Law Times

PAGE 6 u EDITORIAL OBITER By Glenn Kauth A Crunching the numbers at LAO t a time of stretched government budgets, it's hard to argue against Legal Aid Ontario's move in the past couple of years to dramati- cally reduce its deficit. But for those looking for an explanation for why legal aid remains under stress and lawyers continue to be frustrated with the system despite the government's promise of a lot more funding, the province's public accounts are a good place to start. They reveal that LAO reduced its defi- cit to $8.5 million in 2011 from nearly $28 million in 2010. In 2009, the shortfall was $19 million. As Law Times reported recently, many defence lawyers are still unhappy with LAO despite an agreement in 2010 to provide $150 million in more funding over four years to improve legal aid and significantly boost the tariff paid to counsel. But while the tariff has gone up, LAO has reduced the number of certificates it issues, meaning lawyers aren't necessarily making more from legal aid work overall while fewer people get service. The new ruling in R. v. House & McGill, in fact, made it clear how difficult it can be for people to find a lawyer willing to act on a legal aid matter. The government, however, has largely been delivering on the fund- ing promise as LAO's provincial allocations increased to $321 million in 2011 from $286 million in 2009. The forecast allocation for this year, meanwhile, is nearly $333 million. But LAO's budget for certificates in criminal, family, immigration, and other civil matters remained relatively flat at $177 million between 2009 and 2011. In the meantime, the number of certificates issued declined to 100,387 last year from a recent peak of 117,167 in 2008-09. In a recent presentation to lawyers in Ottawa and Brockville, Ont., LAO executives projected a small reversal in that decline this year with 102,857 certificates issued. So where has the new money gone? Obviously, a lot went to reducing LAO's deficit. At the same time, it appears the new funding also helped combat significant declines in the amount LAO receives from the Law COMMENT February 13, 2012 • Law Times Foundation of Ontario. In addition, more money has gone to family law offices, the duty counsel program, the research facility, and bad debts expense. But LAO has also reduced what it spends on the provincial office and appears to have saved quite a bit by shifting its focus towards regional offices and its client call centre. Reducing deficits and finding efficiencies are gener- ally good things, but it's obviously disappointing that the transformative change the government promised has yet to happen. And while lawyers have benefited from the much-needed tariff increase, clients are losing out with fewer certificates and eligibility guidelines that, according to the LAO presentation, date back to 1995 and put the threshold for a single person at $10,800. While some might say the government has done enough given its fiscal challenges, the eligibility thresholds are obviously in need of an update. Access to justice demands it, so rather than continue to dis- place its fiscal pressures on the backs of low-income people facing criminal charges, the government should find other things to cut back. Ontario Place was a reasonable place to start. Maybe a serious effort at reducing the government's adminis- trative costs should be next. It's untenable for Ontarians to continue to shoulder budget increases for the public service in general while watching frontline assistance through programs like legal aid certificates decline. — Glenn Kauth procedures that could take place off site. Clearly, it's a waste of precious re- T sources, a major issue as we prepare this week for economist Don Drummond's report on his investigation into where the province can cut costs by focusing on core programs and, perhaps, raise rev- enues. In concert with what's sure to be a painful prescription for change across the board, Health Minister Deb Matthews also recently foreshadowed changes to the health-care system. What she's telegraphing is what we all know: things must change and that means some sacred cows are going to fall. As a re- sult, the system may cover fewer services in the future. Private clinics may deliver some proce- dures better than hospitals. We may also have to get used to user fees and private health insurance. Th is talk, of course, is political heresy. Just as the extreme right railed about so- called death panels during U.S. President Law Times LT Masthead.indd 1 he joke about hospitals is that they're full of sick people but there are a lot of not-so-sick folks in them because they have no alternative for surgical Barack Obama's attempt to ex- pand health care to all Ameri- cans, the leſt goes into a tailspin if anyone talks about changing socialized medicine in Canada, especially if they raise the pros- pect of a two-tier system. But as Mark Rovere of the Fraser Institute notes, at some point we're all going to have to pay the consequences for a broken health-care model. Some changes have already Queen's Park He's referring to the 2004 Commitment to the Future of Medicare Act that slammed the door on two-tier medicine, extra billing, private health in- surance, and queue jumping. It was a feel-good, smarmy piece of legislation that sought to enshrine the Liberals as the saviours of health care. Fast forward eight years Ian Harvey happened. Ontarians now pay for eye exams and we pay an annual health tax. It's not a huge leap, then, as Rovere suggests, to ask Ontarians to pay some of the costs directly in the form of a deduct- ible or user fees or to allow them to buy additional health insurance from a private carrier. It's this last concept that also causes much consternation. "Th ere's nothing in the Canada Health Act to prevent the purchase of insurance for medically necessary treatment," says Rovere. "Th e legislation that forbids it is provincial." and it has come back to bite them. In the future, Ontario will have to outsource more procedures because doing them in hos- pitals isn't effi cient and the government is broke. Ontario will follow Quebec, which doesn't allow private health insurance but is outsourcing more procedures paid for by the public system to private clinics. Still, is private health insurance so bad? Would it not take some of the pressure off the public system? "Four provinces allow private health in- surance: Newfoundland, New Brunswick, Nova Scotia, and Saskatchewan," says Ro- vere, who notes there are clinics operating Thomson Reuters Canada Ltd. One Corporate Plaza, 2075 Kennedy Rd., Toronto, ON • M1T 3V4 Tel: 416-298-5141 • Fax: 416-649-7870 • www.lawtimesnews.com Group Publisher ................... Karen Lorimer Editorial Director ................... Gail J. Cohen Editor .............................. Glenn Kauth Staff Writer ....................... Kendyl Sebesta Staff Writer ................... Michael McKiernan Copy Editor ..................... Katia Caporiccio CaseLaw Editor .................. Adela Rodriguez Art Director .......................Alicia Adamson Account Co-ordinator ............... Catherine Giles Electronic Production Specialist ........Derek Welford Advertising Sales ............... Kimberlee Pascoe Sales Co-ordinator ................... Sandy Shutt ©2012 Thomson Reuters Canada Ltd. All rights reserved. No part of this publication may be reprinted or stored in a retrieval system without writ- ten permission. The opinions expressed in articles are not necessarily those of the pub- lisher. Information presented is compiled from sources believed to be accurate, however, the publisher assumes no responsibility for errors or omissions. Law Times disclaims any war- ranty as to the accuracy, completeness or cur- rency of the contents of this publication and disclaims all liability in respect of the results of Law Times is printed on newsprint containing 25-30 per cent post- consumer recycled materials. Please recycle this newspaper. any action taken or not taken in reliance upon information in this publication. Publications Mail Agreement Number 40762529 • ISSN 0847-5083 Law Times is published 40 times a year by Thomson Reuters Canada Ltd., 2075 Kennedy Rd., Toronto, ON, M1T 3V4 • 416-298-5141 clb.lteditor@thomsonreuters.com CIRCULATIONS & SUBSCRIPTIONS $175.00 + HST per year in Canada (HST Reg. #R121351134) and $265.00 for foreign addresses. Single copies are $4.00 Circulation www.lawtimesnews.com 2/7/12 3:32 PM in a grey area in Ontario by providing high- level health care to those who can aff ord the annual fees. "Th at's one of the misconceptions," he adds. "All health-care delivery is private. Doctors then bill the public system." It's not like Canada invented socialized medicine. Many countries have it and have been through the same rethinking as their systems broke down. "Switzerland and Germany are good models to look at," says Rovere. "Th ey have universal health care where everyone is forced to buy health insurance privately. But it's competitive, so in Switzerland, for example, you can jump out twice a year to another company if they have a better rate." It's ironic that just as critics are bom- barding Americans with rhetoric about socialized medicine, we're dealing with fears of Americanized health care. Th e greater irony is that the best model LT may be a hybrid of the two. uIan Harvey has been a journalist for 34 years writing about a diverse range of is- sues including legal and political aff airs. His e-mail address is ianharvey@rogers.com. inquiries, postal returns and address changes should include a copy of the mailing label(s) and should be sent to Law Times One Corpo- rate Plaza, 2075 Kennedy Rd. Toronto ON, M1T 3V4. Return postage guaranteed. 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