The amount of money that Canada spends on doctors is expected to grow more quickly this year than spending on hospitals or drugs, according to a new report that predicts the public and private sectors will shell out more than $264.4-billion on health care in 2019.
The Canadian Institute for Health Information (CIHI) said spending on physicians will rise by 4.4 per cent this year – faster than the annual growth forecast for hospitals (3 per cent) or drugs (2.7 per cent.)
The reason? Canada has more doctors per capita than ever before, with the growth rate in the number of physicians more than doubling that of the population over the past five years, according to CIHI, the country’s official health-care statistics agency.
“We’re graduating physicians at a faster rate,” said Michael Hunt, CIHI’s director of spending, primary care and strategic initiatives. “Thus we have more physicians to provide services [and] larger demands for those services.”
The figures for spending on physicians were part of CIHI’s annual report on national health-care expenditures, which takes a big-picture look at how much governments, private insurers and patients are spending to keep people healthy and care for the ill.
The report, released on Thursday, found that hospitals still gobble up a larger share of overall health spending – 26.6 per cent – than any other part of the health-care system.
Hospital expenditures are expected to top $70.3-billion in 2019, up from about $68.3-billion last year.
Drugs and doctors are in a dead heat for second place, with drugs accounting for 15.3 per cent of health spending and physicians accounting for 15.1 per cent in 2019.
CIHI predicts that total spending on medications – a category that includes both prescription and over-the-counter drugs – will be $40.3-billion this year, while physician expenditures will top $39.8-billion.
Canada may be graduating and recruiting more physicians than in years past and spending more on their services, but that does not mean every Canadian who needs a family doctor has one.
About 15 per cent of Canadians, or roughly 4.7 million people, do not have a regular health-care provider, according to Statistics Canada. Waiting lists for family doctors are endemic in some parts of the country. In Nova Scotia, for example, more than 51,000 people – or 5.5 per cent of the population – were looking for a family doctor as of the beginning of October.
Ivy Bourgeault, executive director of the Canadian Health Workforce Network and a professor at the University of Ottawa, said it is “misleading at best and evil at worst” to focus on the crude ratio of doctors to population.
“People use it in ways that are very misleading [and] that are inappropriate. It leaves people in the lurch,” she said, stressing that Canada needs to do a much better job of tracking its entire health-care work force, not just physicians.
Sandy Buchman, the president of the Canadian Medical Association, which represents doctors across the country, said that despite the recent increases, Canada still lags many of its peer countries when it comes to physicians per capita.
What’s worse, he said, is that Canada has “no national health human-resources planning strategy.”
Scattered efforts to lure physicians to under-served regions and unpopular medical specialties haven’t borne much fruit, said Dr. Buchman, a Toronto palliative-care physician.
“We have probably … four or five times the number of pediatricians graduating as geriatricians,” he said. “What does that say about meeting community needs?”
The CIHI report found that although Canada’s population is getting older – those 65 and older accounted for 16.8 per cent of the population in 2017, up from 13.4 per cent a decade earlier – population aging accounted for only 0.8 per cent of the annual increase in health-care costs.
“It would appear that our seniors are aging healthier,” Mr. Hunt of CIHI said.
It could also be that the health-care needs of some seniors are not being met.
Ontario’s fiscal watchdog released a separate report on Thursday showing that nearly 35,000 people, most of them seniors, are waiting for a bed in long-term care, up 78 per cent from 2011-2012.
“Expenditures [data] have their limits,” Mr. Hunt said. “Is there a bigger need? You don’t really capture that in expenditure data.”
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HEALTH REPORTER – Globe and Mail
PUBLISHED October 31,2019