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OPINION: Canada’s health-care challenges are only just beginning

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OPINION: Canada’s health-care challenges are only just beginning

The emergency exit at St. Michael's Hospital in Toronto is pictured in this Aug. 14, 2016 file photo.

The emergency exit at St. Michael’s Hospital in Toronto is pictured in this Aug. 14, 2016 file photo. Photo by Ernest Doroszuk /Postmedia Network

According to recent estimates by the Canadian Institute of Health Information (CIHI), total health-care spending in Canada eclipsed $300 billion in 2020, with most of the increase (almost 90%) due to pandemic-related funding. The growth rate of total health-care spending is forecast to be much smaller (a little more than 2%) in 2021 than in 2020.

However, while spending growth will slow post-COVID, the overall level of health-care spending will continue to rise and cause more problems for governments across Canada. Indeed, there are at least three significant challenges on the horizon that will add to our health-care bill in coming years.

First, it’s important to understand Canada’s health-care spending in a fiscal context. While budget deficits and debt were already a problem before COVID, red ink has surged for both federal and provincial governments to the tune of hundreds of billions of dollars in 2020 and 2021. Moreover, all provinces expect to run deficits until at least 2024-25 and Ottawa isn’t expected to balance the federal budget until at least 2070 , which means more debt accumulation for the foreseeable future.

Second, the increased health-care spending actually included fewer surgeries in 2020 due to cancellations and hospital closures. According to CIHI estimates, overall surgery numbers fell 22% between March and December ( 413,000 fewer surgeries ) compared to the same period in the previous year. While provinces have attempted to tackle the non-COVID backlog of surgeries, even those that made progress such as British Columbia continue to announce further postponements while Alberta, for example, recently cancelled an additional 15,000 surgeries .

All these cancelled procedures must be made up and paid for once hospitals have the capacity to perform them. So while the temporary direct health-care spending on COVID-19 may subside, additional health-care spending to tackle the cumulative backlog will be needed.

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