ER closures and limited staffing | Page 10 | GTAMotorcycle.com

ER closures and limited staffing

So Devils Advocate... you worked hard, saved your money and had a 'normal ' life where you followed an investment path , purchased a home and did things well. You have some cash going towards the finish line.
Dufus across the hall could never really hold a job, spent some time drifiting, been in court several times over unpaid family support.
You should pay more? because you have more and tired harder.? maybe.
 
Mad Mike said:
I look at this as a positive move. DF doesn't have a magic wand, it's going to take time to fix this. At least he's doing something, maybe the best of a handful of shityy options.

Dont forget the last Ontario govt made this mess over their 15 year reign, the current govt got a 100 year storm to stress test what they inherited.

Not only did they need to fix things, they now have to rebuild a labour intensive system in a tight labour market.

First thing I'd do us jack the copay to match local market conditions. I'm sure there are lots of seniors who could afford to pay their way. $2000/mo for lodging, food, and 3 hrs of personal care a day is a bargain.

I know 2 old fellers who just entered LTC this year, their co pay is $88/day. The houses they moved out of were sold for $2m+, and they both have incomes over $100k. I realize this isn't everyone but gearing to income would help funding.
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Agreed, if everything is going wrong, do something different.

IMO the mess started far further back when general respect for each other was the norm. 50 years or more. It started as a tiny leak that went unchecked until the boat rotted out from the inside and is now about to sink. We spend more time bailing than rowing so the progress is what one would expect.

Our social programs were meant as safety devices, not plush mattresses. However there is a component of our policies that one must be kept in a manner to which they've been accustomed. If there is a major change in that the public must be given decades to prepare. You can't pull the rug out from people. Again, decades to resolve when the general public can't handle a covid shut down of a few months. Boo hoo, I need a latte.

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GreyGhost said:
Accelerating moves to ltc makes a lot of sense. Shipping people everywhere will be almost impossible to unwind. Like the CD case chain when we were younger. It takes far longer to get everyone back where they belong. One you are in ltc, your priority is well below someone in the community so realistically you never get a spot in your desired area.
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I'm kind of torn on this one, simply because I don't have anyone in LTC (currently).

But, currently, I'm OK with it. I'm OK with it because we need the space and capacity at this point in time. While I am no fan of DF, he also did inherit this mess from the previous governments and then got walloped with a global pandemic, on an overly stressed, defunded, and overloaded system falling apart at the seams.

You can't snap your fingers and POOF, issue resolved. It takes money, time, and a lot of political effort. Is it there? I don't know.

Maybe adding in some private/subsidized beds is an answer.

Poland has a funny system, if the parents aren't able to care for themselves, and are NOT in a position to pay for proper care then the government goes after the kids with a mandatory payment for caring of their elderly parents. I know because my father just flew out to see his dying mother before she passes. She got gallstones, and during the surgery had a stroke.

Currently unresponsive, with half her body paralyzed. But he got to see her alive, even though she (maybe) doesn't know he's there.

Now since all the kids are retired and on fixed pensions, the gov't has beds for those people, but there's a lineup a mile long because the subsidy is based on income, and you can only imagine how much shenanigans are going on to hide income...but the gov't goes after the kids first for payment.
 
We don’t take care of our own. And many families are trying to preserve moms cash . The aging population has been getting older , legitimately for decades and “we” have selectively ignored it .
I’m not blaming Dougie for this , he got handed a 20yr old turd , you can’t fix this by wishing it away


Sent from my iPhone using GTAMotorcycle.com
 
crankcall said:
So Devils Advocate... you worked hard, saved your money and had a 'normal ' life where you followed an investment path , purchased a home and did things well. You have some cash going towards the finish line.
Dufus across the hall could never really hold a job, spent some time drifiting, been in court several times over unpaid family support.
You should pay more? because you have more and tired harder.? maybe.
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In Canada we have a progressive income tax structure, meaning we take more tax dollars from high-income earners than we do from low-income earners. Retirement and the possibility of LTC don't appear suddenly for most -- we have decades to prepare. We also live in a society where we have a minimum standard for a lot of things, including healthcare, LTC, and education.

My feeling is both should have greater options for those who can afford them. I realize there is a social argument against this and I'm not advocating lowering the bar from where it is, but for opening private options that allow choices for those who choose to work for them. LTC has some options, however the current system is not progressive in terms pricing, everyone pays the same and the system doesn't have the capacity to meet demands. We could simply dump a few billion more into the system, we could also get more creative.

In Norway, LTC costs are usually progressive, users pay 0 to 75% of their income up, with a cap on the actual costs. In Ontario it's $70-90/day, with actual costs being somewhere around $225/day regardless of income. I think it would be fair that wealthier people pay more. Re-jiggin would mean someone with $35K or less would see no changes. People that make more would pay more - capping at $225/day for those making $110K or more retirement income. I don't know how much this would change the financing model, but I'm sure it would make more people consider options like home care and it would pump some dollars back into the system - both could have an easing impact on the current system.

Another thing I'd do is look at increasing LTC facility densities. Right now ON averages 95 people per facility, there have to be efficiencies in raising that number to 200 or 300 - so make that a requirement for new urban LTC facilities. The facility near me was originally 75 beds in 18000sq', they rebuilt it 15 years ago to 65,000sq' and 95 beds.

Finally, if I were King, I'd provide families that provide LTC at home 75% of the per-patient subsidy (after deducting co-pay) they currently offer LTC homes. That would be about $2400/mo -- I'll bet a lot of families could muster the resources to look after grampa if they were getting $2500/mo. This would ease demand AND reduce costs.
 
Mad Mike said:
Finally, if I were King, I'd provide families that provide LTC at home 75% of the per-patient subsidy (after deducting co-pay) they currently offer LTC homes. That would be about $2400/mo -- I'll bet a lot of families could muster the resources to look after grampa if they were getting $2500/mo. This would ease demand AND reduce costs.
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This is a fantastic idea. Majority of the reason (IMO) for people not caring for parents in their house is financial. If you can ease that burden, you open up a whole new economy of care and ease up the system. Sure not everyone can do it, but those that can will take it up for sure. I would.

Hell if they allowed it I would take an additional 2 or 3 strangers to care for if I had an extra $2500/person subsidy.

Sure you'll need permits to do it, hire inspectors to try and minimize/catch abuse of the system, and then you can allow the families that want to actually keep their parents in the house and care for them as now instead of going to work, they can stay home and care for their parents.
 
mimico_polak said:
This is a fantastic idea. Majority of the reason (IMO) for people not caring for parents in their house is financial. If you can ease that burden, you open up a whole new economy of care and ease up the system. Sure not everyone can do it, but those that can will take it up for sure. I would.

Hell if they allowed it I would take an additional 2 or 3 strangers to care for if I had an extra $2500/person subsidy.

Sure you'll need permits to do it, hire inspectors to try and minimize/catch abuse of the system, and then you can allow the families that want to actually keep their parents in the house and care for them as now instead of going to work, they can stay home and care for their parents.
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Abuse would be a problem. To fix that I'd say the LTC patient would need to follow the same application and test that's used to enter LTC today. Perhaps you'll get some applications earlier than expected -- fix that with an entry age min of 75 or some medical criteria like losing a driver's license for health reasons.

Simple obstacles deserve simple solutions.
 
Mad Mike said:
Abuse would be a problem. To fix that I'd say the LTC patient would need to follow the same application and test that's used to enter LTC today. Perhaps you'll get some applications earlier than expected -- fix that with an entry age min of 75 or some medical criteria like losing a driver's license for health reasons.

Simple obstacles deserve simple solutions.
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Abuse will always be a problem. Children that hate their parents will take them in simply for the $ and then not provide sufficient care.

But inspections should be ramped up, and frequency increased.

I assume that your plan, with increase demand for inspections will STILL be cheaper than running the facilities.
 
mimico_polak said:
Abuse will always be a problem. Children that hate their parents will take them in simply for the $ and then not provide sufficient care....
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That's a family issue, no different than locking your kids in the basement.

As for inspections, I think that might be intrusive in a home care setting unless there is cause for concern.

I suspect those who would keep grandma in a backyard shed are already doing it to keep their full pension. If we do find elder abuse -- rescue grama then nail the recipient of a caregiver's allowance to a cross.
 
Mad Mike said:
That's a family issue, no different than locking your kids in the basement.

As for inspections, I think that might be intrusive in a home care setting unless there is cause for concern.

I suspect those who would keep grandma in a backyard shed are already doing it to keep their full pension. If we do find elder abuse -- rescue grama then nail the recipient of a caregiver's allowance to a cross.
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Just flip the living arrangements. Grandma gets the house, kid gets the shed. When grandma dies, house sells and pays the PSW bill. Kid gets to keep the shed if they can find some land to put it on. Call it a tiny house.
 
crankcall said:
We don’t take care of our own. And many families are trying to preserve moms cash . The aging population has been getting older , legitimately for decades and “we” have selectively ignored it .
I’m not blaming Dougie for this , he got handed a 20yr old turd , you can’t fix this by wishing it away


Sent from my iPhone using GTAMotorcycle.com
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A decade or two back a colleague was complaining about the financial arangements of the LTC for his dad. Pop signed over all his assets to go towards care. He got a small allowance. If there was anything left at his demise the kids got it. If the money ran out before he died he was kept on with whatever government assistance came in.

The colleagues complaint was about his inheritance being eroded. Sorry but not sorry.
 
Mad Mike said:
In Canada we have a progressive income tax structure, meaning we take more tax dollars from high-income earners than we do from low-income earners. Retirement and the possibility of LTC don't appear suddenly for most -- we have decades to prepare. We also live in a society where we have a minimum standard for a lot of things, including healthcare, LTC, and education.

My feeling is both should have greater options for those who can afford them. I realize there is a social argument against this and I'm not advocating lowering the bar from where it is, but for opening private options that allow choices for those who choose to work for them. LTC has some options, however the current system is not progressive in terms pricing, everyone pays the same and the system doesn't have the capacity to meet demands. We could simply dump a few billion more into the system, we could also get more creative.

In Norway, LTC costs are usually progressive, users pay 0 to 75% of their income up, with a cap on the actual costs. In Ontario it's $70-90/day, with actual costs being somewhere around $225/day regardless of income. I think it would be fair that wealthier people pay more. Re-jiggin would mean someone with $35K or less would see no changes. People that make more would pay more - capping at $225/day for those making $110K or more retirement income. I don't know how much this would change the financing model, but I'm sure it would make more people consider options like home care and it would pump some dollars back into the system - both could have an easing impact on the current system.

Another thing I'd do is look at increasing LTC facility densities. Right now ON averages 95 people per facility, there have to be efficiencies in raising that number to 200 or 300 - so make that a requirement for new urban LTC facilities. The facility near me was originally 75 beds in 18000sq', they rebuilt it 15 years ago to 65,000sq' and 95 beds.

Finally, if I were King, I'd provide families that provide LTC at home 75% of the per-patient subsidy (after deducting co-pay) they currently offer LTC homes. That would be about $2400/mo -- I'll bet a lot of families could muster the resources to look after grampa if they were getting $2500/mo. This would ease demand AND reduce costs.
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Prepare? What? 50-60% of the population can't pay off their credit cards.

Why? "You desreve a break today" "Freedom 55" and all the other catchy ad phrases that have evolved into being rights.

" I have the right to a house" No you have the right to work for a house.

"Somebody needs to do something about XXX."

"Who?"

"Not me, but somebody. I don't know who specifically or their position but I've voiced my opinion and somebody should act on it by starting a cause. If it makes money count me in. I'll be at Starbucks sipping a latte and shopping for shoes."

CPP may not be the end-all but it's a hint that as soon as you start working you will someday be old and need income.

Too many people think of the goverment as another credit card that gets the limit raised when you overspend. Just pay the minimum balance forever.

CPP and OAS tops out at about $1800 / Mo. or $60 a day. What LTC facility can make money on that?

Norman Bates: "I have an idea."

LTC financial compensation for families caring for family is worth considering except does the extra $2400 a month end up being used to buy a bigger house with bigger mortgage?
 
nobbie48 said:
Prepare? What? 50-60% of the population can't pay off their credit cards.

Why? "You desreve a break today" "Freedom 55" and all the other catchy ad phrases that have evolved into being rights.

" I have the right to a house" No you have the right to work for a house.

"Somebody needs to do something about XXX."

"Who?"

"Not me, but somebody. I don't know who specifically or their position but I've voiced my opinion and somebody should act on it by starting a cause. If it makes money count me in. I'll be at Starbucks sipping a latte and shopping for shoes."

CPP may not be the end-all but it's a hint that as soon as you start working you will someday be old and need income.

Too many people think of the goverment as another credit card that gets the limit raised when you overspend. Just pay the minimum balance forever.

CPP and OAS tops out at about $1800 / Mo. or $60 a day. What LTC facility can make money on that?

Norman Bates: "I have an idea."

LTC financial compensation for families caring for family is worth considering except does the extra $2400 a month end up being used to buy a bigger house with bigger mortgage?
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Nice rant -- you could lecture at the Curmudgeon School!
 
Today was my first visit to a walk-in clinic. My GP hasn't been seeing patients face to face for two years and I bunged my knee.

Naively I, along with others thought it was like a Starbucks with meds. Nope you still need an appointment most of the time. I guess the walk-in means no admittance to patients on stretchers.

The good part is that the doctor was good and gave clear information. However I might not get him again on another visit.
 
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Dirtbiking buddy was telling me that he's been trying for a year to get a specialist to schedule him an appointment regarding a prostate issue. He said one finally got back to him and scheduled him an appointment but it's only a virtual one, not an office visit. "Geez next thing I know he'll be walking me through how to do my own prostate operation!"

Got me thinking how I've been waiting 8months now for a specialist to give me an appointment to get a vasectomy, hopefully I don't have to do it myself through a virtual appointment. In the meantime my wife kicking me in the nuts once a week will have to continue.
 
Ford needs to force doctors back to the office...mine works two days a week for in-person appointments and is booked three weeks out...luckily I have two walk-in clinics close by that actually take walk-ins, but the lack of care from doctors is totally ridiculous at this point...
 
@Hardwrkr13 8 months!? Wtf? I called my family doctor in the morning and had a scheduled call with the clinic 2 days later.

‘How about February?’
‘Can you do it earlier. Like before the snow hits?’
‘Why?’
‘Wife is preggers how am I gonna help her shovel the snow with a snip snip and a week of no heavy lifting’
‘Nov 4 work?’
‘Snip snip’
 
ifiddles said:
Ford needs to force doctors back to the office...mine works two days a week for in-person appointments and is booked three weeks out...luckily I have two walk-in clinics close by that actually take walk-ins, but the lack of care from doctors is totally ridiculous at this point...
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Not wanting to be racist but my doctor is in a racially diverse area. If newcomers to Canada brings the disease tolerance of their homeland, the office becomes a Petri dish. As much as I respect medical staff, if you don't go to work, don't expect a paycheck.

Call 911 for an ambulance and they give you GPS coordinates???
 
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