Defend Public Healthcare

Hospitals are often stereotyped as providers of acute care services.  In fact, acute care accounts for a relatively small portion of total hospital services. As noted a few days ago ,  costs per acute care patient (or, more exactly, per "weighted case")  in Ontario are significantly below the national average, coming in at $5,174  in 2010-11 (and $5,184 in 2011-12). There  was 1,484,046 weighted acute care (and newborn) cases in 2010-11 in Ontario. So  the total acute inpatient cost is about  $7,678,454,004. In 2010-11, the total hospital sector expense (funded from both government and other sources) was $20.6 billion according to figures in the  2010 Budget .   As a result, acute care spending amounts to only 37.2% of all hospital spending. In other words, acute care is a significant part of hospital activity --but it is in a decided minority in overall scheme of things going on at hospitals.   Good news for P3 privatizers , Ontario's privatized P3 Highway,

The real costs for the average hospital acute care patient are declining. As noted yesterday this is true for both Ontario and Canada, based on data just released from the Canadian Institute for Health Information (CIHI).    But the CIHI data also revealed other interesting trends, likely related.   Administrative Costs Decline:  Administrative costs fell from 6.21% of total expenses in 2009-10 to 6.15% in 2010-11 and then down to 5.91% in 2011-12.   With a total hospital spend in the range of $21 billion in Ontario, this 0.3% reduction frees up about $63 million annually. The decline in administrative costs across Canada has also been marked, declining by a similar amount as in Ontario to fall to 4.7% of total  hospital expenditures.   Long-Term Efficiencies Achieved in Support and Administrative  Services: This decline in administrative costs is part of a longer term trend.  A  2005 report  from CIHI indicated  administrative expenses took up significantly mor

Ontario has the lowest hospital cost per weighted case of all the provinces.  And the cost difference between Ontario and the rest of the country is growing. Hospital Cost Per Weighted Case ($) 2009-2010 2010-2011 2011-2012 Newfoundland 6,001 6,283 6,332 PEI DQ DQ 5,257 Nova Scotia 4,998 5,403 5,384 New Brunswick 5,104 5,380 5,390 Quebec 4,455 4,550 4,728 Ontario 5,164 5,174 5,184 Manitoba 5,403 5,438 5,396 Saskatchewan 5,722 5,883 6,174 Alberta 6,139 6,399 6,631 BC 5,456 5,571 5,232 North West Territories N/R N/R N/R Yukon DQ 7,709 7,394 Weighted Average 5,172 5,281 5,335 Source: Canadian Institute for Health Information (CIHI ): Canadia

A Great West Life Assurance executive recently claimed that private insurance for drug plans was becoming unsustainable -- unless changes are made. Almost all private drug insurance plans are paid through employer paid  insured benefit plans (often bargained with trade unions). In fact, although there were significant increases during the 90s and the first decade of this century, drug costs for insured benefit plans have leveled off. For 2010, 2011, and 2012 private drug insurance costs have risen just less than 3.1% per year on average, according to the Canadian Institute for Health Information  (Table A). This is a small fraction of the increases in the 1990s (where the average annual increase was 10.5%) or the first decade of this century (10.3% average annual increase). Part of the slowdown in costs is that some high priced blockbuster patented drugs are coming to the end of their patent protection and are now facing competition from lower priced generic versions. So,

Contrary to the hysteria from conservatives, health care spending continues to decline as a percentage of the provincial budget.   Last year, health care accounted for 38.5% of total expenditures, this year the government plans to bring it down to 38.3%.  This continues the trend downwards since 2003/4 when health care accounted for 40% of total expenditures. Austerity Redux The provincial Budget reports that program spending is going up an impressive sounding 2.99% and health care spending is going up 2.3%.  Although that sounds like a larger than expected increase in these days of austerity, these figures are, unfortunately, misleading. The reason is that last year funding fell well short of the Budget plan and the government is now playing catch-up. The 2013 Budget indicates that the government spent considerably less than it budgeted in the 2012 Budget.  For example, the Ontario government spent $595 million less on health in 2012-13 than it budgeted, a 1.2% reduc