Winnipeg Free Press - PRINT EDITION

Managing health demands

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Health spending in Canada, including the budgets of provincial governments, is expected to grow at a slower rate this year and next, the Canadian Institute of Health Information says. That is true in Manitoba as well, where the budget for health eats more than 44 per cent of the total provincial revenues and has far outstripped inflationary growth since 2000. Hard times make for hard decisions, and Manitobans have just begun to feel the impact of its government reining in the decade-long spending spree.

Health Minister Theresa Oswald says her government is intent on delivering health care in a smarter, more efficient way to keep the cost of the system in check. That is wishful thinking or a politically spun message to explain why less money is being sunk into her budget.

Provinces continually look for efficiency in their health systems, but sharing best practices and adopting newer technology have not had the effects health ministers continually trumpet. Newer technologies have helped spur spending because they also fuel demand.

Ms. Oswald's budget last year spent less than estimated for the first time in a decade, not because of efficiencies, but because some spending was delayed as deficits ratcheted up here, as they did across Canada. Still, Manitoba's rate of increase in health spending far outstripped inflation.

At the same time, however, queues for some services lengthened, even with hundreds of millions more poured into cutting wait times. The only good measure of wait times is for a small clutch of services that were targeted in 2004, in a federal-provincial funding agreement. CIHI's own tracking of four of the five services indicated gains made early on have slipped, and in Manitoba, fewer people are getting hip and knee surgery within the recommended maximum wait time of six months.

CIHI notes that solutions to stem rising health budgets include the use of primary-care centres that employ different health practitioners, including nurse practitioners who can take the load off physicians. Manitoba has started to open some such clinics. But now that the huge federal transfers for cutting queues are all spent, managing wait times will turn to managing expectations.

Editorials are the consensus view of the Winnipeg Free Press’ editorial board, comprising Catherine Mitchell, David O’Brien, Shannon Sampert, and Paul Samyn.

Republished from the Winnipeg Free Press print edition November 1, 2012 A12

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