Tag Archives: Conference Board of Canada

Will health care derail the 2017 target for balancing the books? Not likely.

Picture of coins to illustrate folly of the Conference Board of Canada's health care projections.

The Conference Board suggests that a 4.5 per cent annual increase in health spending will derail plans for a balanced budget in 2017. The thing is, that’s more than double the rate of increase the Wynne government is presently spending on health. (Canstock Photo)

The Conference Board of Canada likes to tell the world that it is independent and unbiased, but a quick look at its board of directors will reveal that it is mostly dominated by leaders from Canada’s corporate sector.

That includes representatives from banking, energy, insurance, and telecommunications, to name but a few of the private sectors chiefs that dominate the board. There are also, for good measure, a handful of board members from the public sector, including two university presidents and one hospital CEO, Michelle DiEmanuele from Trillium Health Partners.

DiEmanuele should be very familiar with what Ontario is spending on health care given Trillium has been subject to the same freeze on base funding that other public hospitals have experienced.

Overall Ontario budgeted for a 2.2 increase in nominal funding for the health care sector in 2014-15. Factor in the present inflation rate of 2.5 per cent (August CPI – Stats Canada), that means health care experienced an overall drop in real inflation-adjusted funding of -0.3 per cent. Add to that the impact of population growth and aging, the real cost pressures are probably closer to 4.5 per cent.

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Picard blames health professionals for slow pace of “reform”

How can we improve Canada’s health system? Blaming the professionals who deliver care defies logic.

You may be very surprised to learn that one prominent journalist says the biggest obstacles to health care reform are the people who deliver it – or more specifically, their unions and associations.

Globe and Mail public health reporter Andre Picard comes back to so-called “vested interests” over and over again in a monograph (The Path To Health Care Reform: Policy and Politics) published last fall by the business-sponsored Conference Board of Canada.

Picard says of health care reform: “those who stand to lose the most are principally health professionals – specifically, the organizations that represent them, from unions to professional organizations.”

As such, so his theory goes, “they have a lot of power right now, and they’re not going to give up without a fight.”

Why would health professionals lose from health reform? Picard never says, although makes vague references to the poaching of professionals that is supposedly driving labour costs up. Really?

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Poking the beast – “P” word missing from reform talk

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.

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P3s for Dummies: Part III — Fool us once, twice, fool us some more

Ontario has been leading the country in pursuing private deals to finance, develop and maintain public infrastructure projects, including a significant number of major hospital redevelopments.

Last week we looked at how public-private partnerships turn projects away from the public interest. In Part I we looked at what P3s are and how the concept of risk has been used to overcome project costs that have been much higher than traditional public procurement. And along the way we poked some fun at the arguments put forward by the business community looking to get rich at our expense.

This week we debunk the myth put forward by the Conference Board of Canada that all is now well in the P3 world.

The Conference Board of Canada has suggested that Canadian P3s fall into two categories – Phase I, which we could summarize as the “we didn’t know what the heck we were doing and made a real mess of things but continued to deny it until the evidence was overwhelming” phase, and Phase II, post 2004, in which provincial and federal governments set up P3 infrastructure offices that, according to the Conference Board, now know what they are doing. Phew! Nothing to see here! Everybody go back to watching hockey.

Of course, when post 2004 P3s go off the rails, they blame it on municipalities, which apparently still don’t know what they are doing. P3s are still a great idea, they say. They just need more, well… rules. After all, this whole idea is not complicated enough already.

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Video: Three-quarters of the world’s population faces rising income inequality

The Occupy movement is changing the way we talk about the economy, particularly around rising income inequality. Earlier this year, the Conference Board of Canada put together this brief video showing how three-quarters of the world’s population is facing rising income inequality. As we have noted in previous BLOG stories, income inequality has a significant effect on population health, particularly on mental health.


Conference Board comes up with phoney alliance to scare Canadians out of their right to public health care

The Conference Board of Canada is the latest organization to try and scare Canadians out of public Medicare.

Launching the “Canadian Alliance for Sustainable Health Care,” the Conference Board opens with a statement that is full of distortions of fact. This is not research, it’s propaganda.

In an op/ed, Anne Golden and David Stewart Patterson use every wrong cliché in the book to try and convince us that “if we continue to treat health care soley as an essential public service, as a sacred entitlement of Canadian citizenship, we are doomed to perpetuate the trend towards higher costs, higher taxes, longer lineups and wait times and growing frustration.”

It’s not hard to read between the lines that the Conference Board is challenging the right of Canadians to public access of quality health care.

The two ignore the fact that wait times have been coming down, that spending on health care has recently shrunk as a percentage of program spending and GDP, that taxes have been cut, particularly for corporations. They say the cost to the Federal government goes up by six per cent per year. But that’s because the Federal and Provincial governments agreed on such an escalator in part to rectify an imbalance between Federal and Provincial contributions to health care. They make the assumption that treating health as an essential service perpetuates higher costs. Would making health unessential make it any cheaper? This is ridiculous.

They say that the time has come to move beyond “rhetorical nostrums” but instead perpetuate their own out-of-date myths about the health care system. Like other propagandists, they prefer to use numbers from the height of the recession than more recent data in making their arguments.

The title “Canadian Alliance” suggests that it is the sum of a group of organizations working with the Conference Board. In reality, it is the Conference Board.

In its statement the Conference Board doesn’t do much to differentiate total health care spending and total public health care spending. They ignore their own charts that show countries with more public and less private health care tend to spend less. They ignore the fact that among the G7 nations, Canada is second only to the U.S. in the amount of private health care in the system.

They say we need to be more efficient, pointing to Japan as a model. It is hard to believe their business members would tolerate a government that bans profits for health insurance, aggressively sets the price of drugs, pays it professionals poorly and has the lowest rate of privatization.

Nor do we think the Conference Board would applaud if we concentrated more of our health system in hospitals, as the Japanese do. Japan has about three times as many beds per capita as Canada. Even with this, hospitals are crowded. There are shortages of obstetricians, anaesthesiologists and emergency room specialists due to low pay, long hours and high levels of stress. Japanese primary care doctors, according to the Washington Post, make up for low treatment fees through astonishingly high volumes, turning their clinics into assembly lines.

While Ontarians may not like Dalton McGuinty’s health care premiums, they would like Japan’s even less – it’s set a four per cent of income. Instead of an individual who earns $100,000 paying a premium of $600 here in Ontario, in Japan you would be paying $4,000.

The Conference Board also misleads by talking about rankings, not on actual numbers. The difference between the life expectancy of Canadians and the Japanese is two years. In the past decade life expectancy of Canadians has increased by close to three years.

There is no question we could do better in the delivery of health care. But please, let’s get a grip and have a debate based on some level of reality.