Opposition parties mislead the electorate when they charge that the Conservative Party has cut spending for medical care. UPDATED OCTOBER 14, 2015.
Here are the facts. The federal Conservatives increased the Canada Health Transfer (CHT) to provinces by billions of dollars per year, and the Conservatives would continue to grow it by billions more after the election. The 2015 federal budget (Table 5.2.6) adds $8.8 billion in additional annual spending to the CHT by 2019/20.
Indeed, spending on medical care will grow faster than every other social policy measure in the federal budget except one – the Old Age Security system.
So why all this talk of Mr. Harper cutting medical care?
The charge that the Conservative Party has cut medical care spending has been made because growing the CHT by $8.8 billion annually means that the transfer would increase at a slower pace than in recent years.[i] Over the last decade, federal transfers for health care grew six per cent each year – outpacing economic growth. Now the Conservatives propose raising the CHT no less than 3 per cent per year, or as fast as the economy grows – whichever is higher.
Why does this matter?
It may not yet be politically popular, but research encourages Canada to contain the growth of medical care spending. Our country spends more public money per person on medical care than most countries. This might be fine if we got better outcomes than most countries. But we don’t. We don’t get better access to doctors, CT Scans or MRIs. We don’t get better outcomes or satisfaction. We do get better paid doctors by comparison with other jurisdictions (OECD 2013).
While not getting big bang for our increasing medical care bucks, our federal and provincial governments have been cutting income and sales taxes. Reducing taxes and raising spending on medical care leaves less left over for other things that often make us healthier: for example, supports for families, education, housing, etc. (For more information, see Table 4 in Kershaw (2015)).
How do the other Parties compare on medical care?
The NDP will grow medical care faster than any other national party, adding another $2.5 billion on top of the $8.8 billion increase the Conservatives already propose. That means by 2019/20, the NDP will increase spending on the Canada Health Transfer by $11.3 billion a year by the end of its first mandate.
To put this NDP proposed increase in context, the entire federal budget for education is presently just under $10 billion a year.
The Liberals will add $1 billion on top of what the Conservatives budget.
The Greens will add $1.26 billion more than the Conservatives by 2019/20.
What do the NDP, Greens & Liberals aim to buy with more medical spending?
For example, both the NDP and Liberals budget more for seniors’ care outside of hospitals. Such care is a good idea because hospital care is particularly expensive. And seniors often don’t want to be in hospitals when needing support with chronic conditions that come with aging. My 99 year old grandmother doesn’t.
The NDP also propose to phase in a universal approach to pharmaceutical insurance and bulk buying. (So do the Greens and Liberals, although Greens only budget about 1/5th of what the NDP do; and the Liberal budget is vague). Again, there is good research to support integrating the costs of pharmaceuticals into our public health care system, in part because doing so will reduce the cost at which our governments purchase medications.[ii]
The additional Green party investment is more oriented toward prevention than treating illness. The Greens propose $913 million to pay for dental care for 700,000 youths in low-income families.
Still, many countries already spend less on medical care per citizen than does Canada (OECD 2013), while already integrating better approaches to caring for seniors, paying for medications and dental care.
So, it is important in this election for all four national parties to explain why Canada can’t achieve these goals within the minimum $8.8 billion annual medical care spending increase on which all parties agree.
This explanation is important, because inefficiency in medical care drains other investment areas.
Consider the NDP platform. By growing the CHT faster than other parties, while not wanting to reverse many recent federal income and sales tax cuts, the NDP have to make other trade-offs.
One way to interpret these trade-offs is to observe that the NDP will add over $11 billion to medical care compared to just $2.5 billion to child care by 2019/20. As a result, the NDP doesn’t have enough money to make its important $15/day child care commitment come to fruition in as timely a way as it otherwise might, because it will take $9 to $10 billion a year to make the child care promise a reality.
This is a pity, because science confirms the value of investing in child care services, including for health promotion.
[i] The Conservatives also changed the Canada Health Transfer to deliver funding to the provinces solely based on the number of people in the province, as opposed to accounting for the age distribution. Since health care spending increases with age, the Conservative change to the CHT is advantageous to provinces like Alberta and Saskatchewan which have young populations, and is disadvantageous to provinces like BC, Quebec and Atlantic Canada.
[ii] As governments contemplate how to integrate pharmaceutical insurance into our public health care system at a moment that the population is aging, it will be important to ensure that the resulting intergenerational costs and benefits of the pharmaceutical program are fair for all age groups.