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September 28, 2006

Campbell's Health Conversation Launched

"The health budget represents 42 percent of the Province's annual budget. If the health budget continues to grow as it has in the past, it could consume over 70 percent of the total provincial budget by 2017. This could squeeze out necessary funding for other critical government services such as education, highways and social services."
Campbell government news release announcing the "Conversation on Health", Sept 28, 2006

"If pigs had wings they'd fly, unless of course they were like penguins."

The Conversation is not off to a good start on its new website. On a page titled "Health Care by the Numbers" we are told that "$12.83 billion is the amount expected to be spent on health care services across government in 2006/07", but Table A.10 in the First Quarterly Report 2006/07, released a few days earlier by the Minister of Finance, reports that $12.933 billion is what is estimated to be spent on heath across government. The Conversation's numbers page goes on to say that 43% is the percentage of total government spending that goes to health care this year, and that 70% is the potential percentage of total government spending that health care could consume by 2017. According to Table A.10 in the First Quarterly Report 2006/07, total government spending is estimated to be $34.636 billion in 2006/07, since 12.933 divided by 34.636 is 37.34% there appears to be a problem with the government's numbers. As for the 70%, it is kind of like the pig with wings. In reality, growth in government revenue has exceeded growth in health spending.

The "by the Numbers" webpage cites statistics on the number of various procedures that were performed, and a backgrounder to the news release refers to the increase in knee replacements, angioplasties, hip replacements and cataract surgeries. It is impossible to verify the figures from anything on the government's website. The Ministry does not publish data on the number of procedures performed each year on any basis that allows comparison to the government's public relations backgrounder. It could at least provide links to the Canadian Institute for Health Information, the Centre for Disease Control, PubMed or any of numerous sites on the economics of health care.

The government needs to remember that a conversation involves at least a two way flow of information. It is not adequate for the government to listen and then legislate with no feedback on its interpretation of what it heard. A real conversation requires that government put its cards on the table. It says it will legislate definitions of the five principles in the Canada Health Act and introduce a sixth principle of sustainability. The Campbell government must have some idea how it would define those terms today. It should share its current views with the public and then feedback throughout the conversation whether its definitions have changed as a result of what it has heard. Most importantly, the government should say clearly how its definitions will change public policy. Exactly how will people waiting for care be affected by one definition or another? Answering those questions would provide the basis for a real conversation on health care.


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