What can we afford? Economists host forum to dissect health-care costs

It doesn't take a doctor, nurse or economist to see there are major problems with the health-care system in Newfoundland and Labrador.

The province spends around $3 billion a year, or close to 40 per cent of its entire budget, on health care — making it the country's biggest spender.

"There is a problem, and everybody needs to kind of face up to it now," said Lynn Gambin, a professor in the economics department at Memorial University who moderated a forum Wednesday asking, "What can we afford?" 

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Organized by the department along with the Collaborative Applied Research in Economics initiative, the goal was to create a dialogue, not only in the room, but across the province.

"While it's really uncomfortable to talk about people's health and put dollar-and-cents amounts to it, sometimes you have to," Gambin said.

"We only have a certain budget and we only have a certain amount of money in the pot."

It's a pot of money that has grown at an alarming rate since the turn of the millennium. In 2001 the province spent around $1.3 billion on health care. Last year, it spent $3 billion, an increase of 130 per cent in 16 years. 

"The biggest single item, quite frankly, is salaries," Health Minister John Haggie said.

"Over the last 10 years we've had very little increase in hours worked. I think it's like three, maybe three-and-a-half per cent, but over that 10-year period we've seen a 30-plus per cent increase in the cost of those hours."

The demand for services, meanwhile, keeps growing.

"Mental health has been the Cinderella of health care for too long," said Haggie.

"Addictions is the poor cousin of Cinderella. It's just not really had any kind of attention it needed."

The minister hinted that more attention could be coming with an announcement about the Waterford Hospital, an aging psychiatric-care facility in St. John's.

Haggie described a "community-based, person-centred and distributed approach," but refused to elaborate on what is being proposed.

"We have extensive discussions with mental-health professionals, including psychiatrists, they are all on board. So that proposal will be going forward to cabinet over the next couple of weeks. Once it's passed that level of approval then we will be in a position to have something."  

Using technology

The forum wasn't about pointing fingers or placing blame but trying to figure out how to create a system that services patients properly without breaking the bank.

An example offered by Haggie is using technology to overcome geography.

Currently the province offers more than 800 patients in rural areas tablets to track diseases like diabetes with the information being sent to a health-care provider. Technology is also used to connect remote patients with therapy assistants. 

"That allows a patient who's referred to establish a therapeutic relationship by whatever electronic means they prefer. You can do it by phone, by Skype or by email, or a mix of all three," Haggie said.

"That's been validated in other jurisdictions, and we're the first area in Canada to use it."

The economists who put off the event will take the information gathered and use it to create more questions. 

"We do have a problem and we want people to start understanding and get a debate going, an open, honest conversation about it at all levels," Gambin said.

The problems can be solved, said Haggie.

"It's not a black hole into which everything will fall. You have to acknowledge with a problem that you can actually wrestle it to the ground and manage it, and we can," he said.

"We've done it in certain areas, and I think a certain air of optimism is out there other than doom and gloom."