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Premier Doug Ford's Ontario

Jasmine18

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I wish there was a middle way in Ontario Politics.

Its Ford with his dumb ideas or the NDP and Wynne types who just keep throwing money down a black hole.
 

AlvinofDiaspar

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That is my point, we think only in extremes about the Canadian health care model.
That is should be fully public which does not even exist in many better European health care systems or that we will have the American Health Care system.
The issue is that I see long term is that health care will cripple our govt budgets but it will lead to just decent or okay at best for all.

You should look at how much public spending the Europeans are providing - just because they have a mixed model doesn't mean the government is spending less there - so if your argument is that it will cripple our budgets, well, using the Europeans as a case study doesn't prove your point. From CIHI:

Here are the numbers for 2015 per-person spending in Canadian dollars, health spending as a percentage of gross domestic product (GDP) and the public/private split for the OECD as a whole and 9 selected OECD countries, including Canada:
  • OECD: $4,826 per person; 8.9% of GDP; 72% public/28% private
  • Canada: $5,782 per person; 10.4% of GDP; 70% public/30% private
  • United States: $11,916 per person; 16.9% of GDP; 49% public/51% private
  • France: $5,677 per person; 11.1% of GDP; 79% public/21% private
  • Germany: $6,709 per person; 11.2% of GDP; 84% public/16% private
  • Sweden: $6,601 per person; 11.0% of GDP; 84% public/16% private
  • Netherlands: $6,639 per person; 10.7% of GDP; 81% public/19% private
  • Australia: $5,631 per person; 9.4% of GDP; 67% public/33% private
  • New Zealand: $4,443 per person; 9.3% of GDP; 80% public/20% private
  • United Kingdom: $5,170 per person; 9.9% of GDP; 80% public/20% private

https://www.cihi.ca/en/how-does-canadas-health-spending-compare-internationally

AoD
 

syn

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You should look at how much public spending the Europeans are providing - just because they have a mixed model doesn't mean the government is spending less there - so if your argument is that it will cripple our budgets, well, using the Europeans as a case study doesn't prove your point. From CIHI:



https://www.cihi.ca/en/how-does-canadas-health-spending-compare-internationally

AoD

It always amazes me just how much the US spends on healthcare per-capita. Imagine Canada did the same?
 

AlvinofDiaspar

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I am in the US. I just had to pay $115 just to see a doctor. Let’s not go down that road.

I don't have a huge issue with co-pay that is designed to discourage needless "consultations" - instead of it being about cost recovery as long as a) a yearly cap for out of pocket and b) a low-income waiver.

It always amazes me just how much the US spends on healthcare per-capita. Imagine Canada did the same?

For-profit motive requires an add-on, tons of bureaucratic overhad (paperwork between providers, insurers, etc); plus on-demand DI or anything else doesn't come cheap. Plus I don't think they have the bulk purchasing powers we have here either.

AoD
 

PinkLucy

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I don't have a huge issue with co-pay that is designed to discourage needless "consultations" - instead of it being about cost recovery as long as a) a yearly cap for out of pocket and b) a low-income waiver.
It was the first line of communication. Before they knew I was Canadian, before they knew what it was about. Before anything. As in “welcome. That will be $115”. That does discourage unnecessary visits but also necessary ones. If it had come up during conversation it would be one thing, but as the opening gambit it was a bit much.
 

Thinker

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It was the first line of communication. Before they knew I was Canadian, before they knew what it was about. Before anything. As in “welcome. That will be $115”. That does discourage unnecessary visits but also necessary ones. If it had come up during conversation it would be one thing, but as the opening gambit it was a bit much.

Anytime governments make "improvements" in medical care, it means cutbacks (efficiencies) and closures (more efficiencies) Looking back at the Harris Govt. they cut back, closed medical facilities, resulting family and specialized physicians to leave the regions and consequently communities without physicians. Few countries in Europe have "improved" their socialized medicine which has resulted in rising insurance costs and pre-existing conditions premiums with no improvement in the system. Co-pay and other scams are a burden to the "working poor, middle class etc" and have not improved care. Emergency departments should be regulated and attached to "walk in facilities" triage will sort the urgent care. The reason for hallway medicine is simply lack of beds on the wards. Some hospitals cut down on beds during summer and other perhaps during other occasions due to lack of nursing staff and housekeeping staff. This has been the routine in most hospitals. Lacking proper compensation for rural clinics and MD's will not attract any family/specialized physicians.
 

JGHali

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I don't have a huge issue with co-pay that is designed to discourage needless "consultations" - instead of it being about cost recovery as long as a) a yearly cap for out of pocket and b) a low-income waiver.

There's no evidence that co-pays do much of anything other than discourage people with little resources from seeking care. And there are plenty of people in the middle who won't make enough to be "low-income" but for whom the cost still matters.
 

W. K. Lis

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Anytime governments make "improvements" in medical care, it means cutbacks (efficiencies) and closures (more efficiencies) Looking back at the Harris Govt. they cut back, closed medical facilities, resulting family and specialized physicians to leave the regions and consequently communities without physicians. Few countries in Europe have "improved" their socialized medicine which has resulted in rising insurance costs and pre-existing conditions premiums with no improvement in the system. Co-pay and other scams are a burden to the "working poor, middle class etc" and have not improved care. Emergency departments should be regulated and attached to "walk in facilities" triage will sort the urgent care. The reason for hallway medicine is simply lack of beds on the wards. Some hospitals cut down on beds during summer and other perhaps during other occasions due to lack of nursing staff and housekeeping staff. This has been the routine in most hospitals. Lacking proper compensation for rural clinics and MD's will not attract any family/specialized physicians.

Part of the "efficiencies" being imposed was the closing or merging of hospital facilities. Instead of having small hospitals serving small communities, for "efficiency" they close them down and build big centralized facilities instead. The problem we have now is that in an emergency, it takes longer to get from home, business, accident scene, etc. to that "efficient" facility. May require an ambulance, police escort, or even an Ornge helicopter to transport patients to the faraway hospital. And that "efficient" facility is now overcrowded and with long waiting times.
 

Thinker

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Part of the "efficiencies" being imposed was the closing or merging of hospital facilities. Instead of having small hospitals serving small communities, for "efficiency" they close them down and build big centralized facilities instead. The problem we have now is that in an emergency, it takes longer to get from home, business, accident scene, etc. to that "efficient" facility. May require an ambulance, police escort, or even an Ornge helicopter to transport patients to the faraway hospital. And that "efficient" facility is now overcrowded and with long waiting times.

Indeed, not only in rural communities. For example, "Doctors Hospital" a facility primary used for day surgeries. When it closed down, these short term and day surgeries were dispersed over the already maxed out schedules within other hospitals of Toronto, resulting in longer waiting periods. The Wellesley Hospital closing added to further stress on the remaining facilities. The Wellesley also specialized in HIV/AIDS medicine, which was transferred to St. Mikes, which led to many complains from those who used their services due to hospital religious policies. The Central Hospital became a small long term care facility. The Grace was also slated to close but it's downtown facility remained open after extensive renovations and caters predominantly in palliative care. So all the efficiencies imposed by Harris resulted in more hallway medicine, patient transportation increases (although that would fall under a different budget after I queried the cost)
 

Northern Light

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CBC has a story up this morning concerning the OSAP grant story. That is to say the success/impact of the previous Wynne program and the impact on some students of its rollback.

https://www.cbc.ca/news/canada/toronto/ontario-schools-tuition-data-1.5003005

The gist seems to be that roughly 40% of students received a grant equal to or greater than 'free' tuition (the average of tuition for college or university respectively.

Further that the program appeared to have successfully reached mostly lower-income households.

*********

Some quick back of the envelope math suggests that OSAP program at up to 1.4B per year was equal in cost to around 45% of domestic tuition revenues.

I took the gross numbers from this 2015 era document, plus current program estimates for OSAP.

http://www.tcu.gov.on.ca/pepg/audiences/universities/uff/ufm_consultation.pdf

Looking at that.........

For argument's sake, assuming we kept the number of study spots constant.

We could simply reduce tuition by 45% across the board in lieu of student aid.

Taken from the numbers used in the CBC report.

That would reduce FT Community College to $1522 per year

It would reduce average University undergraduate to $3,388

It would reduce medical school (as a an example of graduate programs) to $13,783 per year.

All of that is before accounting for student aid from the institutions themselves or from the Federal government.

U of T, as an example, expends 224M on student aid each year, beyond what OSAP provides.

Their info, as noted here: http://www.governingcouncil.lamp4.utoronto.ca/wp-content/uploads/2018/02/a0228-3i-2017-2018pb.pdf, suggests that
the average student paid 47% of the posted domestic tuition rate, after factoring in all student aid.

Look U of T, their average tuition is higher than the norm (around $6,800 for undergrad).

Applying a gross tuition reduction equal to the current tuition differential (posted rate vs paid) would lower tuition by 53%

$3,196 and bring medical school to below $12,000 per year.

*****

Which brings me to my point, somewhat belatedly.

While I disagree with what Ford has done, as it seems sloppy and ill thought out...........and harmful to fairness and access.......

I wonder if there isn't an iota of fairness in imagining that the current student aid approach is the long way around.

Note the numbers above and consider what the Feds, the province, and the Universities and Colleges would save if they simply canned student aid altogether..........

....But applied 100% of the savings (including admin costs) to lower tuition.

I wonder if we couldn't hit 60% tuition relief on a gross basis..........or looking at the numbers above......

What if we left undergrad for university around that 53% reduction and plowed the savings back into lower community college tuition alone......?

Maybe a 75% reduction of those to something like to $692 per year?

I'm just wondering if it wouldn't be far more cost efficient to make tuition affordable rather than partially or fully rebating it or covering it w/loans?

I also wonder what it costs to administer the charging of tuition itself?

Hmmm
 

thettctransitfanatic

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Part of the "efficiencies" being imposed was the closing or merging of hospital facilities. Instead of having small hospitals serving small communities, for "efficiency" they close them down and build big centralized facilities instead. The problem we have now is that in an emergency, it takes longer to get from home, business, accident scene, etc. to that "efficient" facility. May require an ambulance, police escort, or even an Ornge helicopter to transport patients to the faraway hospital. And that "efficient" facility is now overcrowded and with long waiting times.

I don't think "efficiencies" should include shutting down hospitals and telling people to go to get health care in another city, people are inconvinced by having to go from city to city to city to city, and I just don't think Ford understands... wait a sec, Ford wanted to improve northern Ontario and healthcare! This does NOT improve it. Anyone's agree?
 
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Videodrome

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