If you live in Ontario, then undoubtedly you are aware of the issues that plague our health care system. When asked by a journalist about whether Doug Ford was looking into privatizing health care, he responded, “Everything is on the table.” He followed that up with a guarantee: “You will always be covered by OHIP, not the credit card.” Is he following through with that promise?
One can argue that our health care system is in shambles. In July, Lakeridge Health closed their Bowmanville Hospital ICU due to staffing shortages. In late August, St. Mary’s Memorial Hospital reduced the hours of their emergency department due to “continued health human resources shortages.” According to the Toronto Star, Ontario hospitals had to close their ER departments over eighty times this summer. These shortages are causing surgical backlogs and preventing individuals from getting help when needed, especially in emergency situations. Health care professional shortages are a significant cause of these closures and reduced hours.
Doug Ford’s response to the issues concerning health care in the province was that he was considering the use of private delivery of publicly-funded health care. Instead of addressing the nursing shortages, which some argue are caused by Bill 124 (which suppresses wage increases for health care professionals), he decided to go a different route to address this issue. He stated that the status quo is not working, and so health care will “be deliver[ed] in a different fashion.”
So, what exactly does he mean by this? Surely, he does not mean paying out of one’s own pocket for health care expenses. After all, paying out of one’s own pockets for health care expenses is not something that many Canadians’ budget for in Ontario, where our health care is publicly funded by taxpayers. On 14 September 2022, the Ontario government shocked many when they announced that there would be new rules impacting alternative level of care (ALC) patients, which includes possibly paying out of one’s pocket. Starting on 20 November 2022, patients who have been discharged by physicians and need a long-term care bed will be charged $400 a day if they refuse to leave the hospital. This is an attempt to ensure that the beds that are available are for those who really need them.
Bill 7, More Beds, Better Care Act (the “Act”), amends the Fixing Long Term Care Act, 2021 by authorizing certain actions to be done without the patient’s consent. This includes giving the power to hospitals to:
- Have a placement co-ordinator determine the patient’s eligibility for a long-term care home, select a home, and authorize their admission to the home;
- Have certain persons conduct assessments for the purpose of determining a patient’s eligibility; and
- Require a licensee to admit the patient into the home when certain conditions have been met, and allowing persons to collect, use, and disclose health information if needed.
While the Act requires one to make reasonable efforts to obtain consent, it follows that if the patient does not consent, then they may be forced to go to a long-term home, regardless of whether they want to or not. Otherwise, they may stay in the hospital and incur a hefty fee of $400 a day. This undoubtedly will cause strain for many Canadians who are already suffering from the ever-increasing costs of living, especially vulnerable seniors.
Unsurprisingly, this law has caused a lot of criticism and outrage. The leader of the Ontario Green Party, Mike Schreiner, stated that a law like this will put elders at risk. He suggests other alternatives, such as making investments in home care, addressing the staffing crisis (which includes repealing Bill 124), and investing in long-term care homes. Some believe that the focus should be on the staff shortages and investing in our health care system. They argue that giving hospital coordinators more power to find an alternative long-term care bed, even if it is in a location one does not want to be in, is inhumane. The main concern is that this is not a real fix to the health care system in Ontario.
While this may seem shocking at first glance, others have come to accept this and believe it is the right thing to do. They believe that this will help the health care system become more efficient. Individuals who do not leave the hospital when they are discharged may drain resources that may be used to help someone else. Some argue that hospitals are meant for emergencies and that this decision is a smart one—hospital space is scarce, and using this space more strategically can help to improve the system by making it more efficient. Ontario’s Health Minister, Sylvia Jones, stated that this could free up 400 acute beds in our hospitals. Many health care organizations have supported this as well, like Trillium Health Partners.
While this Bill has caused outrage in some, it is also supported by many. Regardless of whether this will increase the number of beds at any given hospital, it can be argued that this is insufficient to address the real underlying problems of the health care system. Perhaps further investment in our health care system and a meaningful overhaul is needed to truly improve the system. What exactly is needed is up for debate.