CANADA – Opposition parties are misleading the electorate when they charge that the Conservative Party has cut spending for medical care.
Under Harper, the federal government has increased the Canada Health Transfer (CHT) to provinces by billions of dollars per year, and the Conservatives would continue to grow it by billions more after the election. The 2015 federal budget commits $2.04 billion more to the CHT in 2016/17. By 2019/20, the CHT will be $6.9 billion higher than this year.
Under the Conservatives, spending on medical care will grow faster than every other social policy measure in the federal budget except the Old Age Security system.
So why all this talk of Harper cutting medical care? Because growing the CHT by $6.9 billion annually means that the transfer would increase at a slower pace than in recent years. Over the last decade, federal transfers for health care grew 6 per cent each year – outpacing economic growth. Now the Conservatives propose raising the CHT no less than 3 per cent per year, or only as fast as the economy grows – whichever is higher.
Why does this matter?
It may not yet be politically popular, but research indicates Canada must contain the growth of health care spending. Our country spends more public money per person on medical care than most other countries. This might be fine if we got better outcomes, but we don’t. We don’t get better access to doctors, CT Scans or MRIs. We don’t get better outcomes or satisfaction. We do get better paid doctors by comparison with other jurisdictions, however.
While not getting a better bang for medical care bucks, the government has been cutting income and sales taxes. Reducing taxes and raising spending on medical care leaves less left over for other things that often make us healthier: supports for families, education, housing, etc.
How do other parties compare on medical care?
The NDP will grow medical care spending faster than any other national party. It will be at least $350 million higher than the Conservatives in 2016/17; and $2.35 billion higher by 2019/20. That means the NDP will increase spending on the CHT by $9.25 billion a year by the end of its first mandate.
To put this proposed increase in context, the entire federal budget for education is presently just under $10 billion a year. Or, the NDP could pay for its entire $15/day child care proposal with this money.
The Greens will also increase the CHT. They will add $343 million more than the Conservatives in each of the next four years.
So far, the Liberals haven’t made any concrete announcements that deviate from the Conservative plan to increase medical care spending $6.9 billion a year by 2019/20.
What does the NDP aim to buy with more medical spending?
Important things.
For example, the NDP budgets more for seniors’ care outside of hospitals. This is important because hospital care is particularly expensive. And seniors often don’t want to be in hospitals when dealing with chronic conditions that accompany aging.
The NDP would also phase in a universal approach to pharmaceutical insurance and bulk buying. (So would the Greens, although they only budget about one fifth of what the NDP do). Again, there is good research to support integrating the costs of pharmaceuticals into our public health care system, in part because doing so will reduce the cost at which our governments purchase medications.
Still, many countries spend less on medical care per citizen than does Canada, while already integrating better approaches to caring for seniors and paying for medications.
So it is important in this election for all national parties to explain why Canada can’t achieve these goals within the $6.9 billion annual medical care spending increase on which all parties agree.
This explanation is important, because inefficiency in medical care drains other investment areas.
Consider the NDP platform. By growing the CHT faster than other parties, while not wanting to reverse many recent federal income and sales tax cuts, the NDP have to make other trade-offs.
One way to interpret these trade-offs is to observe that the NDP will spend less than its major competitors on families with kids in the first couple of years after the election. Compared to last year, the NDP will add $3.7 billion in spending for families; the Conservatives will add $4.6 billion, and the Liberals promise $6.6 billion more. As a result, the NDP doesn’t have enough money to make its important $15/day child care commitment come to fruition in as timely a way as it otherwise might.
This is a pity, because science confirms the NDP are right to invest more in child care services, including for health promotion.
– Dr. Paul Kershaw is a policy professor in the UBC School of Population Health, and Founder of Generation Squeeze (www.gensqueeze.ca).
© 2015 Distributed by Troy Media