Nova Scotia pushing for health funding "equality"

Date: Sept. 22, 2000
Time: 12:07 pm

"As health care costs increase, the poorer provinces are obliged to spend more money per person on health care," said Dr. George Kephart, director of the Population Health Research Unit, which conducted the study. "This in turn diminishes their ability to invest in education, communities, and the environment that we now know are important determinants of health."

The report states that people living in provinces such as Nova Scotia, Manitoba and Saskatchewan need as much as 10-15% more health care services than the average Canadian. In contrast, the average Albertan requires 10-15% fewer health care services. The report also warns that the provinces with the biggest health care needs also tend to be the ones with the biggest fiscal problems and the weakest ability to fund health care services.

Federal equalization payments help to even out differences in the ability of provinces to afford Medicare, but the new study suggests they do not go far enough. The report states that even after equalization payments, poorer provinces still have less to spend on health than "have" provinces such as Alberta, British Columbia and Ontario.

"The most important conclusion to make from this report," added Kephart, "is that provincial inequalities pin the ability to fund their health care systems, and invest in improving the health of their populations is a very serious problem."

Unless steps are taken to distribute federal health care funding according to need, these inequalities will threaten the universality of Medicare in Canada."

Nova Scotia Premier Dr. John Hamm has repeatedly asked the federal government to give more equalization payment money to poorer provinces, most recently in a Sept. 5 letter to Prime Minister Jean Chrétien.

"If Canadians are to enjoy a national, long-term public health care system, regardless of where they live, then Ottawa must agree to work with the provinces and territories on funding agreements that respect regional differences," said Hamm. "An agreement solely based on per-capital funding, without a significant commitment to strengthen equalization, will lead to a medicare system based on where someone lives, not on the health care someone needs."

— Steven Wharry, eCMAJ

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