Last week’s provincial budget was accompanied by an uncharacteristic snippy release from the Ontario Hospital Association expressing disappointment.
While OHA CEO Pat Campbell says there are a few positive initiatives for hospitals and the health care system, the chief complaint is over the lack of a comprehensive capacity plan.
That’s likely a fancy way of saying the government is cutting the heck out of us, putting some of that money elsewhere, and hoping it all balances out okay. If we are looking for any more sophistication than that from government, we’re likely to be disappointed.
Health Minister Deb Matthews has repeatedly said that downsizing hospitals in favor of more community based care is the plan. In the budget they go as far as listing endoscopies, dialysis and vision care as the next wave of services to be divested to not-for-profit clinics, even if no evidence is presented on costs.
Like the rest of the budget, Ontario Finance Minister Charles Sousa did little to change the course of last year’s austerity budget with regards to health care.
One thing is certain – health care is gradually shrinking as a percentage of program spending by government contrary to the hysteria by anti-Medicare advocates. This year it’s projected to be 41.8 per cent of what the government spends on programs and services. Just two years ago the government was talking about spending 46 cents of every program dollar on health care and the media were regularly rounding it up to half the Ontario budget.
In dollar terms, health care gets $1.3 billion more over last year, moving it up to a total of $48.9 billion in spending. That’s about $300 million more than was forecast in 2012. The bad news is the government left $560 million of last year’s health budget unspent, much of it in the hospital sector where job and service cuts are becoming increasingly common.
If the government had been budgeting for inflation (1.2%) population growth (1%) and the effects of aging (1%) health care would need an absolute minimum of $1.52 billion more simply to stand still. That may even be a bit low – health care costs generally rise a bit faster than general inflation. Drug costs, for example, are expected to rise by 5.4 per cent next year.
No matter how the government shuffles the deck, that means continuing austerity for health care.