The project manager’s guide to fixing Ontario

There are two Ontario’s. One that exists for abled, financially secure people — where they see healthcare as universal (because they have insurance), and one for the rest of us. The second class citizen status of disabled and poor communities extends through all our policies, politics and media. These injustices are especially apparent if you are racialized on top of poor and/or disabled. It’s like compounded interest on bias.

Our teary-eyed-suit-wearing-crocodile, posing as Premier of Ontario, has done nothing to fix this situation and via a laundry list of cuts targeted directly at the poor, people on Ontario Works (OW), long-term care, the Ontario Disability Support Program (ODSP) and healthcare, has only made the problem larger for the next political party to clean up. There is a lot to do. There will be expenses. There is no getting out of that. But the fact remains, that not fixing the problem ultimately ends up costing us more in lives and taxes. An inefficient system that does not think about health and safety as preventative measures ends up in the chaos we see around us right now.

As a project manager who specializes in individualized process who has been navigating the healthcare system my whole life, I have an insider view of what holes exist. As a person who pays taxes and is running a small business, I also do not want to hemorrhage funds. I have personally been on support programs and eaten at the food bank though, and I know from experience how people who are doing that right now could be helped by a change of process. Social services are not systems we should keep frozen in time, as though they were religious traditions. It’s time to start a new tradition of smart processes and bold ideas. It’s time to make Ontario for everyone.

ODSP

• Raise rates across the board. The UN thinks we treat disabled people terribly and they are right. It costs more to be disabled than abled and people on ODSP and CPP do not have full coverage for everything they need to get well, or even stay comfortable. It should be more than CERB, but $2000/month should be the minimum considered.
• Fix support process bureaucracy. It’s hard enough for a person with a chronic illness or disability to get a doctor to believe them, it should not be a two year wait to get support. We should not make people become destitute before we help them. If people could keep their homes and have a larger asset group we would have to build less low income housing, it’s better for mental health and they could push through temporary health concerns easier. The way it’s set up now, we create disabled poverty that otherwise would not exist.
• Include a council of people on ODSP across the province as a task force to advise on fixing the system to not be punitive.
• Give people enough money to buy their own food. Food banks are not efficient or cost effective and they are inaccessible to many disabled people. The lack of nutrition, inability to provide medical diets and consistent help makes people sick and they need further medical help and are on support programs permanently as a result.
• Add to the Assistive Device Program and cover physical therapies like lymph drainage, osteopathy and more under OHIP. Right now, many expenses are not covered and you require specialists to fill out the forms to get the few things that are. Those specialists are not free to see, so there is a financial bar to entry for financial support. This makes zero sense.

Accessibility

• Upgrade the AODA to include full accessibility and reflect the lived experiences of disabled people. The Honorable David Onley reviewed the AODA in 2019 and Ford has ignored the recommendations completely.
• Create an “it’s okay to be disabled” campaign. People get worse without accessibility and mobility devices, which leads to further disabilities. It costs less to get someone a walker if they feel it’s not making them a burden on society than it does to buy them a new hip and have a surgery. Many elderly people have the ‘I’m not disabled, I’m just old’ mentality which ends up being costly. One of the worst parts of disability is lack of access. Those who have newly discovered the joys of this via lockdowns, welcome to empathy.
• Look at secondary insurance rules that deny people with pre-existing conditions. This costs the province in healthcare when people get worse as they can’t do physical therapies. Ultimately this should be replaced by true universal healthcare.
• Upgrade legislation for people with environmental sensitivities. We have the least access out of anyone because rules for sitting on advisory boards insist that you belong to a group and we didn’t have one until I made one, as we have specific needs to get well enough to work. Hospitals are not accessible to us, which is hugely discriminatory. Make this a priority to fix.
• Create an app and website for people to report accessibility infractions and human rights violations so that they can get traction on the fixes without having to file costly human rights claims and lessen the amount the province and municipalities has to pay out in legal fees and claim awards. Make human rights systems easy to navigate through technology upgrades and human language centred AIs. Have accessible phone and TTC systems in place for this for those without technology access.

Healthcare

• Growing cities need a new hospitals. Currently the province only pays for the buildings and staff wages. Machines are lacking across the province.
• Hire specialists for the hospitals so that people do not have to travel to other cities. The Toronto centre of gravity for medical professionals creates a void elsewhere. Ontario is large and Toronto is not affordable to live in for support. It’s less costly to move a specialist than to house all the low income disabled people who need them. Think strategically.
• Create accessibility shuttle programs so that elderly and disabled people living in their homes can easily get to appointments, even if they have to travel to another city to do so, while hospitals are being built. Confer with hospitals about bulk booking out of town appointments from the same city near the same time so this is cost effective. Current one-off travel requests end up costing us more money.
• Expand Trillium to be universal pharmacare and expand the types of medications it offers. Have ‘higher income’ buy-ins to help fund which would be dramatically cheaper than people pay for their work plans and make it free for people below a certain income rate. Currently it discriminates against disabled people by not covering compounded medicines which are needed by many with allergies and sensitivities.
• Create similar program to help pay for physical therapies, assistive devices, dental, eyes and so on. Tiered payment so that if you can afford it, you pay in but it would be cheaper than what you pay for your work insurance, or about the same but you get much more for it because there would be no deductibles. Have businesses have to pay into this system too, but make it cheaper than it would cost them to have the insurance programs they currently have so they support it. If your business has an income under a certain amount a year then you don’t have to pay into health insurance, which helps entrepreneurs and start ups and encourages companies to begin here.
• Fund rare disease research. Many of the people who are on ODSP could actually get well enough to work and would not need the program if they could get access to specialists who are actually good at diagnostics. Huge issues within that system with gaslighting of symptoms, refusing to order tests as many are not covered under OHIP.
• Invest in knowledge management program for GPs and Specialists so they can look up the latest research from the groups who are doing it. The Women’s College Hospital Environmental Sensitivity clinic has a 1.5 year wait and they are the only specialists in the province. Most doctors do not know about many of the illnesses covered under the umbrella. Again this ends up costing us in larger interventions needed down the road.
• Change doctor regulations about who can request testing. Currently GPs have to order certain tests at cost while specialists have them covered under OHIP. Specialists should be providing lists of tests that the patient needs to the GP so that they have tests in advance of their first appointment, which unblocks the bottle neck and reduces specialist appointment appointments and costs.
• Update tests that are accepted under OHIP, we are behind in the latest testing methodologies.
• Allow for at home testing for things like UTIs, yeast infections, bacterial infections and paps which can be dropped off at labs for testing. This will save money and time.

Small business

• Create small business supports for super small businesses and disabled entrepreneurs as currently there are none. Think etsy stores, maybe even have a ‘shop local’ marketplace like Etsy built that takes less of a cut from businesses and only takes a cut after you’ve earned above a certain threshold.
• Institute province paid sick days for small business and create a buy-in program for the larger more profitable corporations.

Housing

• Provide more universally designed accessible units in low income housing, and/or provide accommodation bursaries for disabled people who have to live in large expensive cities to access their specialists. Currently most of the homes are full of mould and are actually making people more ill, which keeps them on the support program and costs more in healthcare expenses down the line. Upfront preventative housing and nutrition is ultimately cheaper for everyone. No safe housing exists for people with environmental sensitivities.
• Create mandates for municipalities to build universally designed accessible single family homes. Disabled people of all income levels have few options, and it is a ten year wait list for an accessible unit in low income housing. Clearly there is a greater need than our current build ratio allows for.

This list may look exhausting, but it is not exhaustive, and I’m sure I’m missing things as I rage type through the frustration of knowing there is a better way to do things. We have three parties in line to take over the swamp that the Premier-crocodile has created out of our amazing province. While swamps are a necessary part of our ecosystem, no one wants to live in one directly and we have forced a large portion of our community deep into the mosquito infested muds. We can do better as a province for ourselves and each other. We can make Ontario for everyone.