Ahhh one of my favorite topics…Canadian healthcare spending. I always consider Alberta to be a bit of the `canary in the coalmine`when it comes to healthcare (and conversely healthcare IT) spending. It looks like Alberta is not only protecting healthcare spending, they are increasing it.
Call me cynical, but it may have something to do with demographics and voting patterns. What is of concern to me is that almost every other ministry has to take a haircut so that healthcare spending can increase. Although I do not live in Alberta, what they do is likely to be repeated in other jurisdictions. As a parent with young kids, it concerns me greatly that other services such as education are getting hit badly. Call me Darwinian, but at what point does it make sense for Canada to start to invest more in future taxpayers.
I`m really beginning to pray that investing in healthcare IT starts to pay off, so that the beast known as healthcare spending can be brought under control.
I just finished reading a good article on the future direction of healthcare services funding in Alberta.
Unlike most of my other posts, this has little to do directly with eHealth. Healthcare spending policy is an important issue that will have an enormous impact down to road for all things eHealth. Health Minister Liepert made some interesting comments at the Alberta Association of Municipal Districts and Counties on Thursday. Looks like Alberta is on the fence about privatizating more of their system. According to the article, Albertans want to make sure health care spending levels are protected and the govt seems to be considering ways to do this. Nothing is set in stone, but the Alberta govt seems to be floating some trial ballon ideas to gauge the public response.
Healthcare spending is consuming a greater percentage of all govt spending every year and it has been outstripping inflation for a long time now. At what point do provinces have to start privatizing more of the system? Assuming Alberta privatizes more, I think all the other provinces will follow their lead….what other choice to do they have if the public demands healthcare service levels and spending remains high?
Everything old is new again…unfortunately. Provincial budgets across Canada are starting to be squeezed, here in BC healthcare services spending cuts are coming down the pipe. It also appears to be the case in “rich” Alberta. According to this article:
“Alberta health-care workers will be offered voluntary early retirement as part of a plan to attack a $1.3-billion budget deficit, Alberta Health Services (AHS) president Stephen Duckett announced yesterday. That’s a key part of a two-phase plan that will see $965 million trimmed from the $10.9-billion AHS budget while still improving health care..”
Whether you live in BC, Alberta or parts North or East, healthcare funding for services is feeling a tight squeeze from the economic downturn. What is going to be the impact on healthcare IT spending. Traditionally Health IT spending is less than 2% of operating budgets in acute care, and its seen as a cost item and not an investment. How bad will it get for healthcare IT?
To address some of these challenges, I expect to see jurisdictional/structural change such as an acceleration of the current trend of centralization of service delivery responsibility…or in English…RHA/LHIN amalgamation, and bulk buying. At some point the politicians are going to have to start talking with the CDN public about how much they really want to spend on healthcare, 60%, 80% or 100% of the provincial budget? To date this has not happened, largely because it is seen as political suicide to open this conversation with the public. Considering the current healthcare spending increases, we are going to have this “crisis” conversation within a year or two.
Do I sound like Chicken Little? What does everyone else think?
It appears the media coverage of the eHealth Ontario scandal has peaked…for now. There will no doubt be some serious short term changes (Alan Hudson stays or goes, the eHealth strategy is amended, etc) coming down the pipe. My concern is the spillover effects of the scandal on the larger eHealth agenda throughout Canada. I now live in BC and I’m starting to see stories trying to link prominent eHealth people to the the scandal in Ontario. Some of the worst case scenarios that keep running through my head include:
- The politicians and public lose interest in eHealth, and they develop a tin ear to the benefits of investing;
- Funding starts getting cut of to various national and other provincial eHealth agencies;
- The majority of the senior experienced eHealth leaders get sick of it all and either jump or are pushed out of the industry. Some may see this as a good thing, but we’d lose a huge amount of domain expertise just when we need it most;
- The brightest new entrants into the market see limited opportunity in the market and instead go to work in some other industry;
- etc, etc
I’m sure that Mike will read this post and say “step away from the edge of the cliff Mark and be rational”. I hope he is right and that it is just a case of me making tinfoil hats. I really do try and see the forest for the trees on this stuff, and realize that I may have blatent self-interest (ie my current career path) in seeing the eHealth agenda moved forward. Irregardless of my own self-interest, I keep seeing the crisis in healthcare spending coming to fruition in the near future. We cannot continue to see healthcare spending increase at the current rates, otherwise we will have to raise taxes significantly and triage services. Try and explain to the baby boomers that “sorry we simply can’t help you right now”, and see how they react.
As I have always stated, eHealth is NOT the silver bullet that will solve this problem, but it sure can help improve the overall efficiency of the system. Adding additional paper-based doctors and nurses to the system is an arithmetic solution to a logarithmic problem.