Fears that New Hospital Funding System Threatens Patient Access,
Leads to Privatization: OHC Responds to Throne Speech
Premier Dalton McGuinty is planning changes to hospital funding systems,
according to his Throne Speech today. The changes, if implemented, will
have a profound impact on Ontarians' access to care. Several news
reports are mixing up a new global hospital funding system (called HBAM)
with a proposal to bring in hospital centralization and cuts to local
services through a type of hospital fee-for-service funding competition.
These are two different proposals, though it is possible that both could
be implemented at the same time.
HBAM is a funding system based on calculating population and
weighting it with other factors such as age and particular local
contexts. Hospital fee-for-service competition is the opposite of
a global
funding system based on a formula designed to meet population need.
It is extremely controversial and will lead to worse access problems,
privatization, higher administrative costs and fewer local hospital
services.
“We are deeply opposed to the government’s proposal to force hospitals
to try to underbid each other for funding,” said Natalie Mehra, director
of the Ontario Health Coalition. “This system is the opposite of
patient-centred care. It ignores the human element of health care
entirely.”
“In fact, this system has already been tried in the United Kingdom where
it increased administrative costs and touched off a storm of
controversy. The unpopularity of their health “reforms” is one of the
contributing factors to the British government facing defeat in the next
election.”
“Hospitals underbidding each other has contributed to hospital
bankruptcies in the United Kingdom. It has created instability and has
promoted for-profit privatization of hospital care and services at the
expense of public hospitals. It has actually increased administrative
costs, and did not produce promised cost savings.”
In this system, hospitals would have to underbid each other or meet a
set price for each service. If your local hospital is not able to
underbid to get the funding for a service, you would lose it. Hospital
services would be centralized to pump out high volumes. Hospitals would
have to be renovated, staff moved (possibly repeatedly as each
bidding round took place), and entire administrative systems would
need to be created to price, bid, assess, monitor and manage it all.
“In every town across Ontario, from the smallest
rural areas to those with medium and even large general hospitals,
hospitals would shrink the scope of services they provide to concentrate
on fewer services. Patients – most of them elderly – would have to
find some way to travel from hospital to hospital to hospital for each
different type
of care. Hospitals would become competitors, rather than collaborators
in a public health system.”
“We are strongly urging the McGuinty government to look much more
closely at the British experience in which hospital were force to
underbid one another for funding. It has not saved money, has undermined
the public health system and has pushed privatization. If implemented
here, it would violate the core Canada Health Act principles of
accessibility and comprehensiveness.”
for
world news,
books, sports, movies ...
