Opinion | Doug Ford hasn’t revealed a plan to dismantle public health care, or one to fix it.

They say that a crisis can be an opportunity.

So is Doug Ford deliberately creating a crisis in hallway medicine simply to evoke an opportunity for privatized health care?

Recall that a previous Progressive Conservative government, led by Mike Harris, stoked a crisis in education that triggered teacher strikes. Those tactics, caught on video, helped the Harris Tories implement their controversial “Common Sense Revolution” decades ago.

Today, there is no secret tape showing the current prime minister reusing the Harris playbook. On the other hand, there is no need to fabricate a health care crisis when the system seems constantly in jeopardy, no matter which party is in power.

Corridor medicine cries echoed through Ontario hospitals over the last two election campaigns, with many accusations but no politicians really pointing the way forward. During their first four years in office, Ford’s conservatives sent mixed messages about downsizing, enlarging, downsizing and privatizing.

This week, they unveiled the outlines of a new strategy to restore stability, bombastic if embarrassingly titled “Plan to stay open.”

Not surprisingly, the prime minister and his new health minister, Sylvia Jones, inspired a mixed reaction. Under Ford’s watch, hospital corridors are becoming more overcrowded, waiting lists are longer, emergency rooms are closing, nurses are quitting, COVID is making a comeback and flu season is looming.

Now the focus is on freeing up hospital resources by reducing delays Y locks

That means moving more scheduled surgeries out of public hospitals, including to private clinics, raising suspicions of stealthy privatization.

It also means moving patients with chronic (or complex) ailments more quickly into long-term care where they belong, even with temporary placements until they land on their preferred option. The idea is to reduce the burden on so-called “bed blockers” who often sit for long periods in overcrowded intensive care hospitals, awaiting places in a much-sought nursing home or specialist facility.

Critics worried that the elderly were being herded into unwanted facilities away from friends and family, if only for the short term. Others feared that for-profit clinics would undermine public health care.

However, leading voices in the hospital sector, some of whom have criticized previous PC government decisions, saw the beginning of a pragmatic response to a system that needs to try something untried, rather than do more. than has always been done in the past.

So is this government determined to dismantle the medicare edifice and rebuild it around the for-profit pillar of medicine?

According to the first tests, there is not so much a master plan as a lack of planning on the part of this government.

Jones was initially invisible and now seems inscrutable. He failed to persuade the public or reassure the industry that he has serious solutions just weeks after taking office in June.

Ontario spends a staggering $70 billion a year on health care, a sprawling sector that has a life-or-death impact on 15 million Ontarians. Previous governments of all stripes have long feared that rising costs would soon absorb half of the provincial budget, so they restrained spending, until they panicked and resumed unbridled growth.

Politicians in the province have closed hospitals only to reopen them. They have let the nurses go only to rehire them. They have reduced medical enrollment only to expand it again.

When Dalton McGuinty defeated the previous PC government in 2003, he quickly eliminated numerous OHIP procedures as medically unnecessary, driving many patients to private clinics. His liberals also focused on surgery delays and made significant progress, thanks in part to private management operations that provide publicly funded OHPI services.

The latest crisis predates the pandemic, thanks to a particularly virulent flu season just before the 2018 election. The resulting overcrowding caught liberal rulers by surprise, forcing them to reopen a hospital that they had just closed.

The reality is that health care delivery is an overwhelmingly complex operation that is difficult to scale while staying current. The only certainty is that sticking with the status quo, simply because that’s the way we’ve always done things, won’t get us off the ground.

Arbitrarily cutting money, as Ford first planned in 2018, before backing down under pressure, would only make matters worse. Quietly curtailing future spending, as the Ford government appears to intend to do in the future by failing to keep pace with inflationary pressures, would only muddy the waters.

But throwing more money at Medicare won’t fix the pressure points as our universal system falls further and further behind its foreign counterparts. Clamoring for cash from Ottawa is a Queen’s Park perennial that is beside the point, because Ontario has enough tax points to collect the revenue it needs.

It is too easy to get bogged down in jurisdictional and ideological debates. Federal transfer payments are a pipe dream, just as privatization is a panacea if not done judiciously.

As we deal with the growing pains of OHIP, we must be guided by first principles. Medicare never prohibited the private provision of services, whether by doctors, pharmacies or clinics, it simply prescribed public accessibility of medically necessary services without additional billing.

Instead of obsessing over privatization, let’s focus on innovation. And look to the health care leaders who must point the way for politicians who continue to point fingers for inspiration.

Martin Regg Cohn is a Toronto-based columnist who focuses on Ontario politics and international affairs for the Star. Follow him on Twitter: @reggcohn

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