By macleans.ca - Monday, January 28, 2013 - 0 Comments
The tough choices that aren’t being made
This is as good as it gets, demographically speaking. Right now, Canada is in a demographic sweet spot. Our dependency ratio is currently at an all-time low of 59 dependents (those under 19 and over 65 years old) per 100 working-age adults, who pay the bills. Our share of non-workers to workers will never be so favourable again.
Two well-established trends are behind our current situation: a decline in the percentage of young Canadians due to falling birth rates; and the fact that the bulk of the baby boom generation is still working.
The problem is that this fortuitous circumstance can’t last. Public purses will soon be hit by a rising dependency ratio spurred by a flood of boomer retirees, improvements in longevity and continued sluggishness in births. In theory, governments would adapt to this changing situation by reallocating spending. In its regular update on Ottawa’s long-term fiscal outlook, for example, the parliamentary budget office recently noted that: “Population aging will put . . . upward pressure on programs whose benefits are mostly realized by Canadians in older age groups, such as health care, elderly benefits and public pension benefits.” Such a future funding crunch, however, will be “partially offset by reduced spending on programs with benefits largely focused on younger age groups, such as education.” Continue…
By The Canadian Press - Wednesday, December 5, 2012 at 7:40 PM - 0 Comments
TORONTO – A patients’ advocacy group that says Ontario hospitals are being forced to…
TORONTO – A patients’ advocacy group that says Ontario hospitals are being forced to close beds, shut clinics and cut services that cannot be replaced by community-based agencies is off base, Health Minister Deb Matthews said Wednesday.
“I’m afraid they’re wrong. Services are not being cut,” Matthews told reporters.
“We are shifting where we’re spending, so if somebody can go home from hospital _ get the home care they need at home _ then we want to support them.”
The Ontario Health Coalition said a zero per cent budget increase has forced hospitals to cut services, with out-patient clinics for everything from physiotherapy and pain management to cardiac rehab and audiology being closed across the province.
“The services being cut in hospitals aren’t even provided by home care; you don’t replace a pain clinic in home care, you’re not replacing five hospitals in Niagara with home care, you don’t replace a medical-surgical bed with home care, said coalition director Natalie Mehra.
“The smoke and mirrors is the rhetoric that these are all trade offs, that there are no real cuts happening.”
The government has been increasing funding to the home care and community care sectors to get so-called Alternative Level of Care patients who don’t need to be in expensive hospital beds back home or into a long term care facility.
“We’re seeing our ALC rates in hospitals _ that’s how many people are in hospital who don’t need to be in hospital _ in many parts of the province those rates are coming down rapidly because we’re investing more in home care,” said Matthews.
“We’re improving the care people are receiving, but we’re doing it in a way that gets better value for our health care dollars, so we’re supporting more people at home, more people in the community.”
The New Democrats said they were concerned about the ability of a “health care system that’s falling apart” to keep people healthy once they leave hospital.
“The government’s promise that health care would be protected is being broken, and we’re seeing it in every community,” said NDP Leader Andrea Horwath.
“We’re seeing people who are being sent home from hospital, but don’t have the supports or home care that they need to recuperate and they recycle right back into the emergency ward again.”
The coalition said home care is being more strictly rationed and a recent increase in funding for home care is nowhere near enough to deal with lengthy waiting lists.
“Home care clients are increasingly being wait-listed, or they’re being referred to community agencies who provide something less than home-care services, because there’s not enough money in home care, or they’re just being denied services,” said Mehra.
“They’re seeing much more complex patients, who cost more to provide for, but home care funding per client is shrinking because there are so many more patients being dumped into home care.”
Some patients are forced to pay $50 to $70 for every physiotherapy treatment when hospital clinics close and they are sent to private facilities, added Mehra.
However, Matthews said the government’s efforts to redirect its health care spending should not force people to pay out of pocket for services previously covered under the Ontario Health Insurance Plan.
“Not at all,” she said.
The health coalition said Ontario ranks eighth out of 10 in provincial health care funding, and dead last when it comes to per capita funding of hospitals.
By macleans.ca - Monday, October 1, 2012 at 6:27 AM - 0 Comments
The political workweek of Sept. 24-28 generated five stories with sequels and endings and next chapters that we look forward to reading (and writing):
- The outcry over Public Works Minister Rona Ambrose’s surprise vote in favour of a Tory backbenchers’s motion to study when life begins might have been the sort of story flares briefly and is soon forgotten. After all, even though Ambrose also has cabinet responsibility for the status of women, her vote in the House for a study, which would have reopened elements of the abortion debate, didn’t have much practical impact: the motion was easily defeated. Full stop? Maybe not. For starters, another Conservative MP plans to table a motion condemning sex-selection abortion, a matter on which Ambrose expresses deep concern. She’s been praised for her handling of shipbuilding contracts, trusted by Prime Minister Stephen Harper sort out the F-35 fiasco, but will she become a political liability for reasons that have nothing to do with her core files? Continue…
By Gabriela Perdomo - Thursday, April 12, 2012 at 2:30 PM - 0 Comments
“Call as soon as you’re pregnant,” is what busy midwifery clinics advice Canadian women to do, and more and more moms-to-be are running to the phone as soon as they get a positive test result. A lucky few will get on a waiting list, even fewer will get to see a midwife.
Midwives are becoming increasingly popular across the country. Their job is backed by glowing patient reviews and by a swath of independent reports that praise the nurturing, safe, and low-cost approach to birthing championed by midwifery.
But while midwives are all the rage, you’d never know it from looking at their salaries.
Data provided by the Canadian Association of Midwives show the vast majority of them earn annual incomes of about $65,000, whether they are salaried public employees, like nurses, or independent professionals, like most family doctors.
Even in Ontario and Alberta, the highest paying provinces, only a handful of them (barely) break the $100,000 ceiling. In comparison, the lowest-paid salaried nurse in Ontario made $78,054 in 2009.
By John Geddes - Tuesday, December 20, 2011 at 12:33 PM - 0 Comments
Finance Minister Jim Flaherty’s decision to lay down the law, rather than open up negotiations, on health care transfers from the federal government to the provinces might have been a tad undiplomatic. But there’s only so much anyone can say about the etiquette of federal-provincial relations without losing all contact with reality, and that leaves us with numbers, not niceties, to consider.
And the figures Flaherty put on the table look pretty big. He promises to maintain the current 6-per-cent a year pace of growth in health transfers to the provinces until 2016-17, and after that peg the annual hike to nominal gross domestic product growth, or the increase in GDP plus inflation. Projecting with confidence that far out is impossible, but you’d expect nominal GDP to grow by at least 4 per cent [check the update below].
By John Geddes - Saturday, April 9, 2011 at 11:47 AM - 13 Comments
The most consequential promise of this election campaign—issued this week by both the Conservatives and the Liberals—is the pledge to keep raising federal transfer payments to the provinces for health care, apparently indefinitely, at six per cent a year.
That was the “escalator” rate established under Paul Martin’s 2004 deal with the premiers, which expires in 2014. Renegotiating the pact had loomed as a major challenge for the next federal government. Now, the big decision appears to have been made in advance, not at the fed-prov bargaining table, but on the hustings.