The problem with discussing health care sustainability is there is no definition of what that means. Data would suggest that our health care spending is not out of control – the so-called cost curve has already been bent. Past increases appear to have occurred in sync with economic growth, the exception being the economic crash of 2008. Clearly those who are worried about sustainability are not equating it with affordability.
Across Canada the average increase in provincial health care spending this year is 2 per cent – hardly a matter of excess especially when one considers aging and population growth.
While Canada has done better than just about every other country in the OECD in controlling health costs, it has often come at a difference kind of price given quality issues that persist.
This week the Conference Board of Canada is hosting a two-day conference in Toronto on health care sustainability. Next week the discussions will be sure to spill over into the Ontario Hospital Association’s annual get-together at HealthAchieve. We’ll be at both.
Earlier this year health policy analyst Steven Lewis and former Cancer Care Ontario CEO Dr. Terrence Sullivan issued a paper on how to keep the cost curve bent.
Those darn private for-profit health care facilities.
You can’t locate them where you need them. You can’t tell if their doctor owners are padding their pockets with unnecessary referrals. Quality assurance is still questionable. So, the government concludes, let’s speed up the process of transferring services from hospitals to this sector.
Just weeks after a Toronto Star series highlighted the fact that nine private clinics failed to pass quality inspection and another 64 passed with conditions, the Auditor General of Ontario has issued a chapter in his 2012 report on “independent health facilities.”
The Auditor General notes that about 50 per cent of Ontario municipalities have been underserved by diagnostic services provided by these clinics and about 7 per cent have been consistently overserved from 2007-08 to 2010-11 (fiscal years).
Worse still, the Ministry indicates that many of these facility owners would like to relocate from less populated areas to more population dense locations.
Are we getting value? The Auditor General says we don’t know. Fifty per cent of these clinics (almost all for-profit) are owned or controlled by physicians, many of whom are radiologists. Yet the Ministry has not analyzed the patterns of physicians referring patients to their own facilities. Further many patients are not aware that they could in fact choose any facility or hospital providing such services.