdiction and respect limits on the federal spending power.”

During the leaders’ debate, Stephen Harper said he had a different definition of privatization than Jack Layton. Harper did not include private delivery of publicly-insured health services as privatization, which he refers to as “alternate delivery.”

In a CBC radio debate earlier in same day as the leader’s debate, Colin Carrie (PC MP-Oshawa) said he rejected David Dodge’s four solutions (see story on Diablogue) for health care, suggesting it was not an either/or scenario. The Conservatives are often criticized for not holding up the Canada Health Act (particularly around private clinics). Carrie said “it was the law of the land.”

Carrie said the government is working on programs to keep Canadians well, including doubling the children’s fitness tax credit to $1,000 and establishing an adult fitness tax credit of $500. Neither would be implemented until the federal budget is balanced — according to their plan, that would be 2014-15.

Many in the media have questioned how the Harper government could reduce taxes and escalate health care spending faster than growth in the economy.

Prior to the election call, MP Maxime Bernier had suggested in 2010 the Federal government get out of health care and transfer tax points to the provinces instead. A tax point transfer effectively means the Federal government would reduce taxes to the equivalent of what the provinces need to raise them by, leaving the tax rate the same for individuals. There are several obvious risks to this.

  • The provinces could use the tax points to implement their own tax cuts.
  • We would lose any semblance of consistent health care delivery across Canada.
  • The Federal government would lose any leverage by which to enforce the Canada Health Act, allowing provinces to further privatize and delist services.
  •  Charges for hospital services and extra billing would be allowed to thrive.

Bernier claimed it would allow the provinces to experiment more with different delivery models. The Canada Health Transfer is expected to hit $30 billion by 2013. At the time the PMs office said Bernier was not speaking for the government.

However, Harper himself said as much back in 2001 in the now famous “fire wall” letter to Alberta Premier Ralph Klein. In the letter, Harper, then President of the anti-Medicare National Citizens’ Coalition, argued that “each province should raise its own revenue for health care — ie., replace Canada Health and Social Transfer cash with tax points as Quebec has argued for many years.”

(To get a full history of Stephen Harper’s attacks on Medicare, journalist Murray Dobbin has a detailed chronicle at http://murraydobbin.ca/2011/04/16/dr-harpers-new-and-improved-medicare/  The Star’s Thomas Walkom also looks at Harper’s record, including lack of enforcement of the Canada Health Act, at http://www.thestar.com/news/canada/politics/article/977249–walkom-harper-and-the-subtle-erosion-of-medicare )

Ujjal Dosinjh, the former Liberal Minister of Health, told CBC radio the Tories pushed the health accord into the Senate “to wash their hands of responsibility.” He raised Bernier’s comments and said the Harper government had a “shrinking view” of the Federal role in health care. Megan Leslie, an NDP candidate from Halifax, said the PM had started no conversations with the provinces on the next health accord.

To read the Conservative’s “Here For Canada” platform, go to http://www.conservative.ca/media/ConservativePlatform2011_ENs.pdf


Unlike the Prime Minister, Liberal leader Michael Ignatieff places considerable emphasis on health care in his opening message. Stating the Liberal platform is about equal opportunity, he says Liberal governments have built up the foundations of equality, including establishing universal Medicare. The Liberals have one of the more developed health care platforms among the four major parties. Ignatieff has also promised a Federal-Provincial summit on health care with the Premiers within 60 days of taking office. The Liberals have pointed out that the Harper government has never convened a first minister’s meeting on health care.

While much attention has been spent on their pledge to renew the Health Accord and provide $1 billion for home care, less attention has been paid to their promise to scrap the Harper government’s Public Private Partnership Fund, which the Liberals claim has only delivered 8 per cent of the funds allocated to it. The Liberals would instead use the money for public housing.

P3s have been a feature of much of the recent debate over the Provincial Liberal plans to build new hospitals in Ontario.

The Family Care Plan is similar to the Tory plan – instead of providing funding for professionally-delivered home care services, the money is aimed at supporting families to provide care themselves. One half of the Liberal plan would include an extension of the six-week EI benefit for those who have to take time off of work to care for a “gravely ill” family member. To be eligible, the family member must be “gravely ill with a significant risk of death within 26 weeks.” The Liberals would thereby extend the current six week period to six months (26 weeks).

A new Family Care Tax Benefit would assist low and middle-income family caregivers who provide “essential care” to a family member at home up to a year.  The maximum is relatively modest at $1,350 per year. The Liberals estimate 600,000 family caregivers could take advantage of the benefit at a cost of $750 million per year.

The Liberals feature numerous initiatives on health promotion, including investments in sport and the establishment of a national food policy:

  • Working with the provinces to set national targets for physical activity in primary and secondary schools;
  • A Healthy Choices program to educate Canadians on health eating;
  • Progressive labelling regulations for food, including improving the regulatory process for new health claims;
  • Standards on transfats and salt;
  • $40 million annually for a healthy start program to help children from low-income families to access healthy home-grown foods;
  • A comprehensive review of the Canadian Food Inspection Agency;
  • An increase of $50 million over four years to improve food inspection;
  • Using athletes as role models, the Liberals would commit to stable and sustained funding for “Own The Podium” and Sport Canada.

The Liberals also commit to a Canadian Brain Health Strategy to assist Canadians coping with diseases such as Alzheimer’s, Multiple Sclerosis, and Parkinson’s Disease. The strategy includes public education on prevention, $100 million over two years for research, a sharing of best practices, and a more vague promise to look into potential economic supports for families coping with brain disorders and legislation to prevent discrimination against people showing symptoms.

The Liberals say they will work with the provinces to ensure all Canadians have coverage for catastrophic drug costs for illnesses such as cancer, diabetes, or arthritis.

The Red Book also makes several vague promises to work with the provinces and territories to bolster innovation in the health and bioscience field, improve rural health care, bring down prescription drug costs, improve home care, and address priority areas such as mental health and palliative care.

During a CBC-radio three-party panel on health care, former Liberal Health Minister Ujjal Dosanjh identified new technology and drugs as the largest drivers of health care costs, but said it was something a Liberal government could handle.

To see the full Liberal plan, go to: http://www.liberal.ca/issues/

New Democrats

The NDP have also committed to renewing the Health Accord for another decade, including a six per cent escalator. The NDP would put strings on the money – including “a clear, monitored and enforced commitment to respect the principles of the Canada Health Act.”

The NDP say they will work with the provinces to promote a clear commitment to the single-payer system, make progress on primary care, take steps to replace “fee-for-service” delivery, and take the first steps to reduce the cost of prescription drugs.

The centerpiece of the NDP platform is a plan to work with the provinces to increase the number of doctors, nurses and other health professionals, although the document only sets specific targets for the doctors (1,200 over the next 10 years) and nurses (6,000 new training spaces over six years). To put this modest promise in perspective, 120 new doctors per year would be added to the already existing 65,000 doctors in Canada — an increase of about 1.8 per cent over a decade. Likewise, there are about a quarter of a million nurses, of which the NDP would add an averge of 1,000 per year. 

While the NDP are pledging $165 million to create these new training spaces for doctors and nurses, they are also promising to increase the number of doctors and nurses (no mention of other health professionals) as a priority within the first 100 days.

Jack Layton said “we can’t wait three more years for the government to hire doctors and nurses for families who need them now.” Given the length of time it takes to become a doctor or a nurse, the training spots are not going to fulfill this promise. No detail is in the NDP platform on how many or where this immediate supply of doctors and nurses will come from. 

The NDP would also establish programs aimed at recruiting and supporting low-income, rural and aboriginal medical students.

Unlike the Tories and Liberals, the NDP would designate funding to guarantee a basic level of home care services. They would also include a federal transfer to increase long term care “spaces” and double funding for forgivable loans under the Home Adaption for Seniors’ Independence Program, a program intended to help seniors remain in their own homes. They would help up to 200,000 families a year to retrofit their homes to create self-contained secondary residences for senior family members. The “forgivable loan” would cover 50 per cent of the costs of a renovation up to a maximum of $35,000.

The NDP’s promises on pharmaceuticals include improved assessment to ensure the quality, safety and health effectiveness of prescription drugs, savings through bulk purchasing, a more aggressive price review, and the elimination of kickbacks from drug companies to pharmacists.

In the way of prevention, the NDP offer a Children’s Nutrition Initiative to expand provincial and local programs that provide healthy meals to school children. They would also introduce a National Strategy for Serious Injury Reduction in Amateur Sport Act – a plan to reduce concussions through a variety of strategies.

To review the NDP platform, go to:  http://www.ndp.ca/platform


Elizabeth May says the Green are not a one-issue party. Their 130-page “Vision Green” document is the most comprehensive of the four parties. However, there is very little in their posted 12-page election platform specific to health care. Her platform introduction makes a reference to living in healthy communities and enjoying a life-giving, healthy natural world, but nothing specific to improving health care delivery or prevention.

Vision Green, on the other hand, makes a strong commitment to upholding the Canada Health Act, including measuring the extent of two-tier health care in Canada and striving for its elimination.

It advocates not only the education and hiring of more medical staff, but also re-opening many of the beds that have been closed, better utilizing operating rooms, and purchasing new diagnostic equipment. Unfortunately, while they do talk about needing more health professionals in their preamble, the platform only talks about providing funds to train more doctors and nurses. They call for the fast-tracking and on-the-job mentoring of foreign trained health care professionals.

The Greens call for forgiveness of student loans for graduating doctors, nurses, paramedics, and other health professionals who agree to staff rural facilities and family practice clinics where recruitment is currently a problem.

The Greens also call for expansion of public coverage to proven alternative therapies such as chiropractic, massage and acupuncture. Their health plan also includes a national pharmacare program, accepting the principle that Canadians should spend no more than three per cent of total after tax earnings on necessary prescribed medications. Like the NDP, they would put emphasis on the effectiveness of drugs covered under the formulary.

Vision Green plans to expand home support, home care programs and assisted living services. At a time when seniors are being threatened with illegal hospital charges if they don’t take the first available long term care bed, the Green’s promise to enshrine a policy that seniors’ care must be provided in the communities where they or their families live.

The Greens would also transfer more money to the provinces to open more long term care beds.

The Greens have an extensive prevention platform, including $500 million over five years to aggressively address inactivity and youth obesity.

For mental health, the Greens would transfer funding for non-institutionalized mental health agencies.

While Vision Green sounds great, the budget numbers put forward in the other document – the election platform – certain does not include the wide sweep of Vision Green. The budget does include $300 million a year for national pharmacare and $43 million for a national campaign to discourage marijuana use after the Greens legalize and tax it. Canadians spend about $25 billion per year on pharmaceuticals, which leaves the Green’s $300 million rather limited in its ability to provide universal coverage.

To read the full Vision Green document, go to: http://greenparty.ca/files/attachments/vision_green_april_2011.pdf

To read the Green election platform, go to: http://greenparty.ca/files/attachments/green-book-2011-en.pdf

Groundhog Day again – new CD Howe report uses old data to raise panic about health care sustainability

Dr. Michael Rachlis told the CBC’s The Current that it was like Groundhog Day all over again.

Discussing the latest CD Howe Institute Report “Chronic Healthcare Spending Disease,” Rachlis and Diane Gibson, Research Director of the Parkland Institute, took issue with the gloomy scenarios painted by former Bank of Canada Governor David Dodge and Richard Dion, a Senior Business Advisor with the law firm Bennett Jones.

The reports authors argue that health care spending is unsustainable, forcing Canadians to have a conversation about how to pay for it. The report outlines just four options:

  • a “sharp reduction” in public services other than health care
  • increased taxes
  • co-payment or delisting of services
  • a major degradation of publicly insured health care standards

Dodge, in an interview earlier with the CBC, had said health care costs were rising faster than growth in the economy due to advances in technology, a demographic shift, and prices and wages rising.

He said it was his “hunch” that all four of the scenarios would be implemented to some degree.

Rachlis questioned why the authors of the report used data from 2009 to support their argument instead of 2010. Rachlis says that according to the data, health care spending as a percentage of our overall economy went down (from 11.9 per cent to 11.7 per cent) and that the cost curve will continue to decline over the next three years.

He called Dodge “factually wrong,” stating the CD Howe Institute authors chose to draw their figures from the deepest year of recession. When the economy shrinks, as it did in 2009, it makes health care spending look larger. In fact, he said, health care recorded one of its lowest levels of growth in 2009.

“I don’t know why a report in April does not have data from 2010,” he told the CBC.

Rachlis said costs were in decline in part of because brand name pharmaceuticals have levelled off in price with the expansion of generic drugs. Drugs have been among the fastest rising category within health care.

Diana Gibson said it made no sense to delist services and make Canadians pay out of pocket. “As citizens we pay either way,” she said. By pooling our resources through the tax system, it would be “cheaper.”

She highlighted how the costs of vision care increased 17 per cent after being de-insured, and how the Canadian Centre for Policy Alternatives estimated $10.7 billion could be saved through a national pharmaceutical plan.

Frustrated with the “the same stupid debate,” Rachlis said there were numerous examples of how we could improve our system, but we never hear about them.

Gibson hinted at a motive behind these panic scenarios – she said that health care is attractive to private business – it is not only recession-proof, but demand goes up during a recession. “People are willing to pay whatever it takes. That’s an amazing business opportunity.”

Rachlis and Gibson also argued that the silver tsunami doesn’t really exist – that increased costs due to aging are averaging less than one per cent per year, well within normal levels of economic growth.

Dodge had told the CBC that costs would likely rise to 18 per cent of our economy by 2020. Even with better efficiencies and improvements to the system, he said it would only slow it down to 15 per cent. The problem is the data just doesn’t support that scenario.

He claimed that we don’t really have universal health care now, since 30 per cent of health care spending is private. He said the discussion should really be about where the borders between public and private health care should be.