Healthcare: The Canadian Fiscal Crisis that America Would Love to Have

By Keith Edmund White

Editor-in-Chief

Canada's provinces are beginning to rein in healthcare spending, which means they are putting the breaks on near-double digit percent annual increases.  Sure, this is the beginning of a decade-delayed 'new reality' regarding raising healthcare spending.  But, as Keith White reports, if Canadian spending on healthcare constitutes a crisis, it's a crisis the United States would love to catch.

Jeffrey Simpson at The Globe & Mail highlights a big shift in how provinces are dealing with healthcare spending, and the possibility that provinces may need to start coming to gripes with containing healthcare spending.

After a decade allowing healthcare budgets to increase, all provinces, save one (i.e. Quebec), are holding back on healthcare spending.  Why?   Budgets are shrinking; healthcare costs are raising; and, after years of avoidance, provincial debts have to be reckoned with.

But the lurking sense of 'doom and gloom' in Simpson's article could easily bemuse an American observer.

Canada's Illusory Fiscal Responsibility

Hey Americans, don't feel jealous of Canada's estimable federal finances.

Just look at their provinces, and you'll feel just fine.  

Admittedly, the U.S. has a State pension problem too.

But maybe we should rethink Canada's fiscal image.

Lesson:  Creative accounting exists everywhere, and federalism creates fascinating budgetary flavors.  

From Maclean's:

Snap Shot: Canada Healthcare Costs; International Healthcare Costs

Canada's healthcare is anything but free; but, the cost of Canada's public healthcare system is still considerably lower, on a per capita basis, than the cost of healthcare spending in the United States.

The Fraser Institute last month released The Price of Public Health Care Insurance.  The short report estimates 2012 Canadian health spending and then breaks that spending down by different family types.  The report also shows the steep increase in Canadian healthcare spending witnessed between 2002 and the reports estimated 2012 figure.

Per Capita Cost.  The report also estimates that the 2012 per capita cost, or "the cost of the public health care insurance plan if every Canadian resident paid an equal share," of healthcare at approximately $3,779 CAD per Canadian (or roughly $3,859.00 USA).

Per Capita Country Comparison.  For a sense of how that compares to other nations' healthcare spending, check out this National Geographic (NG) graph using 2007 data.  Note:  This  chart pegs Canadian per capita spending at $3,895 USA.  I suspect the higher 2007 figure is more a reflection of the two countries considerable difference in exchange rates between 2007 and 2012.  This cross-graph comparison quirk notwithstanding, the NG graph still gives a sense of the difference between U.S. and Canadian spending on healthcare.

Snap Shot: The Coming and Going of Canada's Federal Revenues

Source:  Your Tax Dollar, Department of Finance Canada, 2011

Canada's Parliament Returns From Summer Break: Previewing the 2012 Fall Session

CUSLINexus rounds up assessments of Canada's upcoming fall 2012 parliamentary session.

5 Issues That Will Dominate the Fall Session of Parliament, Kieron Lang, CTV News. CTV News outlines and even offers a video segment on the key issues of Canada’s Fall Parliamentary Session. In short:

(1) Trade. EU and Trans-Pacific Partnership deals will get high priority, along with the government's review of a state-owned Chinese company bid to buy Canadian energy producer Nexen).

(2) Quebec. Will the PQ’s return to power in Quebec prompt another referendum. If so, they’ll be headaches in Quebec City and Ottawa.

(3) Government Contracts. There’s been criticism of how the government is handling non-competitive government contracts its administrating.

(4) Courts.  As many as 4 Canadian Supreme Court justices may step down before Harper’s term is up—talk about legacy-making stuff.

(5) NDP.  Last year, the NDP wowed the Canadian political world with a 2nd-place finish. Then, tragically, its leader—Jack Layton died of prostate cancer. Now the NDP’s new leader, Thomas Mulcair has to define himself and the party that needs to show the Canadian public it can take the reigns of Canada’s government.

 
Hoping for a Changed Tone in Parliament? Don’t Hope Your Breath,  Michael Den Tandt, Times Colonist and The Province. Writing for two leading Vancouver publications, Den Tandt previews the fall session—finding it will be much like the last—and again emphasizes trade and Quebec, but highlights the critical role Ontarian voters will play in the 2015 election:

NDP Leader Tom Mulcair has as yet shown no inclination to back away from his “Dutch disease” theme, which holds that the high Canadian dollar, driven by booming resource revenue, is harming Canadian manufacturing, to the benefit mainly of Alberta and the detriment mainly of the rest of Canada.

That ensures the critical political battleground this fall, and likely for the next three years until election 2015, will be economic, with the NDP and Conservatives vying primarily for hearts and minds in Ontario, in particular in the industrial heartland of the southwest, where most Ontarians live and where the economy still rests on automobile manufacturing.

The Conservatives and New Democrats will co-operate, to the extent that both will seek to sideline the third-place Liberals. The Grits will seek to capitalize on their leadership race, which concludes next spring, to maintain visibility. To that end, look for a Liberal leadership candidate or candidates to emerge with a platform that is aggressively conservative economically and just as aggressively progressive on social issues. All eyes now are on MPs Justin Trudeau and Marc Garneau, who are expected to run but have not yet publicly announced their intentions.

Canada’s MPs Set to Return, More Polarized than Ever, Mark Kennedy, Calgary Herald, seconds the polarization while suspecting the Conservatives will push hard to deliver on their platform:

Moreover, emboldened by the majority power they secured in the May 2011 election, the Tories are intent on using that clout for the remaining three years of their mandate to press ahead with an agenda that includes billions of dollars in government cuts, diminished federal environmental oversight on private-sector energy projects, and cuts to the public pension system for future generations of seniors. All have sparked controversy.

But Harper is not backing down, even as public opinion polls showing the Tories’ popularity has dropped, leaving them in a tie with the NDP.

“We’re putting our foot on the gas,” the prime minister said in early July, explaining that he was sticking with the same cabinet ministers because he wants them to continue with the Tory agenda this autumn.

“I’ve told officials in Ottawa the majority is not time to rest.’’

“I think that one step at a time, I think we’re moving the country in the right direction,’’ said Harper.

A Rough Guide to the Fall Sitting, Aaron Wherry, Macleans, gives us a concise, tongue-in-cheek run-down. One aspect worth mentioning, some other debates that will be gripping Parliament:

Stephen Woodworth’s motion on the legal definition of a human being is due to be debated this month. Conservative MP Rob Clarke wants to overhaul the Indian Act. Conservative MP Russ Hiebert wants to change the rules for financial disclosure by unions. And Pierre Poilievre has mused of making it possible to opt out of paying union dues.

Fallout From Cuts Follow MPs Back to Parliament, Jennifer Ditchburn, Chronicle Herald. This Halifax-based publication focuses on the local--emphasizing constituent concerns over Conservative budget cuts:

The Conservative caucus meets for the first time Monday since Parliament packed up for the summer, but the catching-up chatter won’t all be about cottages and barbecues.

Many MPs have had to cope all season with the fallout from last spring’s budget cuts, some of which hit local services in areas such as train travel, the coast guard and interior waterways.

The lobbying has been going on hard in some cases to try and mitigate the impact of the decisions on constituents.