‘Blowing up’ the Canada Health Act not the answer to rising costs: economist
NationalPost.com – news
Nov 17, 2011. By Derek Abma, Postmedia News
One of Canada’s most prominent economists challenges the notion of the public health-care system being “unsustainable,” arguing that cost constraints and better quality care can be achieved through a combination of several actions.
“Having growth in health-care costs outstrip national income does not necessarily mean the system is unsustainable,” Don Drummond, former chief economist for Toronto-Dominion Bank, said in notes of a lecture he was to give at an event in Toronto Thursday. “When asked, voters respond that they are prepared to pay higher taxes and consume less of other public services in order to preserve health care.”
While Drummond said more involvement of the private sector in the delivery of health care could be beneficial, “blowing up” the Canada Health Act in a way that ends or reduces the extent of public coverage for basic medical treatment is not the answer.
He said that “introducing more private charges may distract the public and politicians, putting progress on all reform into paralysis. We should be mindful that the objective is surely to contain total public and private health-care costs, not simply to shift the burden from governments to private individuals.”
This was from text that was to be the basis of a presentation Drummond was giving at a speaking event put on by the C.D. Howe Institute.
Before being the top economist at TD until 2010, Drummond had been a senior official in the federal Department of Finance for more than 20 years, including being an assistant deputy minister to former finance minister Paul Martin, who eventually became prime minister.
Drummond has suggested a multi-pronged approach to control the extent health-care costs rise. He called for a better integration of the overall system that would include better use of technology for accessing patient records, as well as less reliance on expensive-to-run hospitals for end-of-life care or treatment of such chronic conditions as diabetes.
As well, home care and community-based services should be employed as alternatives to hospital care whenever possible, he said.
Private-sector players could be used more for some services, even while maintaining governments as the single payer of essential services, Drummond said.
“Ultimately, policy that encourages competition among providers . . . could result in a more effective system that provides quality care at a low cost,” Drummond said.
Private-sector players could also be used to help find cost efficiencies within the public health system, with their compensation being tied to the degree of savings realized, he said.
Increasing public awareness of how lifestyle choices can affect health could also go a long way to controlling the extent of rising costs, he said, as could focusing on which people are using the health system most extensively.
Drummond noted that in Ontario, one per cent of the population accounts for about 50% of hospital and home-care costs.
“We should better understand the characteristics of these heavy users and what could be done to improve the efficiency of their care,” he said. “Research may reveal the payoffs may lie more in socio-economic or lifestyle approaches than health care, per se.”
The former federal bureaucrat recommended that provincial governments, which pay the direct costs of public health care, take the leader in such reforms rather than waiting for the federal government to step up.
“The federal government walks on eggshells in this provincial domain and will continue to be happy to leave the messy parts to the provinces,” he said.
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