Among Canadian provinces, New Brunswick is spending the third-highest percentage of GDP on health care. A recent report by the New Brunswick Health Council warns that the rate of spending is growing faster than the provincial economy – an unsustainable situation.
Chief executive Stéphane Robichaud argues that New Brunswickers must embrace a new approach – "to see the evolution of our health system as something else than the size of our local hospitals." Campaigning politicians should be the first to adopt this philosophy. It’s not just unwise to promise all things to all people in health care: given the tenuous state of the province’s finances, it’s irresponsible.
Health expenditures account for about 40 per cent of program spending in New Brunswick. Some 23.8 per cent of that spending comes from federal equalization payments. That’s on top of substantial federal health funding transfers. So while health care meets or exceeds the national average in areas such as the number of nurses and technologists, hospital beds, and access to diagnostic equipment, it is heavily subsidized by taxpayers in other provinces.
This arrangement will become more difficult to defend in the next few years as the federal government and other provinces struggle to return to balanced budgets. It is already coming under attack in Alberta and Ontario, where critics such as the Frontier Centre for Public Policy have argued that equalization enables "have not" provinces to supply superior access to health care at the expense of taxpayers in central and western Canada.
As Mr. Robichaud has observed, the current federal-provincial health transfer agreement comes up for renegotiation in 2013, and there will be great pressure to reduce payments. Politicians hoping to be elected this September need to take a long view of the issue, and start shifting the political debate in the direction of cost-effective, sustainable health care.
Over the past two decades, New Brunswickers have invested a great deal in creating a well-staffed and well-equipped health-care system. But the hospital network is not yet organized for the greatest efficiency, and officials are still learning to track and compare the cost of procedures.
The past two provincial governments have each taken steps to contain increasing expenditures. Parties wishing to form the next government must make a principled commitment to re-align health-care resources, for the sake of getting more value out of every dollar and preserving the services that patients need.