Skip to main content

Ontario has highest private health care payments. And now more user fees?

Donald Drummond was recently part of a panel that made a (poorly received) report to  the Canadian Medical Association that recommended the expansion of user fees for Canadian health care (along with some other pro-privatization notions).  


This was notable as Drummond is leading a commission on public services in Ontario (which, conveniently, will report after the provincial election October 6).  


The panel report to the CMA comes as many private clinics are introducing ingenious user fees (e.g .$100 for a glass of orange juice-- I kid you not).  


User fees will enable those with the extra cash to monopolize more of the time and trouble of doctors and other other health care professionals, while the rest of us -- well we will just have to make do.  This is all the more irksome as the well to do tend to be less in need of health care services than the less well set. 


In any case, here are the words of the Director General of the World Health Organization introduction to a 2010 report (Health Systems Financing: The Path to Universal Coverage) that dealt with the scourge of user fees.

As indicated by the subtitle, the emphasis is firmly placed on moving towards universal coverage, a goal currently at the centre of debates about health service provision. The need for guidance in this area has become all the more pressing at a time characterized by both economic downturn and rising health-care costs, as populations age, chronic diseases increase, and new and more expensive treatments become available....Concerning the path to universal coverage, the report identifies continued reliance on direct payments, including user fees, as by far the greatest obstacle to progress.  (My emphasis -- Doug.) 

The report itself suggests it "is only when direct payments fall to 15–20% of total health expenditures that the incidence of financial catastrophe and impoverishment falls to negligible levels."

About 29.8% of Canadian health care expenditure comes from private (rather than public) payments. That's a lot of user fees (for those without private insurance).  And that's high for a developed country.   In fact it rates 18th out of 26 countries reported by CIHI (see chapter 7).


Other measures also bear this out.  Private health care payments account for 3.1% of the Canadian GDP, tied for the fourth highest percentage among the 26 developed countries reported by CIHI. And Canadians spends the third highest amount per capita on private health care payments ($1,216 in 2008).

No surprise, Ontario has higher private payments than any other province both as a percentage of total  health care expenditures (32.6% of total health care expenditures) and in total cash payments per capita  ($1,841 per person) (CIHI 2010 report, pages 32 and 33).  For total cash payments, that's 50% more than Canada as a whole.

So, expand user fees or other forms of private payments?  Quite the contrary.

Labels:

Comments

  1. HGH HormoneSeptember 5, 2011 at 8:21 AM

    This comment has been removed by a blog administrator.

    ReplyDelete
  2. SamualSeptember 6, 2011 at 6:35 AM

    This comment has been removed by a blog administrator.

    ReplyDelete

Post a Comment

Popular posts from this blog

More spending on new hospitals and new beds? Nope

Hospital funding:  There is something off about the provincial government's Budget claims on hospital capital funding (funding to build and renovate hospital beds and facilities).    For what it is worth (which is not that much, given the long time frame the government cites), the province claims it will increase hospital capital spending over the next 10 years from $11 billion to $20 billion – or on average to about $2 billion per year.   But, this is just a notional increase from the previous announcement of future hospital capital spending.  Moreover, even if we did take this as a serious promise and not just a wisp of smoke, the government's own reports shows they have actually funded hospital infrastructure about $3 billion a year over the 2011/12-2015/16 period. So this “increase” is really a decrease from past actual spending. Even last year's (2016-17) hospital capital funding increase was reported in this Budget at $2.3 billion - i.e. about ...
Post a Comment
Read more

Ford government fails to respond to 72% increase in COVID inpatient days, deepening the capacity crisis

COVID infections continue to drive up hospital costs and inpatient hospitalizations in Ontario. For the most recent fiscal year (April 1, 2022- March 31, 2023) hospital stays related to COVID cost $1.221 billion, according to new CIHI data.   This is about 4% of total hospital spending, creating a very significant new cost pressure beyond the usual pressures of population growth, aging, inflation, and rising utilization.   Costs for COVID related hospitalizations increased 22.2% in Ontario in 2022/23 from the previous fiscal year, rising from $999 million to $1.221 billion.  That rise is particularly notable as the OMICRON spike of late 2021 and early 2022 had passed by the the 2022/23 fiscal year.   The $222 million increase in COVID hospitalization costs came in the same year as the Ford government cut special COVID funding and, in fact, cut total hospital funding by $156 million.     In total, there were 60,653 COVID hospitalizations...
Post a Comment
Read more

The hospital crisis: No capacity, no plan, no end

While Canada has achieved universal public healthcare coverage, that does not mean conservative forces have given up trying to erode that coverage and expand corporate care where it does not currently exist. The battle has become particularly intense in Ontario under the Ford Progressive Conservative government, which is implementing serious cuts to the level of care and moving to bring in for-profit mini-hospitals. Inadequate Staffing.   Less and less of hospital spending is on staff.   Employee compensation as a share of hospital expenditures has consistently shrunk in Ontario. This is not some immutable law of hospital development.  It is in stark contrast with the rest of Canada, where compensation has become a larger share and now accounts for 67.1%. Hospitals in provinces other than Ontario now have 18 percent more staff per capita than hospitals in Ontario. Overall, if Ontario had the same staffing capacity as the other provinces and territories, there would be another...
Post a Comment
Read more