Manitoba Must Confront its $91 Billion Healthcare Glacier

December 11, 2014 – Manitobans carry a $91 billion fiscal burden – the higher tax bill for increased healthcare costs over the next half-century – and should prepare now for the coming demographic squeeze, says a report released today from the C.D. Howe Institute. In “Managing Healthcare for an Aging Population: How Manitoba Can Confront Its Healthcare Glacier,” authors William B.P. Robson, Colin Busby and Aaron Jacobs recommend changes to protect young Manitobans from the burden they will otherwise bear as the tax base grows more slowly and healthcare costs rise.

The report rejects higher federal transfers as a solution, noting that boosts in federal funding have discouraged reforms that would have made Manitoba’s healthcare more sustainable in the past, and that transferring resources to Manitoba from other provinces is neither economically nor politically attractive. Instead, it recommends prefunding some services that an older population will require, and benchmarking others against best practices among Canadian provinces.

“Manitoba spends less per capita than most provinces on drugs, likely a direct consequence of focusing public drug coverage based on income,” notes Busby. “But by contrast, Manitoba spends more on ‘other health spending,’ which includes health research, home care, training and other assortments of funding and services. More rigour in evaluating these differences will help Manitobans get more bang per healthcare buck.

As for spending more effectively on an older population, the study recommends that Manitoba should:

• Reduce the ambiguity of current public-private responsibilities for financing long-term care to bolster private savings, and better target public long-term care subsidies to those without the means to pay for it;
• Incorporate coordinated team-based primary care models where patients can get comprehensive non-acute services from an organized group of practitioners such as doctors, nurses, dieticians and physiotherapists, which operate as a unit;
• Implement scope-of-practice changes that would allow less expensive medical providers such as pharmacists and nurse practitioners to deliver services that are currently, and unnecessarily, performed by more expensive physicians;
• Develop better follow-up care for patients discharged from hospital; and
• Allow for improvements in, and more use of, non-institutional care for seniors with chronic conditions.

The authors conclude that selective prefunding and benchmarking against other provinces’ best practices can help Manitoba deliver high-quality healthcare in a sustainable fiscal framework for years to come.

For the report go to: http://www.cdhowe.org/managing-the-cost-of-healthcare-for-an-aging-population-how-manitoba-can-confront-its-healthcare-glacier/28222

For more information contact: William B.P. Robson, President and CEO, C.D. Howe Institute; Colin Busby, Senior Policy Analyst, C.D. Howe Institute, at 416-865-1904; E-mail: amcbrien@cdhowe.org.

NT3