Ontario budget includes short-sighted health-care spending promises
With its recent budget, the Ontario government promised increased health-care spending and “free” prescription drugs. Sadly for Ontarians, these short-sighted feel-good promises will only increase the bill for taxpayers while failing to fix the real problems Ontarians face when seeking medically necessary care.
Consider that Ontarians today can expect to wait an astonishing 15.6 weeks between referral from a general practitioner and actually receiving treatment. Not only is this wait remarkably long in absolute terms, but contrasts sharply with the experiences of patients in other countries with universal health care.
For example, a recent analysis of 11 health-care systems (all universal except, some may argue, the United States) found Ontarians were less likely to secure an appointment with a doctor on the same/next day, were more likely to spend more than four hours in an emergency department, and were more likely to wait more than four weeks for an appointment with a specialist than residents of the average country in the group (performing notably worse than the top-performing systems).
While some might argue that performance justifies the government’s spending increases, past performance suggests otherwise.
During much of the 2000s the provincial government increased health-care spending at an unsustainable rate that outpaced spending on other programs and the province’s economy. As a result, health care grew to consume a larger proportion of Ontario’s program spending and provincial GDP between 2000-2016. Unfortunately, wait times failed to meaningfully improve. Although there were some fluctuations during the period, the 15.6-week wait recorded last year was actually longer than the 13.9 week wait in 2000-01.
While a long string of deficits and mounting debt seemed to have encouraged Queen’s Park to finally slow the rate of health-care spending growth in recent years, last week’s budget suggests a pivot back to the freer spending past. Apparently the government has forgotten that throwing more money at the problem didn’t solve the problem the last time.
And then, there’s the “free” prescription drugs for Ontarians under 25—a group that includes not just children, but individuals old enough to vote, drink, serve in the military and get married. While there’s certainly a case to be made for ensuring that children under the age of 18, and anyone who is fiscally vulnerable irrespective of their age, can access necessary medication regardless of their (or their care-giver’s) ability to pay, the province already has programs to meet these needs.
In fact, Ontario’s Trillium Drug Program does this far more efficiently by covering individuals “who spend approximately 3 to 4% or more of their after-tax household income on prescription-drug costs.” And let’s not forget the potential for prescription drug abuse if pharmaceuticals are “free” for young adults.
With every budget, governments have an opportunity to bring about real positive change. Ontario has, once again, squandered an opportunity to do so. The government could have analyzed and introduced policies found in successful universal health-care systems—embracing the private sector as part of the universal frame work, employing user fees to temper demand, changing how hospitals are funded rather than simply focusing on how much they funded. Instead, it chose the short-sighted and wasteful path of increased funding, coupled with a questionable sleight-of-hand rebranding of provincial drug plans.
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