While taxes continue to drive the debate in the municipal election, the Academy of Health Executives (our hospital CEOs, hereafter called the Academy) is attempting to inject into the debate the need for local hospital infrastructure funding. Plainly put, they want some $80 to $100 million of your property taxes as part of a 10-year, $232-million fund-raising effort.

This raises some fundamental questions. Why the sudden demand for funds? Is this really a local ratepayer responsibility? What other options are available? And where do we go from here?


To be fair, the Academy points out that the need for new hospital infrastructure has been pressing for some time. Our aging population combined with this region's phenomenal growth makes the situation more acute. The academy correctly asserts that the provincailly appointed Health Services Restructuring Commission grossly underestimated transition and new-construction costs when it closed and merged hospitals. The commission bean counters were good with spreadsheets, buy abysmal with real-world cost estimates.

Now, the academy estimates some $548 million in capital needs for our hospitals over the next decade. As noted earlier, some $232 million is to come from you and me, either through taxes, charitable donations or some combination of both.

This is due to a provincial formula that covers 70 per cent of restructuring-related infrastructure costs -- communities have been told to cover the other 30 per cent. For project not related to restructuring, the province must still authorize them, and the cost-sharing is then 50-50.


To a degree, yes. Communities should continue to play a role in funding their hospitals through the various hospital foundations, through individual and corporate charitable donations. However, using the property tax base is a quite another matter. What's next? Will school boards ask local taxpayers to build new schools on top of their provincial taxes? Such a move would set a very dangerous precedent.


Yes. To begin we must remember that hospital restructuring was supposed to save hundreds of millions of dollars. Indeed, the province says it has. So where did all the money go? And where are the opposition Liberals on this file? Earth to Dalton McGuinty, it's time for your policy gurus to do their jobs. Moreover, with Ontario projected to run a $4 billion to $6 billion surplus this year alone, combined with a federal cash infusion from the recent federal-provincial health care deal, surely, the 70-30 funding formula can and must be changed, not only for Ottawa, but across the province.

The issue is one of simple accountability. Given the restructuring commission's total botching of the cost projections for hospitatl infrastructure needs - a province-wide fiasco to be sure - the Harris government must account for this colossal screw-up. Even though the commision was supposedly an arms-length body, the premier and Health Minister Witmer are ultimately accountable for its failings.

For the academy CEOs and the opposition parties (paging Dalton, code blue, paging Dalton) to pursue this demand for increased funding more rigourously is a political and strategic, if not, critical mistake. While I have praised much of the Harris government record, this is one area where the province has failed, and miserably so.

By pursuing a two-track strategy, academy CEOs can and should continue to build a plan for massive community effort. Even is municipalities are asked to foot just 15 per cent of local costs, it will still be a monumental challenge.


In the absence of more details from academy CEOs on the potential costs to taxpayers, municipal politicians are wise to remain mute on this file. Moreover, with less than three weeks left until voting day, a substantive debate on this issue is not possible. Contraty to the assertions of the academy, a full 75 per cent of taxpayers in a recent Compas/Citizen poll said the province should address this problem, while only 15 per cent indicated support for direct municipal taxpayer involvement in hospital financing.

Hospital foundation fundraising plans can continue apace, along with more aggressive lobbying at Queen's Park for a more realistic funding formula. Once both these avenues have been explored, then the new Ottawa council can use the province's new referendum law and ask local voters for a binding decision on a specific hospital levy or tax hike.

If this infrastructure is designed to benefit the people, then let the people decide.