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First step in privatizing healthcare?

raginduck said:
Is this a real number.. or a guess?
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What "number" are you referring to?

If it is the ONA nurse salary number, then it is 100% accurate, pulled from their web page.

Nurse agency salary rates for nurses are on the web as well and based on where you fit on the salary grid they're paying about 50% more, so the $75 / hour is a conservative estimate, not a guess.

Billing rates for contractor staff are typically 2 - 3 times the hourly rate an agency pays to their contractors. If you hire a PSW to come into your home help care for someone the billing rate will be $60 - $65 per hour + HST. The PSW is paid about $20 - $22. A nurse paid $75 / hour by the agency would be billed at anywhere from $150 - $225. This is an estimate based on 40 years of contract management in healthcare prior to retirement, not a guess.

The URL link is for an article referencing Agency billing of between $80 - 150 per hour. My example used a nurse at close to the top of the pay scale and a billing rate of at least $150 would be common, more is possible.

 
GreyGhost said:
Market wage is interesting in a monopoly. It is literally whatever government is willing to pay. If they pick a number far too low, nurses move to other jurisdictions. I don't think we are there. Huge issues in the system but I don't think critically low pay is one of them. Inserting agencies in the center really messes with the program. Drives costs to the moon while providing very little benefit (other than the piles of gold heaped upon the owners of the agencies for doing almost nothing). I don't think market rate for a nurse is $100 as the system would collapse if all were at that number. Putting in controls that limited agency roles (maybe by time or percentage of hours in a facility) would result in better working conditions (and possibly increased pay) for staff nurses as there would be a mandate to keep a high percentage on staff. Easy to fund that when you stop paying agency triple for the same person.
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I think market rates would be more or less like doctors. Nurses with high acuity training would make more than a nurse in a clinic. Much like a brain surgeon makes more than a GP.

Problem with the existing system are many, but IMHO the biggest issues are:
1) Pay is tenure based, performance and skills are not pay differentiators. Smart nurses are easily coaxed out of the public system with 2x paychecks.

2) Agencies are plucking resources from the public system and selling them back st a profit.

3) Nursing union lobbies are restricting supply by limiting training slots and making it difficult yo accredit foreign trained nurses.
 
ReSTored said:
What "number" are you referring to?

If it is the ONA nurse salary number, then it is 100% accurate, pulled from their web page.

Nurse agency salary rates for nurses are on the web as well and based on where you fit on the salary grid they're paying about 50% more, so the $75 / hour is a conservative estimate, not a guess.

Billing rates for contractor staff are typically 2 - 3 times the hourly rate an agency pays to their contractors. If you hire a PSW to come into your home help care for someone the billing rate will be $60 - $65 per hour + HST. The PSW is paid about $20 - $22. A nurse paid $75 / hour by the agency would be billed at anywhere from $150 - $225. This is an estimate based on 40 years of contract management in healthcare prior to retirement, not a guess.

The URL link is for an article referencing Agency billing of between $80 - 150 per hour. My example used a nurse at close to the top of the pay scale and a billing rate of at least $150 would be common, more is possible.

Click to expand...

I highlighted the numbers I was asking about when I quoted your post...

You said...
"Agencies offer more scheduling flexibility and a higher per hour wage. If the agency is paying the nurse $75 / hour they are billing the hospital 2 - 3 times the hours rate or $150 - $225 per hour."

From the article you posted in this reply...
"with agencies charging hospitals between $80 and $150 an hour."

Numbers I've seen from other sources are inline with the article.
 
ReSTored said:
What "number" are you referring to?

If it is the ONA nurse salary number, then it is 100% accurate, pulled from their web page.

Nurse agency salary rates for nurses are on the web as well and based on where you fit on the salary grid they're paying about 50% more, so the $75 / hour is a conservative estimate, not a guess.

Billing rates for contractor staff are typically 2 - 3 times the hourly rate an agency pays to their contractors. If you hire a PSW to come into your home help care for someone the billing rate will be $60 - $65 per hour + HST. The PSW is paid about $20 - $22. A nurse paid $75 / hour by the agency would be billed at anywhere from $150 - $225. This is an estimate based on 40 years of contract management in healthcare prior to retirement, not a guess.

The URL link is for an article referencing Agency billing of between $80 - 150 per hour. My example used a nurse at close to the top of the pay scale and a billing rate of at least $150 would be common, more is possible.

Click to expand...
I think your numbers are a bit off, agencies make avgoid buck but not as much as your guesses. A PSW costs $40/hr in the GTA. Inhad 5 serving us gor 3 months, they were paid $24-$30 hr.

Contract nurses are billed out at $15-20hr above their wage and travel expenses.

The profit margin isn't really an issue, it's less than the overhead for a union nurse. The problem is a public nurse wages are 50% of what they make in private practices. The agencies create demand for their nurses by recruiting which this starves the public system.
 
GreyGhost said:
Market wage is interesting in a monopoly. It is literally whatever government is willing to pay. If they pick a number far too low, nurses move to other jurisdictions. I don't think we are there. Huge issues in the system but I don't think critically low pay is one of them. Inserting agencies in the center really messes with the program. Drives costs to the moon while providing very little benefit (other than the piles of gold heaped upon the owners of the agencies for doing almost nothing). I don't think market rate for a nurse is $100 as the system would collapse if all were at that number. Putting in controls that limited agency roles (maybe by time or percentage of hours in a facility) would result in better working conditions (and possibly increased pay) for staff nurses as there would be a mandate to keep a high percentage on staff. Easy to fund that when you stop paying agency triple for the same person.
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What is a decent wage for any job?

A generation or so back I thought Canada would be there for me if things went sour so as long as I paid my bill I was OK. That is no longer the case. It has become every man for himself. Only the delusional think otherwise.

JFK, in his inaugural speech stated "Ask not what your country can do for you but rather what you can do for your country." That would be a joke today. Grab what you can.

It's worse in occupations such as medicine, law enforcement and teaching. If you overpay, people get into it solely for the money. If you underpay you don't get responsible people. Responsible people must be responsible to their family's well being as well.

For some reason nursing seems to get the dirtiest end of the stick with compensation and it's not just Canada. A sister, nursing in New Zealand has the same problem.

Sadly not only are they short changed financially but since they are the front line of care-giving they also are the first to hear complaints as they are on the floors. The doctors spend more time in their offices as do the other medical executives.

Continued fiscal mismanagement and ethical faux pas from all levels of governments has created a level of mistrust.
 
our one friend doing northern travel nurse work , and she is an RN 'utility nurse' , not a PICU or surgical was working for the province, other gals in her rotation were from an agency. Making $11 an hour more doing identical work. She signs with the agency and is back on the same site 6 weeks later doing the same job , making $11 more. And she stays in the HOOP pension plan, non union .
The system has some issues.
 
crankcall said:
our one friend doing northern travel nurse work , and she is an RN 'utility nurse' , not a PICU or surgical was working for the province, other gals in her rotation were from an agency. Making $11 an hour more doing identical work. She signs with the agency and is back on the same site 6 weeks later doing the same job , making $11 more. And she stays in the HOOP pension plan, non union .
The system has some issues.
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Hmm. DIL is a 2nd year staff nurse in a Northern ON hospital, psych floor, $35/hr + govt benefits +$15k annual bonus for first 3 years. She can go to a contract agency in 6 mos and work on the same floor for $55/hr + $50/day per diem + $2000/mo living and travel allowance - no benefits, no security but tax breaks as an independent contractor.

D is a CICU/PICU nurse. Her first travel contract is in Edmonton, 3 weeks @ 60hrs/week, $stupid/hr + $75/day per diem, 100% accommodation, company car, and airfare.

Not easy work, but if you're happy outside the well served gta you can make bank.
 
Is there an age when the PSA test becomes free, or is it only once they find cancer?
 
I’ll gladly give them the $100 for a Psa test . Some things are worth knowing .


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Friends daughter is a PICU , just finished her certs to become a nurse practitioner. She was splitting between McMaster and SickKids doing two part times jobs in picu, neither hospital could give her a full time position.
Vancouver offered a full time job , relocation expenses and a signing bonus , guess where she lives now. When she announced her leaving both Ont hospitals suddenly had a place . Um no .

So your a staff nurse at hospital xx and you’ve been short staffed all through the pandemic’s, doing miserable shifts and your boss solves the problem with hired guns making twice what you make , staying at the Hyatt and your brown bagging it , they just head back to the Hyatt for prime rib . And we can’t figure out why nurses bail from hospitals and work at Terra nurseries deadheading geraniums.
I don’t know the solution, but my wife is retiring early , from a fairly senior nursing job at OTMH , they could not pay her enough to stay .


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Nursing pay is wackos in Ontario. Is based on tenure, a nurse wiping sniffles gets paid the same as an icu oe surgical nurse. Add to that nurses hourly wage is less than 1/2 that of a teacher, firefighter or cop.

They do have mire freedom to move to locals with better pay, can be an exciting job for a young person interested in seeing the world.
 
for people with no "ties" , kids dogs houses husbands , its a termendous opportunity and I cant discredit anyone from taking the gig. Actually our one travel nurse friend takes her dog, its a conditioin of her contract. Its her security system in really remote locations.
Other gal we hangout with occasionally was formerly the head of OTMH emergency, she mid 40's and very skilled , she just burnt out running a huge ER in a gta hospital, fighting for beds and staff , calling in halton police once a week to manage patients , she seems pretty happy flying into Rez XX for two weeks , then two weeks at home. I get it.
 
I mentioned to my wife retiring in her mid 50's , hey take a two week rotation in the NWT and I can fly up and go fishing , you can make 5K a week. I was politely told to go F myself. Her solution was for me to go work in Butthole , down a mine someplace , and she would go to Miami. I get that also.
 
Baggsy said:
Is there an age when the PSA test becomes free, or is it only once they find cancer?
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IIRC it's a PSA reading of over 5. At around 10 they want a biopsy. The test was around $35 but women get mammograms free. Sexism,

Some activities raise the reading. Riding a bicycle, sex and even the gloved finger.
 
crankcall said:
I mentioned to my wife retiring in her mid 50's , hey take a two week rotation in the NWT and I can fly up and go fishing , you can make 5K a week. I was politely told to go F myself. Her solution was for me to go work in Butthole , down a mine someplace , and she would go to Miami. I get that also.
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Compromise. Take her to Miami, she can make 4kUSD a week, you can fish the Keys.
 
mimico_polak said:
In shocking news to no one...


While I understand some of GTAM believes it's good to have a 'private' option for health care in Ontario...I'm against it, simply because it's going to cost us more, and Douggie is on a bad path IMO that he's trekking here.

It's happening in Alberta already, and that seems to be going toward a dumpster fire.
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As with everything, I think we don't have the whole story here. If hospitals don't have more capacity (seems plausible based on what I have heard), paying private clinics more makes sense as hospitals were paid for out of provincial capital funds. They don't give the clinic up front capital to build the operating rooms. I have no idea about the reasonableness of the magnitude of the difference but directly comparing cost per surgery without looking at the whole financial picture is just propaganda.

Private Healthcare done well (oz for example) can be fantastic saving the public system money and improving public care. Private Healthcare done poorly can both empty public coffers and worsen public Healthcare.

Fwiw, I was talking with someone that works for an organization that is substantially funded by the province. One of their job benefits is access to a private clinic. Grr.
 
GreyGhost said:
As with everything, I think we don't have the whole story here. If hospitals don't have more capacity (seems plausible based on what I have heard), paying private clinics more makes sense as hospitals were paid for out of provincial capital funds. They don't give the clinic up front capital to build the operating rooms. I have no idea about the reasonableness of the magnitude of the difference but directly comparing cost per surgery without looking at the whole financial picture is just propaganda.

Private Healthcare done well (oz for example) can be fantastic saving the public system money and improving public care. Private Healthcare done poorly can both empty public coffers and worsen public Healthcare.

Fwiw, I was talking with someone that works for an organization that is substantially funded by the province. One of their job benefits is access to a private clinic. Grr.
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While I agree that we don't have the full story, I've heard/read of reports of empty operating rooms / clinics in hospitals because there is just not enough people to work them. Of course I don't have hard evidence of this, so I won't provide it.

So to me, that means the capacity is there...but the gov't refuses to invest into that system and elects to transfer that money to the private sector instead for whatever reason (let's assume greed instead of actual compassion).

The biggest issue is the conflicting reports, and both sides messing around with facts / figures to muddy the water and make their viewpoint the 'right' one.
 
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