Out-of-province surgery priceless for long-suffering patients; for taxpayers? Tories just can’t put a price on it

Hey there, time traveller!
This article was published 12/06/2023 (866 days ago), so information in it may no longer be current.

Manitoba’s Progressive Conservative government does not want you to know how much it is paying for out-of-province surgeries.

Over the past few weeks, Free Press journalists have tried — unsuccessfully — to find out exactly what those costs have been.

Although few disputed the need to send patients elsewhere — wait lists had grown to crisis proportions — the decision was controversial.

The Tories claimed they were taking heroic actions to address a surgical backlog created by COVID-19. Opposition parties and health-care unions pointed out that even though the pandemic made things worse, Manitoba was experiencing crisis-level wait times for priority procedures before COVID-19 arrived.

History will likely judge the decision on two main metrics: how many people it was able to help; and how much that help ultimately cost taxpayers.

With an election scheduled in early October, the stakes for the Tories could not be higher. Given the hand Manitoba was dealt — or dealt itself — the out-of-province procedures could be viewed by voters as a bold and courageous move, or a massive waste of money by a government desperate to save face going into an election campaign.

When you take all that context into account, perhaps it’s not surprising the PC government is putting so much effort into keeping the exact cost-per-procedure under wraps.

That is not to say that some numbers have not been revealed.

According to the Diagnostic and Surgical Recovery Task Force, Manitoba has spent $24 million on out-of-province surgical procedures for about 480 individual patients, including $440,000 on travel and accommodation. That works out to about $49,000 per procedure, but given that there is an enormous variation in the cost of the operations being purchased out of province, that’s not a reliable way of assessing the program.

Task force officials acknowledged up front that out-of-province surgery was going to be more expensive than doing the surgeries at home in the public health-care system. The scant information being provided seems to prove that out: the task force has spent 18 per cent of its entire budget to help 480 patients, or about 0.01 per cent of the total number of Manitobans waiting for procedures.

On the surface, that is a questionable result. But again, how would we know for sure whether Manitoba got the best deal possible under the circumstances?

To make that determination, you’d have to know a lot more about how much each individual procedure cost, and compare that to the cost in the public system and — perhaps — the cost of contracting out the procedure to a private surgical facility here in Manitoba.

This level of financial transparency is hardly a revolutionary concept.

Whether it’s the budget estimates, scrutiny of the public accounts or investigations by the auditor general of Manitoba, details on how government spends its money is a key element in ensuring accountability. But when attempts are made to get at the exact details of how that money is spent, and government refuses, then a whole different can or worms has been opened up.

This is a particularly awkward situation for the PCs, given the rhetoric that surrounded their return to power.

Back in 2016, premier Brian Pallister promised his government would introduce a principle to spending that would transform the way the government does business: value for money.

It was, on its own, a worthy pledge. Pallister went on at length about how government needed to make sure that whatever amount of money it was spending, it was being spent wisely. To that end, he commissioned a number of value-for-money audits to examine procurement and other spending, both in government proper and, specifically, in the health-care system.

On the face of it, who wouldn’t want value for money? Unfortunately, Pallister’s dream of financial accountability evaporated almost as quickly as it had arrived in the lexicon of Manitoba politics.

First, Pallister refused to release the value-for-money audits. When he finally relented, the public and news media got to see only a fraction of them.

All of which brings us to today, and what appears to be a concerted effort to conceal information about an important and high-profile initiative to ease the backlog for surgeries.

Government spokespeople claimed exact costs “could only be reported retrospectively as we are billed for care provided to each patient. These costs will be summarized within regular financial reporting.”

Translation? Despite having negotiated a price-per-procedure, some surgeries will still cost more than others. And the reference to “regular financial reporting” suggests we may never see specifics or, even, average costs for each type of procedure.

At this point, it bears repeating that a provincial election is on the horizon. Would a cost-per-procedure be made available if an election were not scheduled for this fall? Perhaps, but it’s impossible to tell.

All that we are sure of is that a former premier’s dream of ensuring value for money is now officially dead.

dan.lett@winnipegfreepress.com