Ontario has highest share of private health care expenditures

Hospital, CIHI report on health expenditure

Ontario has the highest share of private health care expenditure in the country, according to data in a recent report from the Canadian Institute for Health Information (CIHI).  Private expenditures in Ontario run to 32.3% of total health expenditures, higher than any other province (Saskatchewan is at only 24% private expenditures, Manitoba at 25.3%, and Alberta 27.1%). 

Total public sector expenditure in Ontario in 2013 is forecasted at only 67.7% of total health care expenditure, significantly below the Canada-wide average of  70.1%.   

While the Ontario public sector expenditure is down a tick from last year (67.8%), the Canada-wide public sector average is up 4/10ths of a percent (from 69.7% to 70.1%).   

This year, public sector expenditures in Ontario would need to increase 6.3% just to meet the Canadian average -- a $248 increase per person. 

So it is perhaps not so surprising that private health expenditures are 5.3% higher in Ontario than Canada as a whole ($1,883 in compared with $1,787).  

Drugs, Docs, and Hospitals

Ontario spends more per capita than the Canadian average on physicians (6.0% more) and drugs (3.3% more), but it spends less on hospitals: 5.5% less than the Canadian average.

Canada & Ontario Compared Internationally

This is particularly notable as the CIHI report also reveals that Canada as a whole spends more on drugs than any other developed nation except (where else?) the USA.  We spent a total of $752 per capita on drugs in 2011 compared to an OECD average of $495.

Canada is also a top spender on physicians compared to other developed nations.  At $680 per capita in 2011 compared to an OECD average of $402, Canada is tied for the third highest spender on physicians.

But for hospitals, Canada spends only an average amount: $1,298 per capita compared to an OECD average of $1,207.  (And bear in mind that the OECD "rich nation" club includes Turkey and Mexico which spend $361 and $149 per capita respectively on hospitals.)

Bottom line:  Canada spends much more than average on drugs and physicians, and Ontario spends more than the Canadian average.   In contrast, Canada spends an average amount on hospitals and Ontario spends less than the Canadian average.

Health Care Administration Costs: Public vs. Private

Finally, CIHI reports that in 1975, administration accounted for 2.9% of total public-sector expenditure and 2.5% of total private-sector expenditure. But the public- and private-sector trends have differed over time. While the public-sector share gradually declined to 1.8% in 2011, the private-sector share rose to 6.4%.  

The bottom line on this one?  The portion of the private sector health care buck spent on administration is going up, while the portion in the public sector is going down.

Photo: St. Michael's Hospital, Toronto, Paul Bica

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