CANADA'S HEALTH CARE SYSTEM NEEDS SURGERY

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CANADA'S HEALTH CARE SYSTEM NEEDS SURGERY

Posted on 02 December 2009 by SECN.

Troy Media – By Dr. Stephen Murgatroyd

The Fraser Institute published a report in November which has alarming implications for several Canadian provinces, most especially Ontario and New Brunswick. The report, Paying More, Getting Less, looked at whether provincial health care spending in Canada is financially sustainable. It also concluded that Canadians are paying more for government health insurance but getting less. Its analysis wasn’t pretty.

But let’s get back to Ontario and New Brunswick.

It is estimated that, in 2014, the two provinces’ health care system will consume half of their revenues. By 2034, another four of the 10 provinces will be in the same position – Prince Edward Island, Nova Scotia, Manitoba and Quebec will join Ontario and New Brunswick as “fifty per centers.”

Complex implications

The implications of reaching this position are complex. Any attempts to reduce health care costs by passing them onto consumers or by privatizing services are met with angry responses from a public used to its “free” health care. And attempts to cut cost by stealth – by reducing the supply of physicians and nurses, by allowing hospital infrastructure to deteriorate, by delisting services (e.g. chiropractic) and by refusing to cover new medical technologies or license the use of new drugs or procedures – only create longer waiting lists, which also arouses public anger.

As a result, no jurisdiction is seriously looking at reinventing our health care system – something that has to happen if it is to be affordable and accessible.

The alternatives are also equally unattractive politically. To pay for increasing cost of health care, governments will have to increase taxation significantly. Remember that these tax increases will occur at the same time as energy prices increase just as carbon taxes and climate change mitigation starts to bite and inflation picks up following the recession.

Increasing health care premiums – something Alberta just abolished, to its cost – and guaranteeing that these funds will go directly to front line health care services may be a route some wish to follow, but are they willing to pay the political cost?

If taxes are not increased, the other option will be to reduce or even shut down other services so that the money “saved” can be transferred to health. Cutting cultural and social programs, closing a few universities and colleges, accelerating the closure of rural schools are all options that need to be on the table, but it is difficult to imagine any of these being acceptable.

Roger Martin, long time Dean at the Rottman School of Business at the University of Toronto, observes that health care spending is largely about consuming wealth now (though he recognizes that some health spending is focused on ensuring people can work, such as preventive health care and medical rehabilitation) but investment in education is largely about building capacities for future prosperity.

By not dealing with the challenge of health care spending and sacrificing education to pay for health, which is what has been occurring, we are reducing our future prosperity so as to permit current consumption.

In the absence of the political courage to say that the health care funding system emperor “has no clothes,” it will take an independent and respected voice to encourage the public to do so. This voice is urgently needed. The time to deal with health care in a fundamental way is now.

The Fraser Institute analysis is a starting point for this conversation – what we need is leadership to ensure that the conversation actually gets somewhere.