It’s terrifying sometimes to think about how little is being done about looming problems that we ought to see coming a mile away.
Climate change and the debt crises in many Western nations are two examples that jump immediately to mind. Basic projections tell us that these issues will present enormous challenges for the world in the not-too-distant future. And yet, international leaders dither and put forward few concrete policies to address the problems.
But let’s put world issues aside for a moment and focus just on Canada. Here at home, we face our own looming challenge when it comes to health care. Simple math reveals that, with our aging population and the current rate of growth in health-related spending, the system is unsustainable. Everyone knows this — or should know this — in particular, our provincial leaders.
And yet, at their recent conference in Halifax, Canada’s 10 premiers — who have the constitutionally mandated responsibility to administer health care to Canadians — came up with little more than recycled ideas and buzzwords about “innovation” and then proceeded to once again demand a ceaselessly increasing amount of money from Ottawa to cover ballooning health budgets.
The federal government, to its credit, has come up with a somewhat sensible policy on health-funding transfers. For years, the amount of money the provinces receive from Ottawa has been growing at a guaranteed rate of six per cent — well above the rate of economic growth. Clearly, this can’t continue indefinitely, so Finance Minister Jim Flaherty announced last December that the funding allocation would change — slightly.
The annual six per cent increases will continue until 2017. After that, health-funding transfers will be tied to the rate of GDP growth plus inflation, which is estimated to be about four per cent. Even if economic conditions change, the rate of increase will not be allowed to drop below three per cent.
The premiers’ response to this? Manufactured outrage and political spin. And, unfortunately, much of the news media bought it — hook, line and sinker.
Headlines across the country in the past week stated — falsely — that the federal government is “cutting” $36 billion in health funding over the next 10 years. That is just plain wrong. Reducing the rate of funding increases is not at all the same as reducing funding.
In the mid-1990s, Ottawa actually cut health transfers to the provinces — quite severely — under Finance Minister Paul Martin and the Liberal government of the day. These actions were taken at the time to eliminate the federal deficit and put Canada back in a surplus position. Now, with Ottawa again facing budget shortfalls in the tens of billions of dollars, Flaherty’s adjustments to health funding are relatively modest, by comparison. Premiers of the 1990s would have been thrilled to receive what premiers today are grumbling about.
The reality of the situation is that health spending needs to be reined in and that needs to happen at a provincial level. Health care already accounts for about 40 per cent of most province’s budgets and as much as 46 per cent in Quebec. Alberta allocates about 39 per cent of its budget to health but spends more per capita on health than Quebec, Ontario, British Columbia and Manitoba.
Health spending cannot continue to indefinitely increase faster than economic growth. But with health-care needs also set to outpace economic growth, something has to give. The key is to get more service out of each health dollar spent, something the premiers pay lip service to in their latest Health Innovation Report, which states: “Increasing value is essential to ensuring the sustainability of health-care delivery in Canada.”
And yet, the rest of the premiers’ report offers few new or concrete ideas to actually achieve this. Meanwhile, the focus of their public statements remains: “Give us more and more money, forever.”
Like climate change and the debt crises, health care in Canada presents complex and difficult challenges. But the reality of the situation can’t be ignored and the status quo can’t be maintained. It’s time to adopt a more realistic approach and take significant actions to truly deal with the problem.
» Robson Fletcher is a former Brandon Sun editorial page editor who now works in Jasper, Alta.
Republished from the Brandon Sun print edition August 4, 2012