Health budget unsustainable

TheStar.com – Opinion/Editorial
Published On Fri May 28 2010

When asked what’s most important to them, Ontarians routinely rank health care at the top of their list. It is frightening, then, to learn that spending on our health-care system is growing at an unsustainable rate.

On its current trajectory, health care is set to consume 80 per cent of provincial program spending by 2030, up from 46 per cent today. That would bankrupt the government or crowd out every other service from schools to subways.

So change is coming. The only question is whether the government will follow the failed path of the 1990s and freeze or severely limit health spending, only to watch the quality of care decline sharply, or take the politically difficult steps necessary to keep costs down without compromising quality. A new report by TD Bank economists rightly urges the latter and puts forward 10 ideas for getting there. Most of their recommendations seek to boost “cost effectiveness.” This means not just getting more care for the dollar by using health professionals other than doctors to provide a wider range of services, but also providing smarter care to patients.

We’d all benefit from a health-care system that, through its funding structure, encouraged doctors and hospitals to avoid ordering batteries of tests or prescribing a potpourri of pills for patients.

Key to this is getting the computerization of health records back on track. Without an electronic health record, patients will continue to undergo needless tests or get unnecessary medications that can send them to emergency rooms with complications.

Ontario is already moving, albeit timidly, on many of the TD economists’ recommendations, including electronic health records (stalled by last year’s eHealth Ontario scandal) and patient-based hospital funding. Some of the economists’ other ideas will be politically difficult to implement, including putting doctors on salary (as opposed to fee for service) and making usage of the health-care system a taxable benefit. But taken as a package, the TD report is a clarion call to accelerate reforms already underway and begin a serious public debate about more controversial changes.

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