Skip to main content

Rest of Canada spends 23% more on hospitals than Ontario

Rapidly increasing gap between what other provinces & Ontario spend on hospitals
Provincial government hospital expenditure per person in Ontario compared to the rest of Canada based on CIHI data.
A large gap has grown between what the Ontario provincial government spends on hospitals and what other Canadian provinces spend. 

Since 2004/5 the gap has grown from a mere $9.43 per person to $316.50 per person in 2012/13. 


Nine years ago, the difference was 1%. Now, the other provinces and territories (as a whole) spend  23% more per person on hospitals than Ontario does.   


That is an astonishing difference. 


Or at least the size of the difference is astonishing.   But that gap completely fits with the low level of nursing hours per inpatient in Ontario compared to the rest of Canada, the higher number of nursing sensitive "adverse events", the low level of hospital beds in Ontario, the low level of hospital admissions in Ontario, and the high level of hospital bed occupancy in Ontario.


Ontario has fallen so far behind almost entirely during the tenure of the Ontario Liberal government. 


The Canadian Institute for Health Information data goes back to 1974/75. For the first four years, Ontario actually spent slightly more than the rest of Canada. 

Ontario hospital spending declines while rest of Canada grows

After that (except for several years during the early 1980s), Ontario and the rest of Canada spent about the same.  At least until more recent years.  


The current Ontario Liberal government has taken a radically different tack, with Ontario falling much further behind over the last nine years. In the last year reported, per person spending (in nominal dollars) actually went down in Ontario -- it went up $43 per person in the rest of Canada.

With austerity much sharper in Ontario than in other provinces, and hospital spending restraint a central focus for the Ontario Liberals, Ontario is almost certain to fall even further behind in the next few years. 


The Mike Harris government initially sharply attacked hospital spending, but then quietly changed directions when problems became apparent. There is no such sign of a change in policy now. Expect the line on the chart below to go higher. 


Gap between Ontario hospital spending and rest of Canada


(The full figures behind these charts are below.)

Notably, the sharp differences between Ontario and the rest of Canada stand up no matter how the average is created.  The un-weighted average of the spending of the other nine provinces  (created by simply adding together the average per person expenditure of the other nine provinces and dividing by nine)  leads to even more stark results: the un-weighted average of the other nine provinces was $1845 in 2012/13, fully $501 more than the Ontario government per person expenditure of $1344. 

Ontario may be in a more difficult fiscal situation than the other provinces, but this sort of difference in spending is not likely sustainable.  Something has to give -- sooner or later.  



Provincial government hospital expenditures
Total expenditure divided by population.
Total expenditure divided by population.


Year
Ontario per capita expenditure
Canada (excluding Ontario) per capita expenditure
Canada (excluding Ontario) per capita -Ontario per capita: 
$ difference
Canada (excluding Ontario) per capita/ Ontario per capita
1974–1975
 $                   189.81
 $                   172.59
-$                       17.23
91%
1975–1976
 $                   217.45
 $                   217.24
-$                         0.21
100%
1976–1977
 $                   252.23
 $                   244.71
-$                         7.53
97%
1977–1978
 $                   256.23
 $                   253.47
-$                         2.75
99%
1978–1979
 $                   267.20
 $                   277.31
 $                        10.12
104%
1979–1980
 $                   284.88
 $                   302.78
 $                        17.90
106%
1980–1981
 $                   315.48
 $                   356.25
 $                        40.77
113%
1981–1982
 $                   374.29
 $                   416.29
 $                        42.00
111%
1982–1983
 $                   430.66
 $                   496.80
 $                        66.14
115%
1983–1984
 $                   470.03
 $                   524.26
 $                        54.23
112%
1984–1985
 $                   499.58
 $                   540.64
 $                        41.06
108%
1985–1986
 $                   533.30
 $                   561.95
 $                        28.65
105%
1986–1987
 $                   581.35
 $                   600.34
 $                        19.00
103%
1987–1988
 $                   613.68
 $                   633.93
 $                        20.25
103%
1988–1989
 $                   656.00
 $                   671.04
 $                        15.04
102%
1989–1990
 $                   728.01
 $                   718.69
-$                         9.32
99%
1990–1991
 $                   735.23
 $                   761.74
 $                        26.51
104%
1991–1992
 $                   820.10
 $                   799.59
-$                       20.51
97%
1992–1993
 $                   807.36
 $                   822.27
 $                        14.91
102%
1993–1994
 $                   790.21
 $                   810.75
 $                        20.54
103%
1994–1995
 $                   760.80
 $                   782.25
 $                        21.45
103%
1995–1996
 $                   742.97
 $                   767.46
 $                        24.49
103%
1996–1997
 $                   755.13
 $                   744.55
-$                       10.58
99%
1997–1998
 $                   690.92
 $                   745.83
 $                        54.91
108%
1998–1999
 $                   749.12
 $                   783.86
 $                        34.74
105%
1999–2000
 $                   752.02
 $                   809.50
 $                        57.48
108%
2000–2001
 $                   851.85
 $                   866.03
 $                        14.18
102%
2001–2002
 $                   830.90
 $                   930.77
 $                        99.87
112%
2002–2003
 $                   910.08
 $                   981.80
 $                        71.72
108%
2003–2004
 $                   984.99
 $               1,028.85
 $                        43.87
104%
2004–2005
 $               1,069.63
 $               1,079.06
 $                          9.43
101%
2005–2006
 $               1,085.31
 $               1,130.40
 $                        45.09
104%
2006–2007
 $               1,147.34
 $               1,199.11
 $                        51.78
105%
2007–2008
 $               1,188.86
 $               1,260.90
 $                        72.04
106%
2008–2009
 $               1,255.91
 $               1,359.10
 $                     103.18
108%
2009–2010
 $               1,296.66
 $               1,444.27
 $                     147.61
111%
2010–2011
 $               1,343.41
 $               1,613.50
 $                     270.09
120%
2011–2012 f
 $               1,373.59
 $               1,641.24
 $                     267.65
119%
2012–2013 f
 $               1,367.89
 $               1,684.39
 $                     316.50
123%
Developed from [1] CIHI provincial government hospital spending data and [2] Statistics Canada population figures for July of each year.  Download this spreadsheet for more detail.






Comments

Popular posts from this blog

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 in Ontario in 2022/3, up from 47,543 in 2021/2. 

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 15% more th

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 33,778 full t