Access to Health Care in Canada Depends on Where You Live

People in the outskirts of Toronto and Vancouver wait longer for elective medical procedures

Contact:

Martin Zelder, Director, Health Policy Research
The Fraser Institute, (604) 714-4548 Email: martinz@fraserinstitute.ca

Release Date: 9 January 1997

VANCOUVER, BC>>>  The Greater Toronto Area (GTA) and the Greater Vancouver Area (GVA) are experiencing a faster rate of population growth but receive a lesser portion of hospital funding than the cities of Toronto and Vancouver, according to a recent Fraser Institute study.1 "Since private clinics are prohibited from offering any medically necessary service 'closer to home,' people living in the GTA and GVA must join the queue for the services being publicly provided in the city," says Cynthia Ramsay, Health Economist at the Fraser Institute. "Indeed, an increasing number of people living in these outlying areas are having to travel into Toronto or Vancouver at their own expense and on their own time for more specialized treatments, and even for primary and secondary care in many instances."

Lengthy Waits for Those Living Outside the City (Table 1)

• People living outside of Toronto are waiting 20 percent longer to receive elective surgery.
• People in the GTA are waiting from 27 to 150 percent longer for access to diagnostic technology.
• People living outside of Vancouver are waiting 19 percent longer for elective surgery.
• People in the GVA are waiting 7 to 92 percent longer for access to diagnostic technology.

Hospital Funding, Population and Population Growth

• Toronto acute care hospitals receive 72.0 percent of the funding going to the Toronto-Greater Toronto area (table 2).
• The GTA has 50.5 percent of the region's population. It has been growing by over 3 percent a year since 1992 while Toronto's annual growth rate has been only 0.4 percent (table 3).
• Vancouver hospitals receive 57% of the funds going to the Vancouver-Greater Vancouver area (table 4).
• The GVA has 71 percent of the region's population. It has been growing at an annual rate of 2.3 percent since 1991 while Vancouver has been growing at 1.7 percent a year (table 5).

The Solution

The base amount of a hospital's funding relates primarily to the ministry of health's initial allocation decision; it is not sensitive to changing population demographics and patient needs. Basing increases in hospital funding on population growth is not enough. "The entire process of how hospitals and other health care services are funded must be re-evaluated. Each region should be given a demographically determined budget which it spends on hospitals, medical technologies and other health care services to meet the needs of its residents. They should have the responsibility to develop contracts with public or private sector providers and to monitor the services being delivered," commented Ms. Ramsay.

¹The city of Toronto includes Toronto, Scarborough, Etobicoke, and North York. The GTA comprises cities within the Halton, Peel, Durham, and York regions. The Greater Vancouver area comprises Burnaby, West Vancouver, North Vancouver City, District of North Vancouver Lions Bay, Richmond, City of Langley, Langley District, Surrey, White Rock, Delta, Maple Ridge, New Westminster, Port Moody, Anmore, Belcarra, Pitt Meadows, Port Coquitlam, and Coquitlam.

Established in 1974, The Fraser Institute is an independent public policy organization based in Vancouver.

For further information contact:

Suzanne Walters, Director of Communications,
The Fraser Institute, (604) 714-4582,
Email suzannew@fraserinstitute.ca

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