[CA] Ontario begins health-care system overhaul

[David Baxter PhD]

Ontario begins health-care system overhaul
CBC News
Monday, May 3, 2010

Ontario's Liberal government on Monday took the first step in its new health-care accountability legislation, which could result in drastic changes to the way care is delivered in Canada's most populous province.

In this year's provincial budget, the government said it would move towards a patient-based system that would, in effect, have hospitals competing with each other to deliver patient care. Hospitals that provide the lowest-cost treatments would get more patients, more work and more money.

The legislation introduced Monday is called the excellent care for all act, and if passed would "make health-care providers and executives accountable for improving patient care," according to a news release from the Ministry of Health.


The legislation would require hospitals to:

• Develop and post annual quality improvement plans.
• Create quality committees to report to each hospital board on quality-related issues, including the public annual quality improvement plan.
• Link executive compensation to achievement of quality plan performance improvement targets.
• Implement patient and employee satisfaction surveys and a patient complaints process.

"[Monday's] announcement is a key part of the government's Open Ontario Plan to improve quality and accountability in health care by ensuring health-care professionals work together in the best interests of the patient," said the release.

Saving millions, helping patients possible
The province believes the changes could save millions of dollars every year by forcing hospitals to compete for cash by doing acute care in-patient surgeries more cost effectively than others.

"The government is improving the quality of our health-care system while making it more accountable to patients," said Ontario Health Minister Deb Matthews.

"We want our health-care system to be focused on patient needs with health services supported by the best evidence and highest standards."

Ontario already bases some of its funding on this type of model ? notably in emergency rooms.

But the reform being considered by the Health Ministry would broaden those incentives, and that could result in some procedures being centralized in certain hospitals or cut in others.

Critics say the changes could mean that patients in areas outside major centres would almost certainly have to travel for treatment.

Matthews, however, says the proposed changes are "innovative," and would ensure Ontario is getting "the very best value for the money that we spend on health care."

 

[David Baxter PhD]

In this year's provincial budget, the government said it would move towards a patient-based system that would, in effect, have hospitals competing with each other to deliver patient care. Hospitals that provide the lowest-cost treatments would get more patients, more work and more money... The legislation introduced Monday is called The Excellent Care For All Act

What a joke. This is clearly more baffelgab and bureaucratic nonsense from the McGuinty government, a government that has broken more promises and told more lies to voters than any I can recall in my lifetime - and for someone who is as cynical; about politics and politicians as I am that's saying something.

This has absolutely nothing to do with "a patient-based system". This has nothing to do with "excellent care for all". This has nothing to do with standard of care at all.

It has everything to do with providing the cheapest care possible regardless of quality, just like the first volley this government fired recently in announcing cutbacks to what funds are provided to pharmacists.

I don't blame politicians for trying to save money. I do blame this government for thinking the voters in this province are so stupid that we won't notice what they are doing if they couch it in bafflegab that promises better health care.

McGuinty et al. promised not to raise taxes and then hit us all with a new tax for health care. Now they're telling us (predictably) that they've mismanaged the proceeds from that new tax-that-they-can't-call-a-tax and need to cut services - but of course they can't call them service cuts either.

But we can afford to send 4 and 5 year old children to all day kindergarten, a hair-brained scheme that nobody wants and that nobody needs, least of all the children who have just had two more years stolen from their childhoods.

 

[npd]

I do blame this government for thinking the voters in this province are so stupid that we won't notice what they are doing if they couch it in bafflegab that promises better health care.

Canadians and Ontarians aren't stupid in a general sense, but they don't care, and when you don't care, you are ignorant.

The major reason the federal liberals were in power for so long was that they were the party that did what Canadians wanted -(was it right? who knows moral? who knows..but they just looked at the facts and did what people wanted) I wonder if the provincial Liberals are doing the same here.

 

[David Baxter PhD]

Canadians and Ontarians aren't stupid in a general sense, but they don't care, and when you don't care, you are ignorant.

You're wrong. The problem is not that we don't care. The problem is that in the last election there were too many people like me who refused to vote for Lyin' McGuinty again but were given no viable alternative candidates to vote for. The NDP? No thanks... we still remember Bob Rae. The Conservatives? What Conservatives? They had no party and no policies. Tne Green Party? The Marijuana Party?

McGuinty didn't get his second term because people liked him. He got it because he was the only game in town.

You may not be old enough to remember this but McGuinty was actually sued by a citizen's coalition for breach of promise after his first election and his 100 broken promises in 100 days run. And what did the court say when the suit was dismissed? That Canadian voters cannot sue politicians for breach of promise because by now we should expect them to break promises, i.e., that by now we should expect that politicians are lying to us.

What a system.

 

[npd]

There is good research done that says people rather love a candidate or they don't and they don't care about much else if they aren't comfortable with the person in some way..and that may be the issue for the other parties. So you are right about the candidates part and other parties not having a good alternative. I'm just saying, nobody is winning do to good policy here..because nobody pays enough attention to that and there are competing interests. The candidates matter. Reading the electorate matters as well. Good policy? Meh.

That is the real problem imo. We are never getting the best policy really, (unless by accident) because we just don't educate people enough and people aren't that interested.

btw, i kinda liked Rae. After I read his book anyways.("From Protest to Power"

You're wrong. The problem is not that we don't care. The problem is that in the last election there were too many people like me who refused to vote for Lyin' McGuinty again but were given no viable alternative candidates to vote for. The NDP? No thanks... we still remember Bob Rae. The Conservatives? What Conservatives? They had no party and no policies. Tne Green Party? The Marijuana Party?

McGuinty didn't get his second term because people liked him. He got it because he was the only game in town.

You may not be old enough to remember this but McGuinty was actually sued by a citizen's coalition for breach of promise after his first election and his 100 broken promises in 100 days run. And what did the court say when the suit was dismissed? That Canadian voters cannot sue politicians for breach of promise because by now we should expect them to break promises, i.e., that by now we should expect that politicians are lying to us.

What a system.

 

[David Baxter PhD]

We are never getting the best policy really, (unless by accident) because we just don't educate people enough and people aren't that interested.

Nonsense. People aren't interested in health care? or education? or how much they pay in taxes?

Cynical, yes, and I agree that too many people have become so burned by and cynical about politicians that they've stopped listening and stopped voting. That's not the same as not caring about the issues.

btw, i kinda liked Rae. After I read his book anyways.("From Protest to Power"

According to your profile, you are 25. With all due respect, that means Bob Rae became premier of Ontario when you were 5 and was finally booted out after almost destroying the province when you were 10. I highly doubt that you were paying very much attention to politics back then.

Rae is an intelligent man and he may well be a nice guy, but he was a horrible premier.

 

[npd]

Nonsense. People aren't interested in health care? or education? or how much they pay in taxes?

Cynical, yes, and I agree that too many people have become so burned by and cynical about politicians that they've stopped listening and stopped voting. That's not the same as not caring about the issues.

My parents don't care. Most of my friends don't care. I am younger though, so it could be an age thing, but generally, that is my perception. There is cynicism even at our age range but its mostly a feeling that it doesn't make that much difference anyways.

I'm not saying there are not issues at certain points that are so crucial which naturally engage everyone, but usually, its not a huge difference.

These days, in Canadian federal politics, what is the difference between the Liberals and Conservatives? Not very much at all. A few things here and there, on the whole, they couldn't be closer.

According to your profile, you are 25. With all due respect, that means Bob Rae became premier of Ontario when you were 5 and was finally booted out after almost destroying the province when you were 10. I highly doubt that you were paying very much attention to politics back then.

Rae is an intelligent man and he may well be a nice guy, but he was a horrible premier.

Well obviously I wasn't paying attention back then, I was too young, but I do pay very close attention to politics and read about his reign, read his book, etc

I wasn't around in 1867 in Canada either but I know what happened lol

 

[David Baxter PhD]

My parents don't care. Most of my friends don't care.

I don't think you could consider that a random or representative sample.

I do pay very close attention to politics and read about his reign, read his book, etc

That's like saying I've read about HGitler and the Holocaust so I know what it was like.

Talk to people who lived it.

 

[npd]

That's like saying I've read about HGitler and the Holocaust so I know what it was like.

Talk to people who lived it.

I'm not saying his policies had any impact on me just that I know what he did.

But you don't need personal experience to have a valid opinion on something. Your a clinical psychologist. You don't need to personally experience all mental illness to understand it.

 

[Ronbell]

You're wrong. The problem is not that we don't care. The problem is that in the last election there were too many people like me who refused to vote for Lyin' McGuinty again but were given no viable alternative candidates to vote for. The NDP? No thanks... we still remember Bob Rae. The Conservatives? What Conservatives? They had no party and no policies. Tne Green Party? The Marijuana Party?

This is generally how I feel at the federal level. I voted to maintain the same seat in my riding, just because I was content with a minority government, based on the available choices.

Watching politics is a full time job, or should at least be given the same time devotion as a hobby to have a valid opinion on the subject.

I can take this story at face value, as most Canadians do, but you'd need to see the chain of events that lead up to it and then ascertain the motive behind it. It's not as black and white as the text it's written on, just as opinions on people shouldn't be derived from "reading their book". You're only seeing things from the perspective they want you to see, so "your opinion", isn't actually yours. That's the biggest problem with our generation I find. Were so confident, but were making decisions and arguments on minimal information.

I personally can't stay on top of anything, let alone politics, but I do respect people who do. I think it's important to take into account multiple opinions from people "who do care", and then do some follow up research to verify their claims to form my own opinion; if I'm not going to do the leg work myself.

Just my 2 c.

 

[Michael Smoker]

It's always easiest to blame the political party currently in power for everything, but politicians are even more prisoners of reality than we are. The real problem with health care is continental, if not global. For the past 20 years most health care research has been done for the benefit of expensive American private clinics, where the wealthy pay 1,000 times more for health care than the Ontario government does or can afford to. As these newly researched treatments come online, regulatory bodies require Ontario doctors to prescribe them, forcing the government to pay for them, and so we end up with health care chewing up 65% of the province's general revenue.

There are other factors as well, of course--an aging population with consequently more health problems, the tendency to research only lifelong ongoing maintenance treatments rather than cures, the fact that Ontario is no longer a prosperous "have" province but still pays through the nose in terms of transfer payments, and so on. But what we really new is a medical research community that investigates low-cost permanent solutions to health problems, and there is simply no financial incentive for one to exist.

Michael