How did health care become a mess?

It started with cuts to budgets and transfer payments in the 1990s

Re: Is Doug Ford recklessly poisoning Ontario’s health-care system — or might he help fix it?

In my opinion, this was not a useful opinion piece. Picking weak arguments and saying “wrong” may be a great way to fill space but doesn’t provide any new or better information.

Most of the people that I talk to have been aware that our healthcare system may never have been the best in the world.

Even Doug Ford knew there were problems when he took over. Maybe I misheard, but I thought I heard him say he was going to end hallway medicine. To some extent he has moved it out of the hallways and into the streets; as parents wait for emergency care or look for care in walk in clinics and pharmacies.

A better question: How did we get here? It seems hard to believe, but some of us were alive when our governments started funding our health-care system. I’m too young to remember it, but before that, some people used to take eggs and chickens to doctors instead of showing a health card.

To my mind, at the federal level, budget cuts and transfer payment cuts, in the 1990s weakened the system. Combining those cuts with an inflation target of about two per cent per year meant the provinces had to collect more taxes each year just to maintain the status quo.

It was the responsibility of our governments to measure the impacts of these changes and deal with the fallout from those mid-1990s decisions.

Since then, in Ontario, no party has admitted that it should have maintained the system by using the tax points that the federal government transferred at the time to maintain or improve the system.

Mostly I remember governments saying they would cut taxes so the economy would grow. That growth would generate new taxes to pay for health care and education. Some were going to trim the fat too. And here we are. Thirty years older and wondering how this happened.

Could the Ontario parties have avoided this mess? That is a question the Financial Accountability Office of Ontario and auditor general or perhaps a citizens’ assembly could have answered or could answer now. Instead, over several election cycles, we have had lobbyists lobbying, polling results that aren’t shared, cabinet documents that aren’t shared and low voter turnout that has now given a so called majority government to a premier who changes his mind too frequently.

Also, we have developed a healthcare system that enables the senior levels of government to blame each other for the mess they have jointly created. What would I consider some useful questions to consider?

Our country has a population about the size of the State of California. Could we have better accountability if we get rid of the provincial bureaucracies and make the federal government responsible for both standards and payments? We now have a federal government saying that it could contribute more but it wants accountability.

I acknowledge there is Quebec. If they want to, why not let them keep the status quo as a comparison for outcomes.

What system will our kids be dealing with in 30 years?

What types of privatization, if any, actually function more efficiently than a well-managed state monopoly? This seems like a radical question, but when one realizes that one of the assumptions of perfect competition is perfect information, the neo-liberals, neo-conservatives and populists have a lot of misinformation to account for.

In the short term, the opposition must request more from the auditor general and the FAO. We may not like it but they are the best line of defence we have at this point.

We have developed a health-care system that enables the senior levels of government to blame each other for the mess they have jointly created