Tag Archives: Hudak

Can Ontarian’s afford more PC long-term care?

The Progressive Conservatives (PC) under Tim Hudak say they will add an additional 5,000 long-term care beds on top of the 35,000 that are already coming on stream. There is no reason to suggest that Hudak will handle this any different than his predecessor Premier Mike Harris did.

Historically, the relationship between the Conservatives and the long-term care corporations has been very tight.

In 1998, when the government announced a $1 billion would be spent to create 20,000 new long-term care beds in Ontario, the PC’s received large campaign contributions from the top three private for-profit long term care corporations operating in Ontario: Extendicare, Liesureworld, and Central Park Lodges Real Estate Income Trust (CPL REIT)

In 2001 when the tenders were announced, two thirds of the new beds were awarded to for-profit operators. Extendicare, Leisureworld, and CPL REIT received 39.5 per cent of the contracts.

Upon the completion of construction, all the sites received the provincial per diem funding for all beds in operation just like the other facility operators but also continue to receive an additional subsidy of up to $10.35 per bed per day, payable for the next 20 years to offset the cost of borrowing and construction. That is $75,550.00 per bed over 20 years.

This was an unprecedented subsidy of the construction costs for the private sector. After 20 years the facility operators will own the new building with no further obligation to the taxpayers.

In 2001 the private for-profit nursing homes began to operate the majority of LTC home beds in Ontario.

In 2003, Chartwell Real Estate Income Trust (REIT) was formed by consolidating three other private long-term care home operations and according to its trust document was established for the purpose of investing in a portfolio of income-producing seniors facilities. It has grown into one of the largest private long-term care providers in Ontario.

According to information obtained by the Ontario Health Coalition in 2008 through a Freedom of Information request, the lowest level of care is provided in the for-profit nursing homes compared to the not-for profit and municipal facilities.

The latest available data shows Ontario pays 36 per cent more in accommodation rates for long-term care than other provinces.

Most of the large private for-profit operators are structured as a Real Estate Income Trust (REIT) so they don’t pay any corporate taxes.

There is a critical need for long term care beds in Ontario. To get the most efficiency for public funding,  Ontario needs to invest in not-for profit and public long term care beds.

Provincial Tories to keep health tax after all

The provincial health tax will remain in place if Tim Hudak’s Tories win the October 6, 2011 election.

The Toronto Star reports a “source” confirmed the tax would stay despite earlier promises to the contrary.

In February Hudak issued a press release calling Health Minister Deb Matthews a liar for suggesting to a group of visiting nurses the Tories would cut both the tax and the provincial health budget.

Four days after the press release, Hudak reversed himself again suggesting that everything was on the table, including the health tax.

Cutting the health tax would take $3 billion out of provincial revenues that contribute to the $47 billion health budget.

Hudak is expected to reveal his campaign platform at this weekend’s PC convention in Niagara Falls.

What’s beyond the LHINs? Hudak says he’d replace them with nothing

There is no question the Local Health Integration Networks have had their share of problems.

When they were first proposed in 2005, OPSEU warned that it would lead to a rationalization of health care services and shield the politicians from unpopular decisions. To a degree, both concerns have turned out to be true.

One of the few promises provincial Tory leader Tim Hudak has made is to scrap the LHINs. The Tories say it would save $250 million, however, that is the total cost of the LHINs since 2006, not the annual cost. At present the LHINs take about $70 million per year to administer. On a $47 billion health budget (about half of which is within the jurisdiction of the LHINs) that’s a very small percentage allocated for administration.

If Hudak were to scrap the LHINs, he would not even save the $70 million. The LHINs replaced seven regional Ministry offices and 16 District Health Councils which previously cost $48 million. With inflation, the costs would likely remain equivalent to the LHINs if Hudak were to turn the clock back.

But Hudak says he would not replace the LHINs, he would simply cut them. We’re not sure how that would work, and likely neither does Hudak.

Dismantling the LHINs would not be free, as we discovered in the transition from District Health Councils and Regional Offices to LHINs. Costs ranging from broken leases to severance costs would be borne by government. Then there is the cost of transitioning the work.

Hudak doesn’t say what existing infrastructure would absorb the LHIN work, from planning and accountability to public engagement and integration. Is he actually suggesting we don’t need these functions?

The recommendations of the Health Restructuring Commission once dominated Ontario’s health care policy-making. Those recommendations are now more than a decade old. The data by which they came to their conclusions is closer to two decades old. There is a need to gather new evidence and make sound decisions around the future of our health system.

If we are to move forward we really have two choices – reinvent the existing LHINs, or come up with a new structure altogether. Both have their pros and cons.

Unfortunately the McGuinty government never followed-through on the requirement in the Local Health System Integration Act to conduct a review of the LHINs after five years. That would be now.

Neither did McGuinty ever produce the provincial plan that was supposed to be the guiding direction for the LHINs. Instead the LHINs scramble to fulfill whatever priority whim is the flavour of the day at Queen’s Park. Nowhere was this clearer than in the province’s focus on alternate level of care.

While the LHINs were making plans to utilize their aging at home funding, the Ministry changed its mind and suggested that at least half that money be devoted to getting ALC patients out of hospital.

Regardless of who gets elected, it is likely the LHINs will look very different after the October provincial election.