Ontario Liberals want hospitals to compete for cash

This might be asking for skewed reporting and other modes of spinning data so as to attract more cash. We will have to wait and see what happens. Ontario's ideas about saving money in health care often involve hiring expensive experts such as those at eHealth who seem to have wasted wads of taxpayer money and accomplished very little. This is from thespec.

Liberals would have hospitals compete for cash
Loweest bidder would get funding
Patients face might travel further to get care

ROB FERGUSON




Patients would have to travel farther for some operations and treatments but the savings to taxpayers could top $3 billion a year under radical hospital reforms being considered by Premier Dalton McGuinty's Liberals, the Torstar news service has learned.

The plan would have hospitals essentially forced to compete for cash by doing acute care in-patient surgeries and such treatments as hip replacements more cheaply than rivals, with the lowest-cost bidders getting more of the work, sources said Wednesday.

The new "patient-based payment" system would save an estimated 10 to 20 per cent – that's $1.8 billion to $3.6 billion – of the $18 billion in tax money now given to hospitals annually, mostly with no strings attached, said a consultant familiar with the concept.

"The savings come from the reduced duplication because hospitals compete with one another and don't try to be all things to all people," added one Liberal official, conceding that the change may not be welcomed in general hospitals or in those serving rural communities.

However, it would reward better-performing hospitals which could get more money based on the number of patients treated and successful outcomes for their health problems – because the more quickly they can cure or treat patients successfully, the more patients they can bring in.

Under the new system, patients might have to travel across town or to other municipalities as hospitals try to narrow the range of services and procedures they offer, to take advantage of economies of scale that keep costs down.

The government's concern with handing out money to hospitals for general use is that it's impossible to tell exactly where the cash is going and how efficiently it's being used, said another source. "We have no sense of what we're getting for that money. It's difficult to compare one hospital with another. What are the procedures costing?"

McGuinty, who is making "Open Ontario" the main theme for governing through to the October 2011 election in next Monday's throne speech, warned that voters have to keep an open mind on revamping the health-care system.

"One of the things that we necessarily must look at of course is the way that we deliver services. The big challenge for us ... is the ever-escalating costs associated with health care," McGuinty told reporters Wednesday.

"When I got here 20 years ago, I think it was 32 cents on the program dollar went to health care and now it's 46 cents. They tell me that in 12 years, it will be 70 cents on the dollar if we continue at the existing rate of growth," he said.

The danger is health-care costs, particularly with the wave of Baby Boomers turning 65, that will "crowd out" other priorities like education and the environment and the war on poverty and others.

"We have to find a way to come to grips with that. That will all be part of the consideration that we'll be speaking to in the throne speech."

The competitive model is already being used for 10 to 20 per cent of hospital budgets in key areas where the government has worked to cut waiting times for cataract surgeries, hip and knee replacements, MRIs and CT scans.

"It's created competition in the best sense," said Dr. Kevin Smith, chief executive officer of St. Joseph's Health Centre in Hamilton and chairman of the Ontario Hospital Association. "You see who's doing the best work at the lowest cost and who's getting the best results for patients."

The health ministry now pays for cataract surgery at $625 per procedure, CT scans at $250 per hour, MRIs at $260 hourly, and hip and knee replacements at $8,930 per procedure.

McGuinty has played his cards close to his chest on the cost-cutting efforts contained in Finance Minister Dwight Duncan's budget, expected by the end of the month. The government is facing a record deficit of $24.7 billion.

The government faced a rough ride in its first budget in 2004, instituting a health premium of up to $900 per person.

Liberal insiders at Queen's Park confide that the "patient-based payment" strategy is part of its "health-based allocation model" plan for the 14 regional local health integration networks overseeing the delivery of care.

NDP Leader Andrea Horwath of Hamilton said McGuinty's trial balloon "sets out some alarm bells about what this government's intentions are in terms of funding for health care."

Progressive Conservative MPP Peter Shurman (Thornhill) said the Liberals "keep spending more and more by insulating themselves in layers of bureaucracy." He was referring to the local health integration networks and problems at scandal-plagued eHealth Ontario.

McGuinty prorogues Ontario legislature.

While it may be true that McGuinty's prorogation is relatively brief it is still akin to Harper's move in that it is done for purley political reasons as the article points out. Will Ignatieff come out and criticise his provincial Liberal comrade? We will see. It is about time for the public to realise that the Liberals and Conservatives are not all that different. I hope that the public begins to give more support to third parties. Otherwise we will end up with the same situation as in the US with two dysfunctional major parties and no choice for the public.


McGuinty prorogues legislature
Brief break to be followed by throne speech
By Robert Sibley, The Ottawa CitizenFebruary 10, 2010
Stephen Harper did it, so why not Dalton McGuinty.

The Ontario premier said Tuesday he will "briefly" prorogue the provincial legislature, probably next week, and then begin a new legislative session following the Olympic Games with a throne speech.

However, in announcing his intentions, McGuinty emphasized his prorogation is nothing like that of Prime Minister Harper, who has been the subject of considerable criticism for shutting down Parliament for two months.

"We will not follow the federal government's example of an extended break before we have that throne speech," the premier said. "The throne speech will likely come after the Olympics are over, just so you know."

Not surprisingly, the Tories found McGuinty's announcement both cynical and hypocritical. Nepean Carleton MPP Lisa MacLeod, for example, linked the prorogation to the March 4 byelection in Ottawa West-Nepean. McGuinty, she said, doesn't want the legislature in session and the government subject to criticism with such a "game-changer" vote in the offing.

Beth Graham, a longtime community activist who once managed constituency affairs for MacLeod, is representing the Conservatives in Ottawa West-Nepean. She faces Liberal candidate Bob Chiarelli, a former MPP and two-term Ottawa mayor.

"We sort of knew McGuinty was going to (prorogue the legislature)," MacLeod said. "It's always been our suspicion that with the hottest seat in play since McGuinty's been premier, they don't want to be in the House during this byelection. They want to avoid facing questions from the opposition during a hot byelection."

A second byelection is also being held in Leeds-Grenville, to replace longtime Conservative MPP Bob Runciman following his appointment to the Senate. Tory candidate Steve Clark faces Liberal Stephen Mazurek.

Last week, McGuinty suggested the criticism Harper has received over prorogation prompted him to think carefully about any such decision on his part.

"I think it's kind of lent it a different complexion," he said. "Prorogation has been an important and respected parliamentary tool for centuries. But it's important that you don't abuse that."

Elsewhere, NDP leader Andrea Horwath found it "unacceptable" for the premier to be "playing a bit of guessing game with the public in terms of his intentions." Horwath, who spoke before the announcement, said provincial politicians should be working at dealing with the economy, lost jobs, hospital funding problems and the effects of the harmonized sales tax.

Conservative leader Tim Hudak also called prorogation an attempt to "avoid facing questions" in the legislature. "We all saw what happened last session -- a government battered and adrift, a government that is increasing taxes, that had been involved in a huge eHealth boondoggle."

Strangely enough, Hudak's party will actually benefit from prorogation. In December, Tory MPPs Randy Hillier and Bill Murdoch were banned from the legislative chamber. With a new legislative session, they will be able to reclaim their Queen's Park seats.

McGuinty said the brevity of the break will ensure none of the government's legislation is lost.

© Copyright (c) The Ottawa Citizen

Ontario Liberals look like Harper Conservatives

What next? The Liberals will sell off crown corporations even when they provide the province with all sorts of income. However, the Liberal party will get some income into its own coffers when it offers the private sector public enterprises at firesale prices. It seems to make no difference whether Liberals or Conservatives are in power they are all for making sure their corporate friends make all the profits and not the province. Although there will be a one time windfall from the sales that could be used to pay down the debt there will be a decrease in income for the province in perpetuity from the money that would have come in from Lottery and Liquor Board profits. This does not matter as long as there is more opportunity for private profit and subsequent donations to the Liberal cause. This is from the National Post.


Wednesday, December 16, 2009



Ontario looks to sell assets to bring down $25-billion debt

Ashley Fraser
TORONTO - To offset a record $25-billion deficit, Ontario's premier said Wednesday he's considering selling the province's most prized assets, which include utility Hydro One, the liquor control board and the Ontario Lottery and Gaming Corp.

"We've got a responsibility to take a look at all of our assets to make sure that we're getting the best bang for our buck," Dalton McGuinty said at Queen's Park Wednesday. "Especially now in the context of a recession and a significant deficit."

The highly profitable LCBO and OLG are just some of the cash cows that could be sent to market.

The liquor board delivered $1.4 billion dollars last year and the lottery and gaming corporation has been a multibillion-dollar cash cow for years.

Opposition leaders however slammed McGuinty for what they consider changing his tune, saying that in opposition he vowed the province was through selling off public assets.

"This is an unprincipled government," said Progressive Conservative opposition member Peter Shurman. "It's been called the worst government ever in Ontario and it's proving those words are absolutely true."

"It's a quick cash grab for the government," argued Ontario New Democrat Leader Andrea Horwath. "People will pay through the nose in the long run."

The government has hired experts with CIBC and Goldman Sachs to estimate the value of the Crown assets to make sure taxpayers get fair value if there's a sale.

Some observers note the announcement could be a trial balloon designed to gauge public appetite for the idea and doesn't automatically mean the sales will take place.

© 2009 The National Post Company. All rights reserved. Unauthorized distribution, transmission or republication strictly prohibited.

eHealth Ontario sick cronyism....

This certainly will not help the Ontario Liberal party in the polls. It is a sad sordid story of connections rather than efficiency determining who got contracts and the result was fat paychecks but little progress. A lot of the blame must go to those charged with government oversight of the processes. It seems that the government approved in many instances of contracting processes that went against their own guidelines.


$1B waste of money: McCarter
Grits ripped over eHealth spending
By ANTONELLA ARTUSO, JONATHAN JENKINS AND BRYN WEESE, QUEEN'S PARK BUREAU
Last Updated: 8th October 2009, 5:32am

Auditor General Jim McCar-ter's special report on the provincial government's efforts to bring in an electronic health records system concluded that taxpayers didn't get good value for their $1 billion, that in fact, hundreds of millions of dollars were wasted in the effort.
As expected, David Caplan resigned as health minister yesterday, taking responsibility for the lack of oversight, and opposition leaders quickly turned their wrath on former health minister George Smitherman.
Premier Dalton McGuinty, facing arguably the most difficult challenge in his government's six years in office, acknowledged he had been impatient to get an electronic health records system up and running.
"I never said anything about breaking the rules," McGuinty said.
McCarter's probe found eHealth Ontario and its predecessor, Smart Systems for Health Agency (SSHA), suffered from a lack of strategic planning from the beginning.
The goal was clear -- a secure, private lifetime health record for each Ontarian available electronically to all authorized health-care providers -- but there was no road map to get there.
Health ministry staff didn't communicate well with SSHA and eHealth Ontario workers.
Projects almost never came in on time or on budget.
And hundreds of private consultants cashed fat paycheques.
"There were so many consultants, you had consultants basically approving other consultants being hired, often from their own firms," McCar-ter said. "We felt that was clearly inappropriate."
The Ministry of Health, SSHA and eHealth handed out millions of dollars worth of contracts without a competitive bidding process.
The auditors uncovered no problems with the official procurement policies other than they were rather routinely ignored.
One firm, Courtyard Group, received several sole-sourced contracts and renewals, and was awarded a $600,000 contract even though its bid price was 10 times higher than the lowest bid.
Although some of those contracts were handed out by eHealth CEO Sarah Kramer, the auditor found the government's own Management Board, made up of senior McGuinty cabinet ministers, waived tendering rules and split projects into lower-value contracts to bypass procurement requirements for eHealth projects undertaken by the Ministry of Health.
The report notes the firm being awarded this work was in communication with health ministry management about upcoming contract renewals before the requests for services were released to other providers.
"That's clearly indicative to us that somebody had the inside track," McCarter told Sun Media. "This is not how appropriate procurement practices should be handled."
The auditor wouldn't name the firm, but the Ontario health ministry confirmed the company is Courtyard Group.
John Ronson, founder of Courtyard, said in an e-mail his company will be commenting extensively today on the areas of the report that affect them.
"Including the fact that we are the anonymous firm that authored the 2009 strategy that he recognized as being critical to getting the agenda back on track," said Ronson, who served as campaign director for former Liberal leader Lyn McLeod.
Courtyard managing partner David Wattling said the company also provided "excellent value for money" in its work on the diabetes and ePrescribing strategy, having competed for and won 27 eHealth contracts in Ontario and been granted another eight sole-sourced contracts.
McCarter blamed a lack of government oversight, not party politics or personal benefits, for what happened on the eHealth file.
"Ineffective oversight and broken rules go together like a horse and carriage," McCarter said.
He noted the fledgling eHealth Ontario Agency under Kramer repeatedly ignored existing procurement rules in hiring "favoured" consultants without competitive bidding.
Kramer, shown the door when the scandal broke, committed "a judgment error" in awarding contracts without taking competitive bids, McCarter said.
A statement issued by Kramer yesterday disputes the auditor's findings, in particular challenging his assertion that there was no real "urgency" in the situation and ignoring that the "experts" she hired had relevant experience.
"Finally, the auditor general states that the board of eHealth Ontario was unaware of the procurement practices that we were following," she said. "This is simply incorrect. Indeed, the board was explicitly and acutely aware that exemption rules in the procurement policies were being followed because of the urgency of the situation."
PC Leader Tim Hudak called eHealth "a tangled and incestuous web of consultants, Liberal staffers, officials, and operatives ... This is what Dalton McGuinty's culture of entitlement is starting to look like."

Another day another McGuinty promise broken.

This should not be surprising. Next time McGuinty should campaign on this slogan.
If I am elected I promise to break at least one or more of my promises.
He could surely keep a promise like that.

McGuinty muses about cancelling health tax review
Last Updated: Thursday, December 20, 2007 | 8:44 AM ET
CBC News
Premier Dalton McGuinty has suggested he may change his mind about holding a legislative review of the Ontario government's controversial health tax — even though he promised a review when he brought in the tax in 2004.

McGuinty said the government needs the $2.7 billion the tax brings in this year, so a review would be pointless and redundant.

Last week, the government filed a motion to set up the review committee when legislators return to Queen's Park in the spring.

But on Wednesday, McGuinty questioned the need for a review, given that the health tax is going to stay.

McGuinty said the need is "a technical one."

When asked if he considered the need for a review redundant, he had a succinct answer. "Yes."



The premier acknowledges there is a legal requirement for a review, but said that could be eliminated by changing the law.

It was the introduction of the health tax in 2004 that prompted the opposition to claim that McGuinty had broken his election promise not to raise taxes.

Conservative Leader John Tory said unilaterally deciding not to review the tax would amount to another broken promise.

"The painkiller that was offered [to voters] on the day the massive 'broken promise tax' was brought in was the review," said Tory.