Perhaps the most remarkable thing about Ontario’s health-care overhaul is how little we know about what it will actually mean for people who need a doctor’s appointment, lifesaving surgery and everything in between.
Health Minister Christine Elliott finally released legislation to create her new health super agency on Tuesday — weeks after a draft was leaked by the New Democrats — but she largely stuck to talking points about existing problems with health care.
The lack of integration between health care providers, confused patients lost in the middle, unnecessary trips to hospitals because of a shortage of home care services, people in hospital beds who should be in long-term care, and, of course, patients stranded in hospital hallways — Elliott touched on it all.
But how these longstanding problems will be fixed through the new Ontario Health agency is far from clear.
Essentially, the Ford government is continuing down the now well-worn path of deciding that a Liberal-designed system or program is bad and has got to go — before they have worked out the details of what they’ll replace it with.
The McGuinty Liberals created the Local Health Integration Networks to bring health-care decisions closer to the community level. Now, Ford’s Progressive Conservatives are going back to a more centralized model. The 14 LHINs and their sub-regional bodies are largely being collapsed into one mega agency with up to 50 local health teams to co-ordinate services across the province.
The possibility that these teams, which might include doctors and hospitals, along with home care agencies and long-term care homes, could share one budget has the potential to deliver positive change. It would provide a clearer incentive to ensure that patients can access the right care in the right place, which generally costs far less than waiting for things to escalate into crisis.
But if this is also the government’s way to shave dollars out of the health budget, that potential goes right out the window.
So what budget will the agency and teams have? Will any money saved through this restructuring be put back into health care? What happens to the independent agencies like Cancer Care Ontario that are caught up in all this?
Elliott has provided no real answers to these questions. Either she’s not saying because she fears people won’t like what they hear, or she herself doesn’t yet know. Neither option provides cause for confidence.
And the concerns highlighted by NDP Leader Andrea Horwath that this overhaul opens the door to more privatization of health services remain.
Elliott denies it, but her early references to there being no privatization because Ontarians will still pull out their OHIP card, not a credit card, to pay for services didn’t help allay those fears since that still leaves plenty of scope for increasing private, profit-driven interests in health care.
So far, this restructuring (which is expected to take years) seems to be another way for the government to buy itself time to figure out how to deliver on its election promises to cut hospital wait times, end hallway medicine, build 30,000 long-term care beds and invest billions in mental health. All without ever saying how to pay for it.
The government has also said that “sacrifices” will be needed to tackle the provincial deficit, which it inflated through accounting practices. That fact can’t help but colour all the airy pronouncements that this overhaul is necessary for a “seamless” and “21st century approach” to health care.
There’s no doubt Elliott wants to deliver “better patient care,” as she says. Who doesn’t want that? But her government has also made it crystal clear that it’s looking to reduce costs everywhere it possibly can.
And Ontarians already know how rarely those two things go together when it comes to the health services they rely on.
https://www.thestar.com/opinion/editorials/2019/02/28/health-reform.html
Recent Comments