Bleeding Taxpayers: Health Care in Atlantic Canada

By Dena Mitchell, Law, Dalhousie University

Health care in Atlantic Canada is a timely issue. Waiting lists, the “brain drain,” and lagging technology are results of cash-strapped provincial governments trying to cope with federal cutbacks, while at the same time trying to adhere to the federally legislated Canada Health Act. Atlantic Canadians in particular, with higher rates of cancer compared to other regions,¹ and a rapidly diminishing tax base² have reason to be concerned.

Atlantic Canada has been and will continue to be hit hard with increasing health care costs. Both public and private health expenditures continue to increase. Real spending per capita in Newfoundland and New Brunswick steadily increased from 1975 to 1995, while real per capita health spending in Nova Scotia steadily increased to 1994. In PEI, real per capita spending has increased every year except 1995.³ Moreover, total government expenditures in all four Atlantic provinces show trends of increased spending.⁴

Recently, politicians in all four Atlantic provinces espoused increased funding as the answer to improving the health care system. In New Brunswick, the budget for health care will be increased by $34 million compared to 1997.⁵ In June of this year, the Nova Scotia government promised to add $80 million to the health care budget. Newfoundland’s budget for 1998 also promised increased spending of millions of dollars into community health and health care institutions.⁶ The estimates for PEI show increased net health expenditures into the next century.⁷ Many rationalize this increased spending by pointing to our aging population. However, economists from McMaster University have recently suggested that “the collective aging process is much too slow to account for the recent increases [in health care spending], and one must seek the causes elsewhere.”⁸

If increased spending is not due to our aging population, then perhaps it is necessary to ensure comprehensive service? This is not likely. Increased spending does not necessarily translate into comprehensive service as promised in the CHA. Indeed, increased private spending on health care has accompanied increased public expenditures in Atlantic Canada. Even Health Canada admits that “while public sector spending has been brought under control, private sector spending is continuing to grow.”⁹ Furthermore, the Canadian Institute for Health Information predicts that private sector spending will continue to increase at a rate of 5 percent per year.¹⁰ In the Atlantic provinces, private health expenditures as a percentage of GDP have been steadily increasing in the 1990s.¹¹ So while government continues to pour money into health care, people’s out-of-pocket expenses for certain services are also increasing.

There is little doubt that the issue of what to do about health care is a contentious one nationwide. Suggestions of privatization are usually summarily dismissed as “unCanadian.” But what if privatization of health care services in Canada makes our system work better? One study has suggested that 60 percent of Canadians “are supportive of ‘more medical services being provided by private suppliers alongside the public health system.’”¹² One thing is certain: bleeding taxpayers is no longer an acceptable course for a dying system.

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Last Modified: Wednesday, October 20, 1999.