Great column on LHINs:

Ontario has to do decide if it wants to continue to have a health system in which decisional and spending power is concentrated in hospitals or whether it wants regional authorities – called LHINs or something else – that determine the right mix of spending among institutional care, community care, prevention programs and so on.

The fundamental problem is that Ontario has tried to do all these things simultaneously. The result is a bloated bureaucracy with no clear lines of responsibility. The reality is that the province’s regionalization efforts have, at best, been half-assed. LHINs are not the problem, they are a symptom of a much larger problem.

Hudak and Horwath have no real clue what to do about these issues — or if they do, they certainly aren’t revealing their plan. It’s creating tremendous uncertainty in the sector, and already lots of good people are leaving LHINs in anticipation of cuts.

That said, I don’t see that the Liberals have a plan either. They could have spent the last two years reforming LHINs and pushing to (a) show real value in them, and (b) ensure that the decentralization had gone far enough that reversing it would be worse than the alternative. But they haven’t.