
Randall Denley: Ontario's 'historic' spending under Ford sure isn't producing results
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The Ontario government's finances are a paradox. The PC government regularly boasts about 'historic' levels of spending, but faces constant complaints about underfunding, especially from the health-care, education and post-secondary sectors.
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What's the real picture?
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In fact, budget figures show that revenue and spending have increased dramatically since Premier Doug Ford was first elected. In 2019–20, his first full-year budget, total government revenue was $156.1 billion. This year, it's projected to be $219.9 billion, a 41 per cent increase. Spending has gone up by about the same percentage, from $164.8 billion in 2019–20 to a projected $232.5 billion this year.
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With such a large spending increase, it's hard to believe that anything could be underfunded, but discouragingly, that is the case.
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Ontario's per capita spending on health care is second lowest in the country. Per-student funding for Ontario universities is the lowest in Canada. The province does a bit better on public education, with the sixth highest per-student funding nationally.
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Those are disappointing numbers. One would expect more from the country's biggest province.
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It's not like the Ford government is restraining spending to balance the books. Far from it. That first Ford budget had a $9-billion deficit and the current one projects a deficit of $14.6 billion.
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A new report card on this year's budget gives Finance Minister Peter Bethlenfalvy a grade of D- for his performance on the critical issues of debt, debt interest payments, spending increases and tax relief.
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The Canadian Taxpayers Federation report notes that Bethlenfalvy's latest budget increases debt by $22 billion, and says that by the end of the budget year, debt will have reached $461 billion. That's about $28,472 per person, the second highest in the country. Net interest payments will cost Ontarians just over $1,000 per person this year, the fourth highest in the country. Spending is up 7.9 per cent, third highest among provinces.
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The only moderately bright note in the taxpayers' report card was tax relief, where the Ford government finally made permanent a longstanding 5.7 cent per litre gas tax cut.
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Unfortunately, that cut is not typical of the Ford government's performance on taxes. Promises made in 2018 to cut corporate taxes and personal income taxes remain unfulfilled. Ontario's combined federal/provincial top marginal tax rate of 53.53 per cent is the third highest of any jurisdiction in Canada or the U.S.
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Here, at least, there is some reassuring news. The health, education and post-secondary sectors have all benefited substantially from the increased tax take. In 2019–20, health spending was $63.7 billion. In 2025–26, it is projected to be $91.1 billion. Comparing the same two time periods, education has gone from $30.2 billion to $41 billion and post-secondary spending will rise from $10.5 billion to $13 billion.
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PanOptix Pro leverages proprietary ENLIGHTEN ® NXT Optical technology which delivers the lowest light scatter and highest reported light utilization of any trifocal IOL. 1-3,5-9,**,‡‡ PanOptix Pro provides an unprecedented 94% light utilization, compared to a theoretical maximum utilization of 96% for diffractive optics. 1-4,*,**,† These enhancements also provide more uninterrupted light distribution from distance to near, and a 16% increase in optical image contrast between distance and intermediate. 1,††,‡ PanOptix Pro builds on the clinically-proven low visual disturbance profile, high spectacle independence and exceptionally high patient satisfaction of PanOptix. 10-13,§,§§,¶,¶¶ 'Now, with PanOptix Pro, more light utilization and less light scatter is possible‡,‡‡, empowering both my practice and my patients.' 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Article content About Clareon PanOptix Pro Article content The Clareon PanOptix Pro Trifocal IOL is a type of multifocal IOL used to focus images clearly onto the back of your eye (retina) to allow clear vision after the cataract removal. In addition, the center of the Clareon PanOptix Pro Trifocal IOL allows for better near (reading) vision and intermediate (computer work) vision versus what a monofocal lens would provide. Please consult the Directions for Use regarding indications, precautions, cautions and warnings which is available at Article content About Alcon Article content Alcon helps people see brilliantly. As the global leader in eye care with a heritage spanning over 75 years, we offer the broadest portfolio of products to enhance sight and improve people's lives. Our Surgical and Vision Care products touch the lives of more than 260 million people in over 140 countries each year living with conditions like cataracts, glaucoma, retinal diseases and refractive errors. Our more than 25,000 associates are enhancing the quality of life through innovative products, partnerships with Eye Care Professionals and programs that advance access to quality eye care. Learn more at Article content * PanOptix has 88% light utilization (12% scatter light)/PanOptix Pro 94% light utilization (6% scatter light). ** Based on manufacturer-reported values and respective methodology for Clareon PanOptix, Envista Envy, AT Elana, Gemetric and Rayner. † For feasible diffractive optics of up to pentafocal design from Krackhardt et al. †† Simulated photopic through-focus point spread function (light intensity [energy])—polychromatic. ‡ Compared to Clareon PanOptix. ‡‡ Based on bench and vision simulator studies. §Based on prospective multicenter randomized study at 6 months, significantly more subjects reported not experiencing starburst and glare (p<0.05 n=276). §§All-implanted analysis set. ¶In response to the IOLSAT questionnaire question 'In the past 7 days, how often did you need to wear eyeglasses to see'? ¶¶Response to the following question on IOLSAT questionnaire (Version 1.0, December 20, 2018) at 6 months post-op 'Given your vision today, if you had to do it all over, would you have the same lenses implanted again?'; n=127. ‖ Based on worldwide IOL unit sales of Clareon PanOptix and AcrySof IQ PanOptix through Q1, 2024. Ω Severity ratings by phakic patients with simulated implant of Clareon PanOptix Pro and Clareon PanOptix using VirtIOL simulator (n=64). ∂ Based in a meta-analysis of 11 unique clinical studies with 580 patients in 10 different countries, including 'very bothersome' and 'severe' visual disturbances. Clinical studies were performed on the AcrySof IQ PanOptix IOL; AcrySof IQ PanOptix and Clareon PanOptix are optically equivalent. Article content References Article content Alcon data on file, 2025. REF-25218 Alcon data on file, 2024. REF-25221 Alcon data on file, 2015. REF-08546 Krackhardt U, et al: Upper bound on the diffraction efficiency of phase-only fanout elements. Applied Optics; 1992; 31:27-37.; 10. Zhu D., Zhang J., et al. Patient-Reported Outcomes of Visual Disturbances with a Trifocal Intraocular Lens: A meta-analysis. Paper presented at: ASCRS Annual Meeting; April 5-8, 2024; Boston. Muzychuk, A. Defocus Curve Performance of a Novel Hydrophobic Acrylic Trifocal Intraocular Lens: A prospective, Multicenter Canadian Study. ASCRS Annual Meeting, April 5-8, Boston. Rayner Professional Website. Accessed September 2024. Carones F. New Concept of Light Distribution for Bilateral Trifocal IOL Implantation. AAO. 2022;2022:53. ZEISS AT LISA tri family. Supplement in Cataract and Refractive Surgery Today (Europe), September 2014. Zeiss Cataract Insights: Laying the Myth or Reality; Digitalization enhances cataract surgery? Supplement in Ophthalmology Times, Europe; May 22, 2024; Accessed September 2024. Kohnen T, Lapid-Gortzak R, Ramamurthy D, et al. Clinical outcomes after bilateral implantation of a diffractive trifocal intraocular lens: A worldwide pooled analysis of prospective clinical investigations. Clinical Ophthalmology. 2023;Volume 17:155-163. doi:10.2147/opth.s377234. Alcon data on file, 2024. REF-23958. Alcon data on file, 2018. REF-01475. Alcon Vision LLC. Clareon® PanOptix® Trifocal Hydrophobic Acrylic IOL. Product Information. 2021. Charness N, Dijkstra K, Jastrzembski T, Weaver S, Champion M. Monitor viewing distance for younger and older workers. Proceedings of the Human Factors and Ergonomics Society Annual Meeting. 2008;52(19):1614- 1617. doi:10.1177/154193120805201965 Government of Canada CC for OH and S. CCOHS: Office ergonomics. Canadian Centre for Occupational Health and Safety. April 25, 2023. Accessed May 9, 2023. Gundersen K, Potvin R. Trifocal intraocular lenses: A comparison of the visual performance and quality of vision provided by two different lens designs. Clinical Ophthalmology. 2017;Volume 11:1081-1087. doi:10.2147/opth.s136164 Kohnen T, Titke C, Böhm M. Trifocal intraocular lens implantation to treat visual demands in various distances following lens removal. American Journal of Ophthalmology. 2016;161. doi:10.1016/ Lwowski C, Pawlowicz K, Petermann K, et al. Visual and patient-reported factors leading to satisfaction after implantation of diffractive extended depth-of-focus and trifocal intraocular lenses. Journal of Cataract and Refractive Surgery. 2022;48(4):421-428. doi:10.1097/ Alcon data on file, 2024. REF-25903 Alcon data on file, 2024. REF-23554 MarketScope LLC. 2023 IOL Market Report: Global Analysis for 2022 to 2028. St. Louis, MO: MarketScope LLC; 2023. Clareon® PanOptix® Pro Trifocal Hydrophobic Acrylic IOL Model PXYWT0 2024 Directions for Use. Zhu D, et al. Rate of complete spectacle independence with a trifocal intraocular lens: A systematic literature review and meta-analysis. Ophthalmology and Therapy. 2023;12(2):1157-1171. doi:10.1007/ Vision LLC. Modi S, Lehmann R, Maxwell A, et al. Visual and patient-reported outcomes of a diffractive trifocal intraocular lens compared with those of a monofocal intraocular lens. Ophthalmology. 2021;128(2):197-207. doi:10.1016/ Zhu D., Zhang J., et al. 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