Is Health care in need of a Top-up or a Top-down?
In August, the President of the Canadian Medical Association publically stated that Ottawa should provide a financial ‘top-up’ to help provinces deal with the additional costs caused by an aging population. She offered some alarming deductions, saying things like: ‘There is no question that it costs more to look after an aging population.” and “Clear action and increased support are needed if Canada’s health-care system is to survive.” I most heartily agree that the effects of an aging population are dramatically escalating health care costs. On the ‘top-up’ request itself, I am uncertain. What do I mean?
Well, for one thing, in our Province, OHIP is already the largest single public investment the Provincial government makes, easily in excess of well over half of the total public purse! While the Federal government is reducing its historical 6% increase in transfer payments to the Provinces down to something closer to 3%, I am not sure that a simple increase in money thrown at the problem is the best use of our tax dollars. Rather than get into a debate about Health care cost administration effectiveness specifically, I’d like to focus on illustrating the demographic drivers that support the need for a radical, ‘top-down’ assessment of OHIP.
Based upon a CMA poll, Canadians largely support the need for a strategy for senior’s health (84 per ranked it either very important or important). That ranking is just a bit higher than the results for improved mental-health services (83 percent) and more affordable prescription drugs (80%). Enhanced palliative care and home care services came in at 80 and 79 per cent respectively. All of these services, as they relate to elder needs, are inter-related. There is much to debate about funding formulas and service offerings. A little history for everyone; once upon a time, the Federal government funded half of all hospital care and diagnostic imaging. Last year, Ottawa transferred $34 Billion to the provinces which represented just 22 per cent of all public spending on health care. No wonder the provinces want more money! However, when you add what they invest and what the Federal government provides, there is a ton of money available to meet our health care needs already on the table and arguably, less to go around than ever before. That means that the powers to be simply must get down to determining the best bang for our buck with painful objectivity.
Let me present some financial specifics. Over all health care spending in Canada is about $6,000 per capita, but varies significantly by age. Let’s consider the impact of rising overall health care costs through the lens of a rapidly aging population. Canadians in the 30-34 age group have roughly $2,500 in health care expenses per capita; that rises to almost $5,000 in the 60-64 age group; to almost $12,000 in the 75-79 demographic ; and to more than $28,000 in the over 90 age group. We are aging as a population and as such, our nation’s peculiar demographics are adding to the challenges in the current formulary used for health care, one that simply does not consider the longevity that we now enjoy. Our politicians cannot avoid the huge task confronting them; a complete evaluation and re-prioritization of universal health care services. It will be a daunting task but the need to do so is only picking up speed and the process is literally, unavoidable.