British Columbia Premier David Eby speaks to reporters with Alberta Premier Danielle Smith during meetings with Canada's other premiers at the Council of the Federation meetings in Halifax on July 16.Darren Calabrese/The Canadian Press
There is an immutable rule of health care physics in Canada: for every modest proposal of reform there must be an instant and disproportionate burst of fearmongering.
So it goes in British Columbia, where the upstart Conservative Party (unrelated to its federal namesake) released its health care policy, proposing reforms that were modest, bordering on timid. That did not stop the B.C. NDP from asserting that Conservative Leader John Rustad intends to gut the province’s health care system.
“I heard the announcement from John Rustad that if he’s elected premier, the BC Conservatives are elected to government, that he’s going to cut $4-billion from our health care system,” Premier David Eby told reporters during a mid-July press conference. Later, on a provincial radio program, the Premier asserted that, “It was there in black and white.”
None of that is true. The Conservative health care policy does not mention $4-billion in cuts, whether in black, white or any other colour. (In fact, there is no costing – an unforced error that opened the door to the NDP’s misinformation.)
It does, though, cite a report from Deloitte Canada that discusses broad approaches for containing the rise in health care spending over the next decade and a half.
The report is manifestly not a manifesto for taking a meat cleaver to health care budgets. The consultancy outlines a scenario in which the modernization of public health care results in efficiencies that reduce the proportion of gross domestic product spent on health care in 2040 to 11 per cent from a projected 14.9 per cent (and the current 12.4 per cent).
Is that a cut? Not really, since the economy will be growing during that time: 11 per cent of that much bigger 2040 economy would be in, dollar terms, more than the current amount being spent. Even an average growth rate of just 1 per cent would mean the 2040 expenditures were higher – just not as high as if health care budgets were not constrained.
From that, the NDP asserts that the Conservatives are aiming to cut $4-billion in health care spending in their first year in office, a clearly nonsensical argument.
If the New Democrats are concerned that a government is scheming to cut the proportion of GDP spent on health care, they may want to cast a glance at their own budget. The government’s fiscal plan shows a slowing rate of increase in spending, enough that the share of GDP spent on health care drops in the next two years – the very accusation that the NDP have lobbed at the Conservatives.
In an interview, NDP MLA Ravi Parmar noted that his government has already increased health care spending substantially. And he said the government will unveil more health care promises during this fall’s election campaign, and that the budget contingency fund could be used for health care. As well, previous NDP budgets have added new spending on top of similar projections.
Until then, however, the NDP plan is to reduce health care spending as a percentage of GDP – it’s there in black and white, to echo Mr. Eby.
All of this underscores the essential silliness of measuring the performance of a health care system only by the volume of dollars poured into it. One would hope that if technology or other reforms reduced costs without hurting service levels, any political party would welcome the savings. And one would hope that political parties could debate reforms on their merits rather than concocting fears of cuts.
There are Conservative proposals (some of which were earlier articulated by their rivals on the right, BC United) worth discussing, if only as a precursor to larger reform.
The Conservatives, for instance, want to move away from block funding for hospitals to a fee-for-services model. Such a move is promising and could focus hospitals on crimping administration costs, as well as creating an apples-to-apples benchmark for private facilities performing publicly paid procedures.
Similarly, both BC United and the Conservatives are proposing greater use of private facilities to clear out backlogs in the health care system.
The NDP has moved in the opposite direction, buying up private facilities. Which approach will deliver faster care at the lowest cost? That’s a discussion worth having during the provincial election.
But that will require the parties to engage on the merits of their proposals rather than trying to drown out debate with fabricated – and sadly predictable – fearmongering.