Speaking of “priorities,” Canada’s quietly looming health-care crisis

rcmplove

A big-hearted smile from a Canadian “Mountie” was a little refugee’s first experience of Canada after crossing the border from the U.S. last winter.

I know I’m not alone in this: the feeling of being fortunate, relieved, and proud, to be a resident of this good country called Canada, as the sands run out for the otherwise deeply troubling year of 2017. Not that prospects for 2018 hold much promise of being better.

There are other good places to live, countries and communities large and small where people who believe in human decency are doing what they can to keep that light on; people who know in their hearts that unless we can learn to live together and celebrate our diversity, rather than hate it, there is no hope for the future. 

Canada is a big country, a work-in-progress with a lot of challenges to face, and still, a relatively small population for its size to pay for all that needs to be done.

Last winter, because of family circumstances, I found myself taking a virtual crash course in the Province of Ontario’s home-care, “Home First,” home-care system, and then Long-Term Care. It was an eye-opening experience.

I came to the conclusion that Ontario, and the rest of Canada, including the federal government itself, are heading into a health-care crisis as members of the trend-setting, postwar baby-boom generation enter their senior years and beyond. Canada has a universal, publicly-funded, health-care system. Every Canadian resident – citizen, or newly-arrived immigrant – is covered. No one has to worry about going broke to get medical treatment.

But I am inclined to think a health-care funding crisis is already upon us, that big changes in the health-system and/or massive transfusions of government (taxpayer) money sooner rather than later are needed. Surely, dealing with it is a national priority.

And yet, why are we hearing so little about it?

My ears perked up when I heard Canada’s auditor-general, Michael Ferguson, say this week that fixing the ironically-named Phoenix public-service pay system should be the federal government’s “highest priority.”

Not that it’s not important. The morale of several hundred thousand people who work for you and I certainly is, for their sake and ours, and the good of the country. By all means add it to the list of important issues, if it isn’t already there.

As of last June, when the auditor-general’s office did its ground-work, more than 150,000 government employees were still waiting for $500 million worth of pay requests to be processed. Ferguson said it will take much more than the $540 million the government has set aside to fix the problem, possibly as much as $1 billion or more.

The switch to Phoenix from the previous pay system began during the tenure of the former Conservative, Harper government in 2009. It was supposed to be a cost-saving measure utilizing the latest, high-tech, data-management know-how. Ah, brave new world,

The current Liberal government blames the previous government. The new leader of the now-opposition Conservatives, Andrew Scheer, says the Liberals were warned, but pushed the Phoenix “start” button anyway. And so it goes, the old political blame-game.

The bigger question, which no one seems to talk much about, is why the U.S.-based, multi-billion-dollar software giant, Oracle Consulting, that supplied the PeopleSoft system doesn’t just fix it. But in all the news reports I’ve read or heard, that name has never been mentioned.

But I managed to find an Advanced Contract Award Notice (ARCAN) on a government pdf internet site that showed the company name, and address of Oracle’s Canadian subsidiary. The purpose of the ARCAN was to “signal” the government’s intention to award a six-month contract to Oracle Consulting Services, starting Sept. 29, this year, while giving other “suppliers” an opportunity to demonstrate their capability to also do a thorough assessment of the system. That could lead to a “full tendering” process. The deadline for submissions was Sept. 29.

Reacting to the auditor-general’s report, Canada’s Public Services Minister Carla Qualtrough said the government would look at all options for the long-term, including whether Phoenix will still run the federal pay system.

She did not mention a six-month contract with Oracle Consulting, or anyone else.

Meanwhile, widespread public discussion about the future of seniors’ health-care has gone missing for months since the provinces and territories inked deals with the federal government for additional health-care funding, including home-care for seniors.

But has the crisis passed? Is it no longer a high-priority issue, perhaps even the “highest priority?” Or is it, to coin a phrase, an “inconvenient truth” set aside until some of the other dust settles?

“Without a change of course, health spending would eat up 70 percent of the provincial budget within 12 years, crowding out our ability to pay for many other important priorities,” the Ontario Ministry of Health and Long-Term Care said in a 2012 “Action Plan” about the future.

Ontario has put a lot of emphasis on home-care with its “Home First” program. But home-care has its limits, while waiting lists for Long-Term Care (LTC) beds, and the cost for the mainly frail elderly people who will increasingly need them, continue to rise.

A bed in a semi-private room now costs more than $2,000; and more than $2,300 for private. That’s about half the actual amount. The rest is subsidized by the provincial government to the tune of close to $30 billion annually. That doesn’t include other expenses which remain the responsibility of the LTC resident, like medicine and other services not covered by a private insurance plan, if they have one. Ah, so that explains all those ads on TV.

Meanwhile, a dark cloud now hangs over the LTC system, or what used to be called nursing homes, in the wake of the Elizabeth Wettlaufer murders, with a public inquiry now underway.

The Public Inquiry into the Safety and Security of Residents in the Long-Term Care Homes System has been mandated by the Ontario government to investigate “the circumstances and contributing factors” of those terrible “events.”

“The Inquiry also has the ability to consider other relevant matters . . . to avoid similar tragedies,” says an Inquiry news release.

There are many aspects to the LTC crisis, including staffing, public accountability, and, of course, funding.

So, what is the highest priority for the taxes you pay for the upkeep of this good, hopeful country? A pay system called Phoenix that so far can’t fly, or rise again? Or health care for your elderly loved ones?

They shouldn’t be the underdog in the federal distribution of precious public money.

elderly

A version of this post was originally published in The Sun Times in November, 2017

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