health care

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Last week the Canadian Institute for Health Information lifted the veil of secrecy surrounding the performance of Canadian hospitals with its Canadian Hospital Reporting Project, an interactive web site that measures the performance of Canadian hospitals based on 21 clinical and nine financial indicators.

This project, known by the acronym CHRP, is a bold and much awaited step toward greater patient rights, transparency, and improved health care delivery in Canada.


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With rumoured spending cuts in the upcoming federal budget, look for the Conservatives to play up one area of spending they’ve committed to increasing: health care transfers to the provinces. Last December, Finance Minister Jim Flaherty announced a new 10-year plan for health care transfers that will see transfers increase by six per cent for the next five years and thereafter by the rate of economic growth until 2024.


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This week, Ontario Health Minister Deb Matthews published her plan for controlling provincial government health spending. While the Minister is correct when she says the growth of provincial health care spending is not sustainable, her proposed solution – more government-imposed central planning and bureaucratic management – is wrong. Ontario’s health system does not have a ‘management’ problem; it has an ‘economics’ problem.

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Facing a $16-billion deficit, the Ontario government announced it will stop funding a handful of medical services currently covered by the public health insurer. This should come as no surprise, as it has become the norm in Ontario as well as other Canadian provinces. This is because cost-containment strategies such as rationing access to medical services are intrinsic characteristics of single-payer health insurance.

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As the premiers meet this week in Victoria, a number of provinces are clearly distressed about the federal government’s plan to reduce the automatic annual increase in health transfers from the current six per cent to the rate of economic growth starting in 2017-18. While the announcement has not been applauded by most premiers and their respective health ministers, it is long overdue.

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When provincial and territorial health ministers recently met in Halifax to discuss the 2004 federal-provincial-territorial agreement on health transfers, which is set to expire in 2014, the resulting news reports simply reinforced the status quo. The provinces expect more money for health care from Ottawa.

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The true cost of Medicare for individuals and families in Canada is often misunderstood, with many people thinking it’s either free or covered by our provincial health insurance premiums.

This misconception has many sources. In part, it stems from the fact that health care consumption is free at the point of use, leading many to grossly underestimate the actual cost of care delivered. Furthermore, health care is financed through general government revenues, rather than financed through a dedicated tax, further blurring the true dollar cost of the service.


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Whenever talk of health care reform arises—and praise for European countries that combine universal coverage with more private sector involvement—a reflex inevitably kicks in. For some, it seems more privately-delivered or privately-insured health care is a policy choice akin to religious heresy. It’s almost as if government delivery and government insurance were an 11th Commandment: Thou Shalt Only Provide Health Care via Taxes and the Public Sector.

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With a provincial election approaching in Ontario, a recent Nanos poll shows that health care remains the most important issue for the majority of voters. The second and third most important issues are the economy and high taxes.  In truth, all three issues are connected. Public health spending is a major cause of higher taxes and higher taxes hinder economic growth.