Health Care on the Edge

1. Health Care on the Edge A Plea for Compassion presented by The Thunder Bay Health Coalition

2. Thunder Bay Health Coalition • A chapter of the Ontario Health Coalition • Members are citizens concerned about health care, many of whom represent local organizations • We support public health care - Government funded, universally accessible care, delivered without a profit motive

3. McGuinty Praises Nurses' Fight for "Strong and Sustainable, Publicly Funded and Delivered Health Care System." TORONTO, Sept. 20 - Ontario needs a change to a government that respects medicare and the people who deliver it, says Ontario Liberal Leader Dalton McGuinty. "It's time to invest in greater resources, ensure increased accountability, and stop the creeping privatization of health care," McGuinty said.

4. Post-Election: The “5.6 Billion” • Why is it a surprise? Liberals predicted a hidden deficit • Ultra-conservative Fraser Institute says PCs running $4.5 billion deficit • TORONTO, Sept. 22 - The ultra-conservative Fraser Institute - with senior fellows Mike Harris and Preston Manning - today released a report saying Ernie Eves' PCs are hiding a $4.5-billion deficit and Ernie Eves' uncosted promises will only make things worse.

5. The Liberal numbers Liberal Plan was Tested • TORONTO, Sept. 22 - Experts from across Canada have pronounced the 2003 Ernie Eves budget is hiding a massive deficit. • Our plan holds the line on taxes, ensures balanced budgets, enhances essential public services and sets aside $1 billion reserves every year. Ontario Liberals will cancel Ernie Eves' $3.2 billion giveaway to Ontario's largest corporations and $500 million handout to private schools.

6. What the Liberals left out “The direct fiscal impact of these two plans on the 2006 Deficit is quite similar: $3.7 billion for the Conservatives and $4.0 billion for the Liberals.” “Either fiscal plan will have to be significantly revised to balance the provincial budget this year and through the next term in office.”

7. How big is the ‘structural’ deficit? • Included in the $5.6 B are one time items • Hydro One/OPG impact of 1.3B • ‘Contingency’ of 0.6 B • One Time SARS costs of 0.6 B • The Canadian Centre for Policy Alternatives projects a deficit of 2.2 Billion in 2004/05 and a surplus of 300 Million in 2005/06 if the Liberals do not launch their new initiatives

8. Which deficit to discuss? • During the election the Liberal focus was on a decade of cuts to social programs • Since the election, what we hear about is the financial deficit

9. So what should we do about the budget?

10. Why are health care costs so high? • Demographics • P3 deals by any other name are still profit making ventures for the investment groups, at public expense • Private facilities, paid for by public money draws funding and resources away from the public system • Health expenditures now include profits for corporations - Long Term Care and other corporate service providers

11. Eves PCs must explain why they signed private hospital deal • OTTAWA, Sept. 28 -The Eves PCs must explain why - in the final week of an election campaign - they signed a deal for a private hospital. "I am astounded that Ernie Eves would sign a deal for a private hospital in the last week of an election campaign," said Liberal Candidate Jim Watson. "He can't hide behind bureaucrats on this, he needs to explain why he wants to saddle Ontario with a two-tier approach that was rejected by Roy Romanow." • Watson also demanded the terms of the deal be made public. "If Ernie Eves is so proud of this private hospital deal, he should release all the details today," Watson said. Watson said while Ottawa needs a new health care facility, it should be publicly owned and operated, not a private hospital.

12. Todays “rentals” -yesterdays P3 • The Liberal Minister of Health has continued the PC back room negotiations to privatize hospitals • Call it a lease payment, call it rent - whatever you call it, it is a capital program with an additional 10-15% fee for profits which creates a false sense of health care costs • It is no surprise that health spending is increasing so fast, the government is adding in a profit margin for every private facility

13. PC: Pay-as-you-go health care • KITCHENER-WATERLOO, ON, Sept. 9 - "Eves has opened the door to creeping privatization. The people of Kitchener-Waterloo know what's hidden behind Door Number One in Eves Let's Make a Deal approach to health care," said Kitchener Centre Liberal candidate John Milloy. • An MRI technologist was recently hired away from Windsor's Hotel-Dieu Grace Hospital to work at the private pay-as-you-go KMH Cardiology and Diagnostic clinic in Kitchener, which opened over the summer. The technologist was lured away with a $15,000 bonus.

14. McGuinty Liberals have plan to increase MRI and CT services • TORONTO, Sept. 22 -A McGuinty Liberal government would increase access to public MRI and CT services across Ontario, and work with experts to set and meet maximum needs-based waiting times for care. • "Ontario voters will choose between the Eves PCs giving billions away to large corporations and private schools or the McGuinty Liberal plan to put those hard earned tax dollars to work in our hospitals, providing health care services we desperately need," said Pupatello.

15. Long-Term Care • A P3 paradigm in action • The government is now paying private developers to build facilities, complete with profit margins • Service standards have been in decline since private operations have taken over

16. The Private Delivery Model • Retirement REIT’s mandate is to provide the best  possible standard of accommodation, care and services to our residents, and to treat them with respect, dignity, and compassion. Our business mission is to generate stable and growing distributable income and maximize unit value through the efficient management of our senior care homes and related services, and by growing the business through accretive acquisitions and new developments, primarily in Canada. From: http://www.retirementresidencesreit.com/investment/index.asp (Emphasis ours)

17. Retirement REIT Performance

18. Extendicare Achieves 75% Increase in Third Quarter Earnings Third Quarter Operational Highlights: • The Ontario and Alberta governments implemented long-term care spending increases effective July 1 and August 1, respectively. These combined funding changes improved the Company's third quarter revenue from Canadian operations by approximately $3.0 million and EBITDA by approximately $1.5 million. • The Company also benefited from the opening of new nursing homes in Ontario, adding approximately $6.3 million of revenue and EBITDA of $1.4 million to the quarter. Four nursing homes were opened in 2003, with an additional one scheduled to open in January. November 6, 2003

19. What else costs more? • Pharmaceuticals: Ontario’s drug costs have increased by 130 % since 1995/96 while pharmaceutical corporations top the Fortune 500 list in profits. We need controls on drug pricing. • De-listing Services: De-listing moves the cost of health care services to the patient. Cuts to substance abuse and mental health programs also transfer costs to other agencies. • Home Care: The competitive model for home care has completely destabilized a program critical to help people maintain independence and pushes the ill and disabled into more expensive institutional care.

20. Responsible spending isn’t about cutting service • Tax revenues: MoF assumptions include an 11.5% growth in corporate profits for 2003, yet corporate tax revenues are forecast to drop over 3% in 2003/04 from 2002/03 • “Publicise” Services: Annual average operating cost per bed in a long term care facility is over $30,000. Removing a 7% profit could reduce that by over $2,000 per bed. • Borrowing: An acceptable measure to protect social programs

21. “Administrative savings” = “Steering, not rowing” • TORONTO, Sept. 9 - Ernie Eves today claimed that 'administrative savings' aren't cuts, which is precisely the same argument the Harris-Eves PCs made in the 1995 election - before they cut everything from health care to water inspections. Reporter: "I understand that you are planning on seeing administrative efficiencies of $800 million this year, $700 million the next year, $750 million the year after and $850 million the year after that. Health care and education account for about 70 per cent of your total spending. Will any of these cuts come in health care or education?” Eves: "There are no cuts in this. These are 'administrative savings.'"

22. The Liberal Dilemma Honour a promise to the Canadian Taxpayers Federation by continuing a decade of cuts to public servicesORHonour a promise to the voters of Ontario by renewing social programs and public services

23. Our Bottom Line • We are willing to pay our fair share ... we support fair taxes to rebuild social programs • We can't afford privatization ... it is an expensive hidden tax • Medicare's future is at stake ... We must reinvest in public healthcare • We voted for change and we meant it ...keep your promises

24. The March budget is your opportunity to choose (WHITBY, ON, Oct. 1) Choose: • Better schools and health care -- instead of massive tax giveaways for large corporations and private schools. • More family doctors, nurses and hospital beds -- instead of a failed approach that has made Ontario tenth out of ten provinces in having enough family doctors, nurses and hospital beds.