Ontario Pre-Budget 2014: Finding the Right Balance - Submission to the Standing Committee on Finance and Economic Affairs
Summary of Recommendations
- Ensure the fiscal capacity to deliver all essential health, health care, social, and environmental services by building a more progressive tax system
- Increase revenue sources that encourage environmental and societal responsibility. Begin by phasing in environmental levies, such as a carbon tax, to help pay for the damage polluters cause and to support the social programs and services most needed by at-risk populations.
- Work with the federal government to research the scope of tax evasion losses, and then put in resources to recover the lost revenues.
Social Determinants of Health
- Immediately increase the minimum wage to $14 per hour, and automatically index it to the rate of inflation thereafter in order to bring workers 10 per cent above the Low Income Measure of poverty.
- Improve access to affordable housing and stimulate job creation in the process.
- Transform the social assistance system to reflect the actual cost of living.
- Set ambitious toxics reduction targets. Ensure people have the right-to-know about the existence of toxics in the environment, in their homes, in their workplaces, and in consumer products.
- Minimize the energy footprint by: focusing first on conservation and energy efficiency, relying minimally on existing coal plants until they are closed, increasing reliance on renewable energy, and strategically using natural gas and hydroelectricity imports from Quebec to meet any energy shortfall.
- Create new dedicated revenue sources to pay for a substantial expansion of transit and active transportation.
Medicare: Fiscal Issues
- Work with the other provinces to bring the federal government back to the table to negotiate a 2014 Health Accord to replace the expiring 2004 accord. Part of that negotiation would include preservation of the Health Council of Canada.
- Expanding our publicly funded, not-for-profit health-care system to all medically necessary areas, starting with universal home care, universal pharmacare and dental care for people living with low income.
- Focus on well-researched and demonstrated policies and evidence-based clinical practices to optimize the health of people, families, communities, and our health system.
- Given the federal threat to close the door on supervised injection services, we urge Premier Kathleen Wynne to demonstrate leadership and immediately fund services in Toronto and Ottawa.
- Reject efforts to commercialize or privatize health-care delivery. Place a moratorium on new P3 negotiations and contracts. Prohibit medical tourism, and do not allow Canadians or foreigners to buy their way to the front of a queue for insured health- care services.
Medicare: System Improvements
To ensure co-ordination between the various elements of our health system, we must secure system integration and decrease duplication. To achieve this, we ask that government:
- Support Local Health Integration Networks to achieve regional health system planning, integration and accountability for all health sectors, using an evidence-based and person-centred approach rooted within a population health, primary health-care framework.
- Commit to providing all Ontarians with access to integrated interprofessional primary care by 2020 in nurse practitioner-led clinics (NPLC), community health centres (CHC), Aboriginal Health Access Centres (AHAC) and family health teams (FHT), and fund them to work to full capacity.
- Improve navigation across our complex system by partnering with patients to co-ordinate their care through primary care.
- Transition the 3,500 case managers and care co-ordinators from Community Care Access Centres into primary care through a carefully crafted labour management strategy that retains their salary and benefits.
- Narrow the gap of about 17,600 RN positions as quickly as possible. Ensure that staffing mix decisions are based on client need.
- To protect the safety of our seniors and to ensure their timely access to quality care, phase in new minimum staffing standards in long-term care, starting with a minimum of one nurse practitioner per 120 residents.
- Ensure 70 per cent of all nurses work full-time so patients have continuity in their care and care provider.
- Maximize and expand the role of RNs to deliver a broader range of care, such as ordering lab tests and prescribing medications.
- Secure fair and competitive wages for nurses and nurse practitioners working in all sectors of health care. RNs face substantially lower compensation in primary care and home care, while Ontario NPs receive substantially lower compensation than NPs in jurisdictions like Alberta.
Read the full submission attached below.