Some have said the October 10 Ontario
election is in large part a referendum on the current
Liberal government's record managing the province's
giant healthcare budget. With its large population,
huge territory to administer and its ever-rising healthcare
expenses, Ontario's campaign debate has thus far proven
them right. Many of the most important battles between
the three major parties have been waged over the sustainability
of healthcare spending.
PREMIUM
PLEDGES
Ontario's $2.4 billion health premium - introduced in
2004 despite the Liberals' promise during the 2003 election
campaign not to raise taxes — has become the main
rallying point for the opposition Progressive Conservatives
and third-place NDP.
"The so-called health tax is nothing
more than a huge tax increase and one of the biggest
broken promises in political history," PC leader John
Tory stated in a release. Mr Tory has pledged to eliminate
the tax entirely within four years, but insists he will
be able to increase healthcare spending by $8.5 billion,
in part by making the system more efficient. NDP leader
Howard Hampton has also proposed phasing out the health
tax and promises a $450 refund per person next year
if he is elected. To offset the loss of tax revenue,
Mr Hampton says he would raise income taxes for the
wealthy.
In response to critics of the health
premium, Liberal deputy premier and health minister
George Smitherman has warned that cuts would threaten
healthcare services. "All of the progress we've made
to reduce wait times and boost the number of doctors
and nurses is at risk," he said in a release.
Premier Dalton McGuinty has said
he had no choice but to introduce the tax after inheriting
a $5.6 billion deficit from the former Conservative
government. He pledges no further tax hikes, but insists
it's necessary to maintain the health premium. However,
for the 2006-07 fiscal year the McGuinty government
posted its second consecutive balanced budget and a
$2.3 billion surplus.
Livio Di Matteo, PhD, a professor
of Health Economics and Policy at Lakehead University,
is doubtful of Mr McGuinty's claims. "Is the health
tax absolutely essential? Probably not," he says. "Revenues
have been healthy over the past few years and the economy
has been relatively stable. Unless there is a major
turn, you could probably phase out the tax by first
reducing it by one quarter, see how that affects things,
and then progressively phase it out."
MEDICAL
CONCERNS
The province is currently short 2,000 doctors and 8,000
nurses by the Ontario Medical Association's count. If
those who are 65 and older decide to retire, it may
lose 2,500 more doctors. The Liberals recently announced
an IMG fast-track program targeting healthcare workers,
but the Tories say the Liberals recruitment strategies
have failed: the number of doctors accepting new patients
has fallen since they took office.
Ontario's progress on e-health
records (EHR) is well behind that of Alberta, BC and
PEI, but the Liberals are still aiming for universal
EHR coverage by 2014. The Conservatives make similar
promises and say they will immediately take advantage
of the federal funding for e-health programs the Liberals
have missed out on.
The news isn't all bad for the
Liberals when it comes to healthcare, however. They've
had some success in reducing wait lists. Wait times
for diagnostic scans, cancer treatment, cardiac operations,
cataract surgeries, and hip and knee replacements have
all decreased since 2005.
PRIVATE
MATTERS
There's one healthcare spending issue that's received
precious little discussion from party leaders so far,
says Eduardo Sousa, a member of the Ontario Health Coalition's
board of directors. "We're not getting a sense of how
committed some leaders are to single-tier health care,"
he says.
The Conservative platform vaguely
commits to public-private partnerships "provided that
services are paid for by OHIP, meet provincial standards
and do not allow queue jumping or patients paying from
their own pockets." That policy has come under attack
from Minister Smitherman who called John Tory the "dance
partner" of new Canadian Medical Association president
Dr Brian Day, whose prescription for Canada's healthcare
system, Minister Smitherman alleged, is motivated by
profit.
With a new lawsuit filed in the
provincial Superior Court challenging the province's
ban on private care (for more on this case, see "New
lawsuit threatens Ontario private care ban" on page
21), Mr Sousa says the parties must be clear on where
they stand. "We want to know how seriously the provincial
government would fight this challenge," Mr Sousa says.
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