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Solving the public health care sustainability puzzle.

Year: 2002
Type: article
Abstract: For the last 15 years, Canadians have faced uncer-tainty regarding the availability of public funds toprovide universal, high-quality health care. In this paper, we point out the essential stability of Canada’s health care spending during the last decade and the need for resources to ensure that an aging population will have access to the increasing range of beneficial health technolo-gies and services it legitimately expects. We lay out princi-ples and options for structural changes necessary to ensure the stability of public health care funding. The media and governments often present health care costs as rapidly escalating. Expressing expenditures in ab-solute numbers of dollars ignores both inflation and changes in the size of the population. Per capita spending ignores the aging of the population and economic growth. Expressing expenditures in terms of the gross domestic product (GDP) captures the relation between health spending and societal resources. In 1992, Canada’s total spending on health care as a per-centage of its economy reached 10 % of the GDP.1 Of these expenditures, 74%, or 7.3 % of GDP, represented govern-ment expenditures.2,3 Responding to concerns about deficits, both federal and provincial governments reined in health spending. Consequently, per capita spending on health care fell between 1992 and 1996,1,2 and did not return to its 1992 level until 1999. Given the economic growth over this pe-riod, Canada now spends only 9.4 % of its GDP on health care, substantially less than in 1992 (Fig. 1). International comparisons reinforce this picture.4 In 1992, only the United States spent more on health, as a proportion of GDP, than Canada did. In 1998, the latest year for which figures are available for international com-
Language: English
Open Access status: green
OpenAlex ID: W1766981701
FWCI: 5.501
Cites: 8
Cited by: 20
Related to: 10