Over the past several months, one thing has been on the minds of politicians and the public regarding healthcare: is there enough money (Zimonjic, 2023)? Since covid-19 swept across the globe, the healthcare industry has seen a staggering increase in spending in Canada to account for the problems caused by the pandemic. But is it enough? Is Canada in a healthcare funding crisis? In short, no. In some aspects, we may spend too much on one thing (more on that in another of my editorial blog posts concerning Doug Ford’s proposed duplicate “for-profit” healthcare policies) and too little on other aspects. From the Federal and Provincial government’s viewpoint, however, we spend enough.
Healthcare spending has been at its highest since the inception of public healthcare in Canada. However, it is much more complicated than having enough money to run our hospitals (Moir and Barua, 2022). In particular, preventative measures and funding for programs such as mental health, pharmacare, dental care, and family physicians are vital to reducing the impact and burden on our hospital system (CBC News The National, 2023). The problem lies in the fact that Canadian healthcare only funds part of these preventative measures.
https://www.budget.canada.ca/2023/report-rapport/chap2-en.html
On the surface, both the Federal and Provincial governments are making a concerted effort to bolster healthcare spending with an eye to future problems. Funds are being sent to the provinces through the Canada Health Transfer (CHT), a federally mandated program which sees part of the burden of healthcare placed on the federal government, and allocated by the province and the hospitals for each department. The recent Federal budget has a new plan to increase spending through the CHT to “historic” levels (Government of Canada, 2023). Similarly, provinces, such as Ontario, have taken up the call to try and find new ways to circumvent funding issues by incentivizing the private sector to invest in private clinics for certain elective surgeries (Crawley, 2023). Whether the new-found push for private clinics is a good idea remains to be seen, as it has several insurmountable problems which might hurt funding. Nevetherless, as a whole, it is clear that both levels of government are keeping an eye on healthcare funding.
On one front, the Federal government is attempting to tackle dental care as one of its new initiatives (Canada Revenue Agency, 2022). The dental plan covers only families earning less than $90,000 per year. The Federal government hopes to create and continue to fund this dental care program starting at the end of 2023 to provide dental care to Canadians who need it the most. While some are critical of the program’s costs, it is unfair to say that the Federal government is not investing directly in the healthcare of Canadians (Osman, 2023).
Moreover, the battle continues to try and include a Federally funded pharmacare program that was one of the stipulations of the New Democratic Party’s (NDP) political coalition to bolster the Liberal minority government in the House of Commons (Pelley, 2022). While the program seems to be stuck in the mud, there is hope that in the future, the program will provide another essential preventative healthcare avenue of funding for the public healthcare system by reducing the cost of essential treatments and pharmaceuticals for all Canadians.
On the human front, as the pandemic has slowly begun to stabilize, there are still worries that covid has severely depleted the reserves of hospitals despite the increase in spending. Covid has also contributed to the healthcare industry becoming an increasingly stressful environment compared to other essential working positions (René, 2022). To compound this issue, registered nurses (RN) have a historical pattern in which they leave high-stress environments for those of “greener pastures,” such as hospitals in the United States (McGillis et al., 2009). While part of this can be attributed to monetary compensation, something more funding could solve, McGillis’s research concludes that it is not the only reason. More full-time positions and the potential for “ongoing education” contribute to “an important motivation for Canadian nurses to move to the United States.
The nursing situation in Canada is not an isolated incident either: Canada also has a noted family doctor shortage (The College of Family Physicians of Canada, 2022). Doctors with the credentials, or the ability to practice in local communities, are turned away or are choosing to go to different countries to practice. Should Canada want to find a way to increase its desirability factor, the provinces and the federal government must work together to come to a solution that makes Canada a more attractive place for healthcare workers.
The good news is that healthcare is a pressing issue for all levels of government. Covid 19 has spotlighted the inefficiencies that Canadian healthcare has gathered over its lengthy history. Notably, healthcare funding is at an all-time high, not-including the severe bump in funding during the early months of the pandemic throughout 2020-2021. The bad news is that the allocation of funds continues to be logistically and politically controversial; healthcare practitioners, the federal NDP and the Liberal party have been hard at work trying to come up with a solution to give hospitals a well-deserved break. Dental care, pharmacare, and making Canada a desirable country for healthcare providers are some of the most pressing matters the provincial and federal governments are discussing. Moreover, there are constant issues with the allocation of provincial funds going to places where they are needed most — something which policy initiatives including private clinics contradict.
So, is Canada in a funding crisis? No. However, funding allocation still needs ironing out and will always be in contention.
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For more info and examples on some of the allocation of funding in Ontario prior to the covid pandemic, as well as some of the policy reccomendations from the Ontario ministry of health, see here:
Mowat, D. L. (2016). Public health funding model for mandatory programs. Ministry of Health and Long-Term Care.
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References
Canada Revenue Agency. (2022, September 20). Canada Dental Benefit. https://www.canada.ca/en/revenue-agency/services/child-family-benefits/dental-benefit.html
CBC News: The National . (2023, February 6). Canada’s health-care crisis: Problems, solutions and privatization. [Video]. YouTube. https://www.youtube.com/watch?v=His4MmMGLGI
Crawley, M. (2023, January 13). Ontario poised to give private for-profit clinics bigger role in surgeries | CBC News. CBC. https://www.cbc.ca/news/canada/toronto/ontario-doug-ford-private-clinics-health-care-1.6712444
Government of Canada, D. of F. (2023, March 28). Chapter 2: Investing in Public Health Care and Affordable Dental Care | Budget 2023. https://www.budget.canada.ca/2023/report-rapport/chap2-en.html
McGillis Hall, Pink, G. H., Jones, C. B., Leatt, P., Gates, M., & Peterson, J. (2009). Is the grass any greener? Canada to United States of America nurse migration. International Nursing Review, 56(2), 198–205. https://doi.org/10.1111/j.1466-7657.2008.00706.x
Moir, & Barua, B. (2022). Comparing Performance of Universal Health Care Countries, 2022. In Policy File. The Fraser Institute.
Osman, L. (2023, March 28). Budget 2023 expands dental-care program, but expected cost balloons to $13B – National | Globalnews.ca. Global News. https://globalnews.ca/news/9585059/budget-2023-dental-care-program/
René, B. (2022, February 2). Governments need to act now: Nurses are hanging on by a thread. Canada’s Nurses. https://nursesunions.ca/governments-need-to-act-now-nurses-are-hanging-on-by-a-thread/
The College of Family Physicians of Canada. (2022, May 5). Family doctor shortage in Canada | The College of Family Physicians of Canada. https://www.cfpc.ca/en/news-and-events/news-events/news-events/news-releases/2022/family-doctor-shortage-in-canada
Zimonjic, P. (2023, January 2). More money is a must, but health-care delivery also needs a major rethink, doctors say | CBC News. CBC. https://www.cbc.ca/news/politics/healthcare-crisis-doctors-hospitals-rethink-1.6695642