Commission on Justice and Peace Document Archives

The Challenge

It’s not exactly a neglected topic, is it? Health care in Canada is the subject of more federal-provincial conferences, more newspaper ink, more political campaign threats and promises, and more media noise than any other issue of public policy.

It’s easy to provide frightening statistics about what health care costs in Canada. In provincial and territorial budgets, health care trumps every other public expenditure, sometimes consuming close to 50% of programme costs1. Through transfers to the provinces under the Canada Health Act, health care weighs mightily on federal coffers as well. The numbers can be terrifying, unless they go on to document what happens where there isn’t a public system like Canada’s. One careful report2 notes that the high level of total health care spending in the United States translates into far more spending per capita than in Canada—like paying for national health insurance, but getting instead only a fragmented system with serious gaps in coverage. Americans spent $5,267 (U.S.) per capita on health care in 2002, compared to Canadians who spent $2,931 (Canadian). Families USA, a health-care advocacy group, reports that more than 14.3 million Americans now spend more than one-quarter of their take-home pay on health insurance, even though coverage is shrinking and employers are capping the employer contribution to soaring insurance costs. Meanwhile 45 million Americans are without any health coverage, and medical bills account for almost half of all U.S. personal bankruptcies.3

Analysis and comparison can make Canada’s system look wonderful, but the raw numbers by themselves can still be terrifying. One estimate says that we spend about $130 billion per year on health care. People can easily conclude that we can’t go on affording this. And indeed, there are many voices saying: It’ll ruin us! Medicare is unsustainable!

But is the assertion that Medicare is not sustainable borne out by the evidence? Not according to a study by the federal government’s Dept. of Finance. In a speech to the Registered Nurses’ Association of Ontario on April 23, 2004, The Honourable Roy Romanow quoted this study. It stated that “The analysis discounts… theories that rising health care costs will bankrupt federal and provincial governments…The aging population alone will not drive up costs astronomically…As the country gets richer, it will be able to afford more health care as well. Governments’ share of total health care spending for the country will likely remain less than 10% of the size of the Canadian economy”. The time frame for the study is 40 years. (4. “Alice Through the Looking Glass: Standing Up for the Future of Medicare”, The Honourable Roy J. Romanow, P.C. Notes for Keynote Address, RNAO Annual General Meeting, April 23, 2004).

File Type: pdf
Categories: English, Healthcare
Tags: health policy, healthcare, public health
Author: Janet Somerville