Anyone who believes Doug Ford and Danielle Smith speak for the great majority in their provinces might want to look again at an Ipsos poll taken late in January 2023.
It asked whether respondents agreed or disagreed with “I am in favour of private health care for those who can afford it.”
A full 60% agreed Canada-wide. In Quebec as many as 75% were in favour. In Manitoba and Saskatchewan it was 70%, and in BC 65% — all above the 60% Canadian average.
Atlantic Canada was below average — with only 57% in favour. But at the lowest end it was only 52% in Ontario and 49% in Alberta!
Meanwhile, a few Ontario voters paying very close attention may also be wondering how Premier Ford’s current interest in private health care options relates to the broader innovative health care reforms his government introduced almost four years ago?
Somewhat ironically, various piecemeal reforms and pilot projects of the past generation finally came together in an almost major burst of change under the first Ford government’s People’s Health Care Act of 2019.
Even with its populist title this act reflected the Ontario Ministry of Health’s long-meditated variation on “Integrated Health Care” reform — a policy-experts’ strategy for improving health care delivery in North America and beyond.
In late June 2019 the Ford government’s “new bold vision” was applauded by the Premier’s Council on Improving Healthcare and Ending Hallway Medicine : “The Ontario Health agency, and Ontario Health Teams [two new organizational structures created by the 2019 act] are important parts of building an integrated health care system in Ontario.”
The Council went on : “ When teams of health professionals work together to serve the same group of people … resources would follow the patient. There would be an emphasis on prevention and well-being.”
The COVID-19 pandemic no doubt affected the practical realization of this vision. Former health minister Christine Elliott’s decision not to run in the 2022 Ontario election may have added a further complication.
Something of the 2019 vision nonetheless survives in an early February 2023 health care reform update tabled by current health minister Sylvia Jones, and headlined “Your Health: A Plan for Connected and Convenient Care.”
The recent progress can also be seen in the Annual Business Plan, 2022/23 of Ontario Health — the single centralized agency presiding over the more decentralized world of Ontario Teams in the aspiring new integrated care system.
In 2022/23 Queen’s Park has been spending some $30.5 billion on the Ontario Health agency and its various Ontario Teams, out of a total Health Sector spending of $75.2 billion.
Dr. Mekalai Kumanan, president of the Ontario College of Family Physicians, has similarly suggested that so far only some 25% of the province’s family doctors are “working in teams” where “physicians are supported by nurses, dietitians, social workers and more.”
At the same time, there has been progress. The newly centralizing Ontario Health has (in its own business-plan words) “created one high-performing team from 22 previous standalone agencies and organizations, saving the government over $219 million.”
In understanding the companion Ontario Teams concept it seems important to remember that there are several levels of lower-level teams.
According to the February 2023 update : “Across the province, 54 Ontario Health Teams are working to improve transitions between health care providers.” An additional four are in the works for a total of what seem to be 58 geographically based regions.
Yet a key task for these regional Ontario Health Teams is fostering the smaller primary care teams of Dr. Kumanan’s “physicians … supported by nurses, dietitians, social workers and more,” that so far involve only about a quarter of family doctors.
Sylvia Jones’s February 2023 update suggests a carry on slowly approach to all this : “We are also providing … $30 million” to “create up to 18 new … interprofessional primary care teams, which include … nurses, doctors, social workers and others.”
Meanwhile, of course, there is as well something of a fresh note on the innovation that continues to drive Ontario health care policy.
As the February 2023 update explains, to help reduce “wait times” for such “surgeries and procedures” as Hip Replacement, Knee Replacement, and Cataract Surgery the Government of Ontario will also be “providing these publicly funded services through community surgical and diagnostic centres.”
And suddenly this runs into a big Canada-wide debate on “private health care for those who can afford it,” which 60% of all Canadians favour — but only 52% like in Ontario!