Skip to main content

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

Popular posts from this blog

Six more problems with Public Private Partnerships (P3s)

The Auditor General (AG) has again identified issues in her annual reportwhich reflect problems with Ontario health care capacity and privatization.   First, here are six key problems with the maintenance of the 16 privatized P3 ("public private partnership") hospitals in Ontario:
There are long-term ongoing disputes with privatized P3 contractors over the P3 agreements, including about what is covered by the P3  (or “AFP” as the government likes to call them) contract.The hospitals are required to pay higher than reasonable rates tothe P3 contractor for  maintenance work the contractor has deemed to be outside of the P3 contract. Hospitals are almost forced to use P3 contractors to do maintenance work the contractors deem outside of the P3 contract or face the prospect of transferring the risk associated with maintaining the related hospital assets from the private-sector company back to the hospitalP3 companies with poor perf…

Health care funding falls, again

Real provincial government health care funding per-person has fallen again this year in Ontario, the third year in a row.  Since 2009 real funding per-person has fallen 2.6% -- $63 per person. 

Across Canada real per person funding is in its fourth consecutive year of increase. Since 2009, real provincial funding across Canada is up $89 -- 3.6%.
In fact the funding gap between Ontario and Canada as a whole has gown consistently for years (as set out below in current dollars).

Ontario funds health care less than any other province -- indeed, the province that funds health care the second least (B.C.) provides $185 more per person per year, 4.7% more.  
Provincial health care spending in the rest of Canada (excluding Ontario) is now  $574 higher per person annually than in Ontario. 

 Ontario has not always provided lower than average health care funding increases-- but that has been the general pattern since 2005.
Private expenditures on health care have exceeded Ontario government increases …

Ontario long-term care staffing falls far short of other provinces

CUPE and others are campaigning for a legislated minimum average of four worked hours of nursing and personal care per resident per day in long-term care (LTC) facilities.  New research indicates that not only is LTC underfunded in Ontario, it is also understaffed compared to the other provinces. 
LTC staffing falls short:  The latest data published by the Canadian Institute for Health Information (and based on a mandatory survey undertaken by Statistics Canada) indicates that staffing at long-term care (LTC) facilities falls far short of other provinces. 
Part of this is driven by a low level of provincial funding for LTC.

Ontario has 0.575 health care full-time equivalent employees (FTEs) per bed staffed and in operation.[1]  The rest of Canada reports 0.665 health care FTEs.[2] The rest of Canada has 15.7% more health care staff per bed staffed and in operation than Ontario.[3] 

No other province reports fewer LTC health care staff per resident (or per bed) than Ontario.[4]

Occupancy r…