Social Policy in Ontario

NDP’s prescription is mere rhetoric and poor policy

Posted on September 26, 2015 in Health Debates

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TheGlobeandMail.com – Globe Debate
Sep. 26, 2015.   Jeffrey Simpson

We get so drugged during election campaigns by exaggerations, rhetoric and distortions that explaining the facts seems like a hopeless endeavour.

What does one say – to take one example – about this staple of NDP rhetoric: the pledge to “undo decades of Conservative and Liberal cuts to health care?” This statement is completely false, but in a campaign, politicians too often get away with factual murder.

From 2000 to 2010, a decade that spanned Liberal and Conservative governments almost evenly, health-care spending doubled: to $200-billion from $100-billion. It rose on average during that period by 7 per cent. Some “cut.”

Going further back, yes, health-care spending fell below the inflation rate in 1992-1996, partly because the Liberal government slowed down the yearly transfers to the provinces. But after that, transfers soared, more than making up for the four years of slowdown.

Since 2010, the increases to health-care spending have dropped to about 2.5 per cent a year – about the rate of inflation and population growth. Conservative Leader Stephen Harper has continued the Paul Martin Liberal government’s policy of increasing transfers to the provinces by 6 per cent every year. He promises to reduce the increase to about 3.5 per cent after 2017-2018 – hardly a cut, just a slowdown.

Of the many dumb things that could be done in health care, ramping up the increase to 6 per cent again would be among the stupidest, because Canada is already the sixth-highest spender per capita on health care among countries with largely public health-care systems.

Moreover, if one lesson leaps out of the recent Canadian experience of the 2002 Romanow Commission’s recommendation of big health-care spending increases and many international studies, it is that more spending does not necessarily improve health care. It sounds terrific on a platform to pledge more spending and to make false statements about “Conservative and Liberal cuts.” Factual inaccuracy leading to bad policy is a bad combination.

A 6 per cent increase, such as the NDP proposes, would fuel health-care inflation just when it has been brought under control. Some of the new money would be spent very unwisely, as in the NDP promise – a reprise of a similar one from the 2011 campaign – to give money to the provinces to train more doctors. Sounds great, right?

Perhaps in its rush to impress the public, the NDP has again ignored some basic facts. According to the Canadian Institute for Health Information, 2013 was the seventh straight year in which the ratio of doctors per population increased because the number of physicians climbed at a considerably faster rate than the population.

Between 2009 and 2013, the growth in the number of physicians outpaced population growth threefold; 2013 saw the largest number of physicians ever recorded in Canada. All provinces recorded increases.

Projections are that physician numbers will continue to grow. Medical school enrolments have been rising. Between 2009 and 2013, the number of medical degrees rose 14 per cent, enough to cope with retirements. Ontario predicts that the number of physicians will go up by 13 per cent from 2015-2020, even taking into account a recently announced small reduction in residency positions. Some specialties (orthopedics, for example) are graduating surgeons for which there are no places.

Figuring out how many doctors, and what kind, will be needed a decade from now is hard. Young female and male doctors work fewer hours than physicians did several decades ago, so more may be needed, but these have been emerging from medical schools.

We do know that physicians trained in diseases afflicting the aged, such as Alzheimer’s, diabetes, cancer and coronary ailments, will be in greater demand. So will family physicians working with other health-care professionals. And there is a challenge that has been around for a long time: finding enough physicians for rural and remote areas.

These are challenges of allocation within the medical profession, and would not be rectified by pouring more money into training additional doctors when Canada already has a record number.

Why the NDP for two elections in a row has beaten the drum that Canada needs more doctors in the face of evidence to the contrary, and that health-care spending should resume its inflationary pace once again, illustrates the triumph of politics over evidence.

< http://www.theglobeandmail.com/globe-debate/ndps-prescription-is-mere-rhetoric-and-poor-policy/article26546244/ >

Tags: budget, Health, ideology, mental Health, standard of living

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