I generally haven’t used this blog to comment other groups and their points of view but I have seen a number of graphs that just rubbed me the wrong way. Why did it bother me, well I work with data for a living, and when I see data poorly presented (whether deliberately or not) in an effort to make a point it upsets me.
You can see the Citizens for an Accountable Mega Hospital Planning Process (CAMPP) graphs on the data section of their webpage and they have popped up on Social Media over the last week or two. So far they have calculated Taxi Costs to the new Mega hospital site, the Total Aggregate Distance traveled; and the Distance to the Hospital from City Hall comparing Windsor to many other communities. To offer my full disclosure, I have written my feeling initial feelings on the Mega-hospital plan on this blog and I think at some point I signed the CAMPP petition. Since than my opinion has evolved a little with me more or less settling on I would like it in the City but am not opposed to the proposed location.
Now I don’t believe that this group is trying rouse rabble as some in the Windsor Star and social media have claimed but I do feel that some of the information they have presented is a distortion and not only hurts their cases but also clouds the wider discussion around the hospital site and its impacts on our region.
Taxi Cost Calculations
Now, I had never heard of World Taximeter before I saw their post and I don’t have any idea how accurate it is or isn’t (a bit on that in a few paragraphs). What is missing from the calculation is an inquiry of how much it would cost to take a cab from the County (note they did add this to their calculations after I wrote this section of the post, my numbers and theirs are pretty close).
What CAMPP does like to discussion as it is beyond their mandate is the fact that Windsor-Essex County has a regional health care system and people who have accidents, injuries or illnesses in the County are transported into Windsor to one of the two in the city (Met being the primary urgent care facility for the County). Yes Leamington has a hospital but almost all serious and surgical cases come into Windsor. Unfortunately no calculations were offered for the cost increases or savings for someone living in Amherstburg, Essex, Tecumseh, Belle River, Kingsville or Leamington to the new Hospital site.
As you can for for individuals in several communities World Taximeter has come up with modest savings ($20 round trip) at the new site. The fact that someone from Amherstburg is paying over $120 according to the calculator to get to the City and back is a separate issue (Regional Transport anyone). Which brings me too a couple of issues the tool itself. After some googling of reviews I found that most calculations have a 10% discrepancies in the fares listed to actual amounts paid and the time of day has a major impact on the fares accuracy. Part of the issue is that the calculation tries to estimate waiting times based on historical traffic usage. This means that if you input a cab cost at 3pm you will get a different amount returned to you at 8pm (the same is probably true if you were actually taking a cab). Without knowing what time that the calculations were made, there is no way to accurately compare the costs (Note: my estimates were calculated between 9 and 10 pm). As a result, the fares that are currently being measured are the cost to get to a field on the border of the City. The calculator can’t accurately measure what it will cost to get to the eventual hospital in 7 to 10 years because traffic patterns haven’t changed. Once there are actual facilities out on County Road 42, there will economies of usage that will dictate that cabs will be used to traveling there, using the most efficient route and infrastructure will be expanded to accommodate that traffic, thus driving down costs.
The second issue is that the calculator or CAMPP don’t account for flat rates or any negotiated fees as a part of the trip to the hospital. A google search for Leamington to Windsor Cab fares found $65 dollar cab fares to Windsor. Again, not cheap but a consistent cost that would not change regardless of where the hospital is. Many county communities have a similar flat rate costing to get to Windsor. A call to Veteran Cabs told me they don’t do flat rates in the City but in speaking to two separate drivers over the weekend, who generously gave me their personal cards, they did tell me that for a consistent service a flat rate could be directly negotiated with them to get me to the hospital.
Aggregate Distance Traveled
This chart shows the total distance that would be traveled from each city ward (and selected County Communities) if EVERY person from the ward went to the new hospital location subtracting the distance they would have had to travel currently.
Setting aside that a rigorous calculation would have controlled for population using a weighted average. Last year only 28,000 people were admitted to Windsor Regional Hospital for the number of admissions to reach the level that was calculated (approximately 300,000) it would take a decade or more. If Leamington was included It could be suggested that families accompany admissions but there is no way to tell if families are traveling from the same location or are they coming from out of town to see their family member in the hospital as a result any direct calculation would not be supported in fact.
Beyond this, I am still not sure why LaSalle, Amherstburg, Leamington or Kingsville aren’t calculated. Although CAMPP have said that they exclude Leamington and Kingsville due to the local hospital in South Essex. Unfortunately, Mega-hopsitals have a history of resulting in the closure or loss of services in small hospitals. The Niagara region, Oxford County, Wallaceburg to name a few. Leamington and Kingsville residents already travel to Windsor for many surgical procedures so by not including the entire county in any calculation leaving important data out of the discussion.
Distances from City Halls to Hospitals
City Halls are a potential measure for the centre of a city but not the measure for where people live in the City. In the case of Windsor, City Hall is at the extreme north end of the City meaning that almost everyone in the city (except for a small portion of people living on Riverside Drive) actually live closer to the new hospital site than the City Hall! From a planning standpoint many of the communities listed are not on bodies of water/or a border which in turn allowed for a circular development pattern around a city centre. As a result they likely haven’t had the singular directional of sprawl that Windsor has faced which in turn has enabled a more even development pattern and compact urban centre thus lowering the distance to the Hospital.
If CAMPP really want to measure how close people are to the hospital, they should look at population density and see where people actually are and how far they are from the hospital. Population age could be another measure, as age correlates clearly with health care needs. As a result, older segments of the city are more likely to need a greater proportion of health services than younger segments of the city. These might be difficult to track down but they are measures with greater rigor than drawing a line from an arbitrary building in a city centre.
The other issue is that their measurements (this hold true for all of their calculations) calculates to the nearest Hospital while at the same time they fail to account for the alternative sites that will be developed as a part of the Mega Hospital plan. The Grace Site, Tayfour site, and Ouellette site will still be medical facilities in the City of Windsor, will still be staff by hospital staff and still play a roll in their neighbourhoods and communities. True not every service is offered at each site but today with the two hospital sites certain facilities are prioritized for certain procedures (Met having the Cancer Centre for example). Some long term care and surgical recovery and rehab already occurs at the Tayfour site, meaning that daily visits to the Mega-hospital may not be required to see a recovering family member.
As a result, they have in my opinion a set of shifting goal post and by not measuring all possible alternatives clouds the arguments that you are trying to make. Why are you measuring to the closest hospital from City Hall when most citizens of Windsor live outside of Ward 3 doesn’t make sense. Beyond Windsor in many of the City’s that were offered in comparison, they are apart of larger metropolitan areas where residents have access to different facilities out side of their city boundaries if they wish to use them or they have multiple hospitals in their community which means measuring from City Hall is only telling part of the story.
What They Else Don’t Account For
Given the above, all of these estimates are to reach a facility that will not be built or in operations for 7-10 years, resulting in assumptions about current costs being applied to the future. Their arguments assumes that the same City Councillors who are being lobbied by this group to not support the hospital site are not going use the Mega-Hospital location as a primary reason to invest in transit across the City and Region, install bike lanes and ensure residents have access to medical treatment.
Maybe those routes won’t be as quick as a cab/car but they will be cheaper thus giving individuals an option. They also assume that over the next 7 to 10 years that Uber or some other transit disruption doesn’t occur, driving down taxi costs or that the taxi companies won’t implement a flat fee to get you to and from the hospital. They don’t take into account the possibility that there may be a transit shuttle connecting the 4 hospital sites (Tayfour, Grace, Ouellette and County Rd 42) for staff and patents, something which I have heard is rumoured will be implemented. Will it be free, probably not, will it be less than $100 probably.
What I Completely Disagree with
For the items above, I can accept their decisions as a method of calculation and available data do provide some restrictions but in the commentary for the Taxi Costs the following accompanied the graphs on Facebook:
Here’s another important point: we haven’t yet seen the impact of the proposed hospital site on the cost of ambulance services. This graph is as good of a proxy for the direction of EMS costs as we could expect to see at this point in the process.
Lets be clear, EMS costs are completely separate from individuals transit costs so to even equate them in the same discussion is clouding the issue. There are currently 12 EMS stations around the City of Windsor and in the County. Since EMS operates in the County and regularly brings patients into the city, easy access to a hospital on the South end of the city will probably improve patient outcomes as minutes = lives saved and dollars don’t matter. To claim that taxi costs which are designed to make profit for the cab company and driver equates to a publicly funded EMS system is a poor association at best.
I think that what the CAMPP and other Mega-Hospital groups are doing a public service by sharing information about the possible impacts of the Mega-Hospital site. But when they share data, that is in my opinion, clearly biased or incomplete they are doing themselves and this debate a disservice.
If they truly want to change minds (particularly of the committee) they need hard facts backed up by rigorous methods. How many West-End or Downtown residents will be forced to take a longer taxi ride and pay out of pocket? For some of them, the high cost of the taxi and penny pinching that could result may be a price worth paying for getting relief from pain or the treatment of an illness. So how many low income people in Windsor does that leave without access to medical care from the Mega-hospital?
No location is perfect, no site will be without disadvantages, if the CAMPP want to change the Ministry of Health’s mind they will need to prove that the proposed location isn’t only bad for the city but bad for people’s health and in an ideal world offer alternative locations or solutions to fix the problem. I am sure that those involved in the CAMPP project will disagree with parts (or all) of my and they are free to do so. I am happy to comment on this but based on the data they have posted they haven’t changed my mind and I doubt that they have changed the Ministry’s.