Ontario Majority Government 2022-2026 (?)

[Brad Sallows]

Can't really discuss the major difficulties of any province without discussing the feds because of the amount of money in transfers.

Where powers are divided, federal governments (not just here) offer money to entice lower levels of government to do things in the latters' areas of responsibility on terms the former dictate. There can be no guarantee the transfers will be sufficient in perpetuity.

This division creates poor incentives. The lowers constantly badger their upper for more money, but the upper has not much control over how well the lowers manage the money and the lowers insist on protecting their turf; the upper is reluctant to be on the hook without control. Something analogous to "responsibility without authority" results ("financial responsibility without authority"?). I would have thought the perils of those situations would be Poli Sci 001 material, understood and respected and avoided by all the bright people with advanced degrees from prestigious institutions who are running things.

 

[The Bread Guy]

...."Sure, as long as we recognise the fact that this comedy of errors is not just Ford's baby. He inherited it.

For sure - but as others have said about long-history, multi-gov't screw-ups elsewhere, it's his to fix now.

... How many times during training have you heard. "Don't stand there! Do something, even if it turns out wrong, DO SOMETHING!"

That's what Ford has done with the time & resources alloted to him ...

Bad shit happening, no doubt (and has been for a while). If it was considered a truly IA situation, though, all sorts of tools could be wielded without having to wait for legislative process. And you're bang on that this doesn't need the "Royal Commission Light" treatment going on with minutes, expert sub-panels and the like ad infinitum. I just think a month or so of "hang on a sec" is not unreasonable if it means an at least a potentially better solution. Again, "it's only just for a while until we fix other stuff" solutions have been known to hang around a long time while the other stuff remains unfixed.

That being said ...

Can't really discuss the major difficulties of any province without discussing the feds because of the amount of money in transfers. Where powers are divided, federal governments (not just here) offer money to entice lower levels of government to do things in the latters' areas of responsibility on terms the former dictate. There can be no guarantee the transfers will be sufficient in perpetuity. This division creates poor incentives ....

Nobody - including myself - is denying this is part of the problem. The issue, though, is what's to be done now.

While I don't think it's as IA-worthy as FJ says, reforming the transfer payment system is a longer-term solution needing consideration, but not one that clears out hospital beds really quickly. Somewhere in between there, maybe.

 

[Good2Golf]

In large part, because we have almost half of the population, of Canada, in Ontario.

And tax revenue…

 

[Brad Sallows]

The fastest way to solve a capacity problem is to allow people to profit by serving it. If people refuse to allow that because of ideological preferences, it's on their heads.

 

[The Bread Guy]

The fastest way to solve a capacity problem is to allow people to profit by serving it.

That's the fastest way, for sure. There's still enough horror stories out there, though, to make one cautious about the terms of such private sector service delivery. Good example of how it can work ...

Welcome to Shouldice Hernia Hospital, The Global Leader in Non-Mesh Hernia Repair.

For over 70 years, we have been the only licensed hospital in the world dedicated to repairing hernias. More than 98% of our cases are performed with our natural tissue technique...without the use of mesh.

www.shouldice.com

Not so good? I know of a jurisdiction where the private sector can do certain x-rays cheaper (to the system - no user pay) and faster than the public system, but they can't share the x-rays themselves with the public-system hospital because for some reason, the hardware and product are different. There's likely lots more clunky detail there I don't understand, but that sort of thing makes one want to be careful about setting up terms & conditions (without, of course, making it unprofitable for the service provider).

 

[OldSolduer]

Can Manitoba have Kenora?

 

[Fishbone Jones]

Can Manitoba have Kenora?

No, you can have Timmins, but only if Aunt Jenny can stay where she is.

 

[Fishbone Jones]

We're already running a private for profit/ social medicine system. It's a hybrid. Not free, but not exhorbant. We pay for that in wait times, shortages of personnel and equipment and foregoing cutting edge treatment. There are no sacred cows.

 

[mariomike]

There's still enough horror stories out there, though, to make one cautious about the terms of such private sector service delivery.

Not a political opinion. Just my personal observation from being sent into all the municipal, not-for-profit and for-profit LTC homes in town over several decades.

My mother is 90 and still healthy and active. But, if / when the time comes, I will try to get her into a municipal or not-for-profit home.

Yes, I understand I may not have much control over the matter.

 

[The Bread Guy]

Can Manitoba have Kenora?

You just want them for the waterfront property & joint work, am I right?

Thunder Bay surgeons will do hip and knee replacements for Manitobans

Read the full story and comment on Tbnewswatch.com

www.tbnewswatch.com

We're already running a private for profit/ social medicine system. It's a hybrid. Not free, but not exhorbant. We pay for that in wait times, shortages of personnel and equipment and foregoing cutting edge treatment.

We also have a mix of private and non-profit long-term care facilities, with users' mileage varying widely. That's why I want government to be at least a bit cautious about how the private sector is brought in, especially if people don't have a choice where they're going. I'm not going to go this far ...

3 Ontario political parties pledge to end for-profit long-term care | Globalnews.ca

The NDP, Liberals and Greens say the COVID pandemic shone a light on long-term care, and they say it showed that private corporations should not be in the business of elder care.

globalnews.ca

... but I want there to be a bit of decent recce (not forever recce), not "hey diddle-diddle, right up the middle - even if it's the wrong answer".

 

[Fishbone Jones]

You just want them for the waterfront property & joint work, am I right?

Thunder Bay surgeons will do hip and knee replacements for Manitobans

Read the full story and comment on Tbnewswatch.com

www.tbnewswatch.com

We also have a mix of private and non-profit long-term care facilities, with users' mileage varying widely. That's why I want government to be at least a bit cautious about how the private sector is brought in, especially if people don't have a choice where they're going. I'm not going to go this far ...

3 Ontario political parties pledge to end for-profit long-term care | Globalnews.ca

The NDP, Liberals and Greens say the COVID pandemic shone a light on long-term care, and they say it showed that private corporations should not be in the business of elder care.

globalnews.ca

... but I want there to be a bit of decent recce (not forever recce), not "hey diddle-diddle, right up the middle - even if it's the wrong answer".

Government should not be in the business of businesses. There is nothing worse than a government business with unlimited taxpayer money and run by bureaucrats. I can get by with government facilities leased to an organization with a good record. The government can set the standard and terms and provide funds for upkeep. The profit margin per home should be capped as part of the deal.

 

[The Bread Guy]

... I can get by with government facilities leased to an organization with a good record. The government can set the standard and terms and provide funds for upkeep. The profit margin per home should be capped as part of the deal.

That could work well - assuming the company's happy with 1) the subsidy they get, and 2) the amount of money they'll be allowed to make. While you're leery about government running things, how confident are you those same governments can set the standards AND come up with contract terms that consistently get the job done? Mixed record there with most governments of all stripes.

 

[Fishbone Jones]

Most of the rules are already there. It can be done much the same way as the feds lease postal outlets. A bit simplistic, but essentially the same type of partnership.

The province can build a home, with all the laws and regulations covered. A turnkey operation. The govt will be responsible for certain things, just like the vendor. So the vendor will get a maintenance fund and a salary for running the place. Both to be negotiated. I'm just spitballing here, but we could have all kinds of places built within 6 months, with expressions of interest already in place. All made out of ticky tac and all look just the same. Standard layouts and equipment. It needs to be subcontracted though. We don't want OPSEU running the place full of government caregivers. I think it can work.

 

[mariomike]

We also have a mix of private and non-profit long-term care facilities, with users' mileage varying widely.

Ontario Long-Term Care Covid-19 Commission:

Consumer preference: The long-term care waitlist is shorter for for-profit homes (32 per cent) compared to not-for-profit and municipal homes (68 per cent).

https://files.ontario.ca/mltc-ltcc-final-report-en-2021-04-30.pdf

page 39.

From what I observed, not surprised.

 

[Brad Sallows]

There's still enough horror stories out there, though, to make one cautious about the terms of such private sector service delivery.

Yet the US manages. I'll take the empirical evidence over Baba Yaga.

 

[The Bread Guy]

Most of the rules are already there. It can be done much the same way as the feds lease postal outlets. A bit simplistic, but essentially the same type of partnership.

The province can build a home, with all the laws and regulations covered. A turnkey operation. The govt will be responsible for certain things, just like the vendor. So the vendor will get a maintenance fund and a salary for running the place. Both to be negotiated. I'm just spitballing here, but we could have all kinds of places built within 6 months, with expressions of interest already in place. All made out of ticky tac and all look just the same. Standard layouts and equipment ...

That could work if all the caveats could be guaranteed, for sure.

I'm still a titch leery because the last time a Team Blue government offered up $ for private sector LTC beds (this would have been Harris or Eves - can't remember who was at the helm that point), they wanted to do it cheaper than public sector, so they didn't offer enough per bed to build or per day to run to attract ANY private sector bidder to step up. And Lord knows Team Red, Queen's Park League had all sorts of chances but didn't ....

I'm curious to see how this'll all unfold.

Yet the US manages. I'll take the empirical evidence over Baba Yaga.

There's enough evidence there's a fair number of glitches in their private-sector health care system, so I'm going to take the word of the associations running private-sector nursing homes in the U.S. that they're swimming the same waters as we are.

AHCA Releases Report Highlighting Unprecedented Economic Crisis in Nursing Homes

Correction (3/14/22): A key finding of the report (percentage of residents living in financially at-risk nursing homes) has been updated to reflect a projection by CLA, not a current statistic. WASHINGTON, D.C. – The American Health C...

www.ahcancal.org

Survey: Nursing Homes Still Facing Staffing & Economic Crisis

WASHINGTON, D.C. – As more than 500 long term care professionals gather on Capitol Hill this week to meet with the nation’s lawmakers, the American Health Care Association (AHCA), representing more than 14,000 nursing homes and other long term care fa...

www.ahcancal.org

 

[IKnowNothing]

Yet the US manages. I'll take the empirical evidence over Baba Yaga.

There are far better examples/ arguments for the introduction/ increase of private for a more hybrid system than the US.

 

[YZT580]

Almost every major centre in Ontario had an Ontario Hospital at one time, all single floor. Woodstock, Guelph, Orillia, Sudbury just to name a few. Most still exist as private concerns. Could always buy them back but to what purpose? Need a training centre for staff, a career map to encourage people to sign up and a locally based organization that care about Aunt Bessie to run each one. Why, because she is their Aunt Bessie. Personal concern is essential. There is a need to get the food away from the institutional system that was mandated by the NDP years ago: that is what did in meals on wheels as well. Most of the not for profits I have visited are crap. My 2 cents

 

[Fishbone Jones]

Who is Bessie? What happened to Aunt Jenny?

 

[Brad Sallows]

If only there were no glitches in "public" enterprises.