The issue that defines us as Canadians -- health care -- is one of the hot-button issues in the Ontario election.
No wonder. Health care consumes 43 cents of every dollar collected in taxes or transferred from the federal government, according to the Conference Board of Canada, with the growth in spending the past 15 years averaging 6.5% annually.
If that's not enough, the challenge is daunting to deliver services people expect and need: One in six hospital beds is occupied by someone who no longer needs it but can't be cared for at home because of a lack of support services, or can't find a spot in long-term care. That bottleneck has backed up our emergency rooms, creating delays, and in London has caused patients to be placed in hospital wards whose staff lack the expertise to provide optimal care.
Those pressures will grow worse as our population ages: In the next decade the number of Ontarians over age 75 is expected to grow 32%.
While all Ontarians will have a say over the future of health care when they go to the polls Oct. 6, Londoners will play a special role -- we'll decide whether to endorse the efforts of Liberal Health Minister Deb Matthews in her riding of London North Centre or vote her out.
If anyone had any doubt of the high stakes here, consider that last week Matthews declared her government will foot an estimated $15-million tab to demolish South Street Hospital and clean that site so London, which owns the land, can sell it for development, land that happens to be in Matthew's riding.
Matthews wasn't shy about linking the funding decision to her influential seat in cabinet.
Nor was NDP health critic France Gelinas of the Nickel Belt.
"The only reason (Matthews) made the announcement is she wants to hold on to her seat and we're in an election. The minute all the other municipalities hear London get this from the province they will all be in line (for money)," Gelinas said this week.
Matthews said she understands what's at stake, not just for her, but the future of health care.
"We need to make changes to our health-care system so we can sustain universal health care," she told The Free Press.
There are surprisingly few differences in what changes are being advocated by Ontario's three leading political parties.
Liberals, Conservatives and New Democrats all say universal public health care is a core Canadian value they'll preserve.
All say they'll increase spending on health care overall and place a focus on home care and clearing the bottleneck of health-care beds. All seem committed to caring for more of the mentally ill in the community rather than in psychiatric hospitals.
None speak much about how so much of our health care is neither universal nor public:
- One-third of health-care dollars are spent on private care and only those with private insurance or who qualify for certain government programs get low-cost access to pharmaceuticals, eye care, dentistry and psychologists.
- Wait times vary across the province and those with money sometimes seek health care outside our borders.
Our collective decision may come down to this: Which political party do we most trust to make changes.
Conservative health critic Christine Elliott of Whitby-Ajax says voters have run out of patience with Liberal leadership.
"This is a government that promised a 10-year plan three years ago and still hasn't (delivered it)," Elliott said. "We have a plan to deliver a patient-centred plan."
Gelinas says it's New Democrats who are most committed to fixing what ails health care and safeguarding it for future generations.
"We are the party of Tommy Douglas," Gelinas said.
Not surprisingly, Matthews has a different take: She contends her party has reduced surgical wait times and helped many more Ontarians get family doctors. Her party should be trusted to overcome other challenges, she says.
"We have some momentum going. We've come such a long way and we need to keep going forward."
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What the parties say:
Where the New Democrats, Liberals and Conservatives stand in six areas within the critical health-care issue.
1) How do you clear the logjam of hospital beds?
NDP: Provide more and better home support and stop bidding out work to bottom-dollar private companies. Improve primary care through family health centres.
Conservatives: Add 5,000 long-term care beds and spend more on home care, especially to help with non-medical household needs so people can be treated at home.
Liberals: Get more people in hospital to go home with support. Use nurse-led outreach teams to treat those in nursing homes. Build community support.
2) How do you close mental health beds and move care to the community?
NDP: Create a single body responsible for the design, management and co-ordination of the system.
Conservatives: Create more supportive housing and help for people with mental illness and a second, serious cognitive problem.
Liberals: Ensure there's enough community support before closing beds because there are high social costs if patients in the community go untreated.
3) Who pays to close South Street Hospital?
NDP: There are another 18 Ontario communities that want money to decommission their own hospital sites and all should be helped, not just the one in Matthews's London riding.
Conservatives: An Ontario government with a $14-billion deficit can't afford to remediate all old hospital sites so it's irresponsible and politically expedient for Ontario's health minister to promise $15 million for her riding.
Liberals: Announced during the election the provincial government will pay the full tab, drawing cheers in London but jeers from other parties.
4) Chief executive salaries
NDP: Cap hospital CEO and executive pay at $418,000 -- twice the premier's salary.
Conservatives: Dock pay from CEOs who don't meet performance targets.
Liberals: Reduce pay in a "meaningful" way if hospitals don't meet performance targets they set for themselves with Health Ministry oversight.
5) Transparency
NDP: Scrap regional bureaucracies called Local Health Integration Networks (LHINs), extend ombudsman oversight to hospitals and long-term care facilities and get rid of a Liberal loophole that would enable hospitals to shield records from citizens.
Conservatives: Scrap LHINs, require open bidding on contracts and get rid of a Liberal loophole that would enable hospitals to shield more records from citizens.
Liberals: Preserve LHINs because they create more accountability, not less. Back legislation that allows public access to hospital records and the exceptions to that access backed by hospitals.
6) Emergency rooms waits
NDP: Cut wait times in half, funding new family health-care clinics providing 24/7 care and investing in long-term care and home care.
Conservatives: Spend more on home care and long-term care so ER patients can get a hospital bed more quickly.
Liberals: Invest in home care and continue efforts to relieve pressure on ERs -- 21 short-stay beds have already been created.
E-mail jonathan.sher@sunmedia.ca, or follow JSheratLFPress on Twitter.
Source: http://www.lfpress.com/news/london/2011/09/30/18766241.html
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