While our Money Issue was still on the newsstands, the provincial government released its 2010-11 budget on Feb. 9. I won’t rehash the criticisms of the opposition and other pundits – the record deficit, the iffy revenue projections, the off-balance-sheet capital spending – but I would like to draw attention to an elephant in the room that not even the Wildrose Alliance dares take a poke at.
I’m talking about the Blob that is inexorably eating everything around it, health care. As the budget documents note, it now accounts for more than 40% of operational spending. The 17% increase in spending on health this year wipes out any savings from cutbacks in 14 other ministries and then some. Consider this: the budget cuts 800 out of the 27,000 or so civil service jobs. Meanwhile Alberta Health Services alone directly employs more than 85,000. In other words, the health infrastructure is more than three times the size of the government itself. Tail wagging the dog?
Of course everybody wants quality health care – the polls confirm this, hence the political parties don’t want to touch it. And the same phenomenon is taking place everywhere in the developed world; just witness the debate over “Obamacare” in the United States. But as the province that spends the most on it in Canada and sets the benchmark for doctors’ and nurses’ compensation nationwide, Alberta should be taking the lead on a discussion of how to control costs.
It involves some hard questions. For example, an inordinate share of health care spending is consumed by patients in their last year of life. Meanwhile, medical science keeps coming up with expensive new technologies to prolong that a little bit longer. But for governments concerned with the well-being of the whole society is this the best use of limited funds? How do you tell a taxpayer the technology is available to keep their loved one alive, but we can’t afford it? Still, we need to be having this discussion and we aren’t.
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