{"id":79247,"date":"2019-12-27T08:00:57","date_gmt":"2019-12-27T13:00:57","guid":{"rendered":"https:\/\/huntsville.dopperonline.ca\/?p=79247"},"modified":"2019-12-27T08:00:57","modified_gmt":"2019-12-27T13:00:57","slug":"the-big-challenges-series-escalating-health-care-costs","status":"publish","type":"post","link":"https:\/\/doppleronline.ca\/huntsville\/the-big-challenges-series-escalating-health-care-costs\/","title":{"rendered":"The Big Challenges series: Escalating health-care costs"},"content":{"rendered":"<p>&nbsp;<\/p>\n<p><em>By Ross Maund and Dave Wilkin   <\/em><\/p>\n<p>This is the first article in our series on the Big Challenges facing Canadians in the decades ahead. We begin with some key growing social issues, and in this article we focus on the challenge of escalating cost of health care. This topic is extremely important to all Muskoka residents, especially given the open questions surrounding the future of our local hospital redevelopment and the implications that arise from it.<\/p>\n<div style=\"float: left; margin-right: 14px;\"><strong><broadstreet-zone zone-id=\"45658\" keywords=\"\" soft-keywords=\"true\" zone-alias=\"\"><\/broadstreet-zone><\/strong><\/div>\n<p>Global health-care costs are increasing at <span style=\"text-decoration: underline;\"><a href=\"https:\/\/www2.deloitte.com\/global\/en\/pages\/life-sciences-and-healthcare\/articles\/global-health-care-sector-outlook.html\" target=\"_blank\" rel=\"noopener noreferrer\">over 5.4  per cent annually<\/a><\/span>, more than double general inflation or GDP growth. It has pushed health-care spending to become the single largest budget item in all Canadian provinces, consuming about <span style=\"text-decoration: underline;\"><a href=\"https:\/\/www.fraserinstitute.org\/sites\/default\/files\/sustainability-of-health-care-spending-in-canada.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">41 per cent of all provincial program spending<\/a><\/span> on average. In Ontario, hospitals gobble up <span style=\"text-decoration: underline;\"><a href=\"https:\/\/www.fao-on.org\/en\/Blog\/Publications\/health-update-2019#:~:targetText=Health%20spending%20is%2041%20per,cent%20of%20total%20program%20spending.\" target=\"_blank\" rel=\"noopener noreferrer\">36 per cent of the massive $60B health care budget<\/a><\/span>. This challenge is what precipitated provincial premiers\u2019 recent call for Ottawa to boost provincial health care transfer payments (<span style=\"text-decoration: underline;\"><a href=\"https:\/\/www.fin.gc.ca\/fedprov\/mtp-eng.asp\" target=\"_blank\" rel=\"noopener noreferrer\">covering 1\/4 of health care spending in Ontario<\/a><\/span>) from 3 per cent to 5.2 per cent annual growth.<\/p>\n<p>The principal drivers of the rising health-care costs are well understood, and they are most prominent in developed countries:<\/p>\n<ul>\n<li>Demographics \u2013 aging (increase in human longevity) and the high level of chronic disease associated with this segment of the population<\/li>\n<li>Unhealthy lifestyles and diets<\/li>\n<li>Growing societal stresses, mental illness and addiction<\/li>\n<li>Increasing expectation by the public for costly new drugs and advanced clinical treatments<\/li>\n<\/ul>\n<p>This situation becomes more urgent as governments face slowing economic growth, a growing list of spending priorities and rising debt levels. <span style=\"text-decoration: underline;\"><a href=\"https:\/\/www.macleans.ca\/economy\/the-most-important-canadian-economic-charts-to-watch-in-2020\/#:~:targetText=Canada's%20GDP%20per%20capita%20is,the%20output%20of%20the%20economy.\" target=\"_blank\" rel=\"noopener noreferrer\">Canadian economic growth is stalling<\/a><\/span> with real GDP per capita growth recently turning negative (Ontario just above zero).<\/p>\n<p>Clearly, the current path is not sustainable, and solutions must be found. There is no silver bullet to easily solve this cost dynamic. These key elements are emerging as important parts of most governmental strategies and investment priorities:<\/p>\n<ol>\n<li>Population wellness and prevention\/reduction of escalating chronic disease.<\/li>\n<li>Early diagnosis and intervention (particularly mental health and addiction) that supports keeping people out of inpatient care.<\/li>\n<li>Expanded capacity of senior living infrastructure and in doing so vacating high cost ALC beds in acute care hospitals.<\/li>\n<li>Improved operating efficiencies and effectiveness through new technology<\/li>\n<li>Streamlined overheads, administration structures, processes (e.g. capital planning).<\/li>\n<li>Purchasing standardization and aggregation.<\/li>\n<li>Extend lifetime of existing infrastructure &#8211; increased emphasis on regular maintenance\/upkeep<\/li>\n<li>Align user expectations to limitations.<\/li>\n<\/ol>\n<p>It is clear that we are at the beginning of major transformational change in health care. Investment in these (and more) priorities should slow accelerating health-care demand and cost escalations. Given governments\u2019 growing fiscal challenges, investment in these priorities is critical, or significant reductions elsewhere is inevitable.<\/p>\n<div style=\"float: left; margin-right: 14px;\"><strong><broadstreet-zone zone-id=\"45658\" keywords=\"\" soft-keywords=\"true\" zone-alias=\"\"><\/broadstreet-zone><\/strong><\/div>\n<p>So how does this impact us locally? <span style=\"text-decoration: underline;\"><a href=\"https:\/\/www.mahc.ca\/en\/about-mahc\/stage-1-proposal.aspx\" target=\"_blank\" rel=\"noopener noreferrer\">Muskoka Algonquin Health Care&#8217;s (MAHC) recently submitted hospital redevelopment plan<\/a><\/span> to the Ministry of Health more than doubles the existing hospitals\u2019 footprints, expands bed count by 64 per cent, and pushes up un-escalated operational costs by 40 per cent. This, despite a forecasted <span style=\"text-decoration: underline;\"><a href=\"https:\/\/www.fin.gov.on.ca\/en\/economy\/demographics\/projections\/#:~:targetText=Under%20all%20three%20scenarios%2C%20Ontario's,million%20on%20July%201%2C%202046.\" target=\"_blank\" rel=\"noopener noreferrer\">ten per cent population growth and a senior population share increase of eight per cent<\/a><\/span> during the same 14-year period. Adding new MRI and stroke rehabilitation services\/beds is very positive, but the overall scale of the increases seems out-of-line.<\/p>\n<p>MAHC\u2019s submission also lowered the local share cost from $148M (recommended by their consultant) to $94M, a $54M reduction. This reduction was achieved through a $19M Furniture Fixtures and Equipment &amp; Information Technology (FFE&amp;IT) reduction, plus the reuse of almost all existing FFE&amp;IT assets, valued at $35M. This seemingly overlooks the existing $9M FFE&amp;IT deficit and is un-aligned with priority #4 above \u2013 Investing more capital in technology and equipment supporting new services and capabilities and less in large new buildings is a better use of scarce health care funds.<\/p>\n<p>This cost estimate is well out-of-line compared to other hospital infrastructure projects.  In addition, all amounts are stated in 2019 dollars and so they exclude significant cost escalations expected in the future.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-79258\" src=\"https:\/\/media-doppleronline-ca.s3-accelerate.amazonaws.com\/2019\/12\/MAHC-hospital-comparison.png\" alt=\"\" width=\"801\" height=\"297\" srcset=\"https:\/\/media-doppleronline-ca.s3-accelerate.amazonaws.com\/2019\/12\/MAHC-hospital-comparison-300x111.png 300w, https:\/\/media-doppleronline-ca.s3-accelerate.amazonaws.com\/2019\/12\/MAHC-hospital-comparison-750x278.png 750w, https:\/\/media-doppleronline-ca.s3-accelerate.amazonaws.com\/2019\/12\/MAHC-hospital-comparison.png 801w\" sizes=\"auto, (max-width: 801px) 100vw, 801px\" \/><\/p>\n<p>Our conclusion <span style=\"text-decoration: underline;\"><a href=\"https:\/\/doppleronline.ca\/huntsville\/we-believe-mahcs-plan-for-two-new-hospitals-will-be-rejected-by-the-province\/\" target=\"_blank\" rel=\"noopener noreferrer\">remains as stated previously<\/a><\/span>: MAHC\u2019s plan runs counter to the above government priorities and is well out-of-line with what other communities actually receive. Our Municipal and District governments should not wait for the province to reject it, which could take years.  Instead, they should demonstrate leadership by sending a clear message to MAHC that it is mistaken \u2013 in fact \u2018Municipal support is NOT growing\u2019.<\/p>\n<p>Watch for our next article, which lays out our suggestions for a better pathway forward!<\/p>\n<p>Read related article: <span style=\"text-decoration: underline;\"><a href=\"https:\/\/doppleronline.ca\/huntsville\/canadas-challenges-are-jeopardizing-our-future-commentary\/\" target=\"_blank\" rel=\"noopener noreferrer\"><em>Canada&#8217;s challenges are jeopardizing our future<\/em><\/a><\/span><\/p>\n<p><em>Ross Maund, career senior executive<\/em><br \/>\n<em>Dave Wilkin, P. Eng, M.Eng.<br \/>\nBoth are Huntsville residents, and former MAHC board directors<\/em><\/p>\n<h5 style=\"text-align: center;\">Don\u2019t miss out on Doppler!<\/h5>\n<p style=\"text-align: center;\"><strong>Sign up <a href=\"https:\/\/doppleronline.ca\/huntsville\/dont-miss-out-on-doppler\/\"><u>here<\/u><\/a> to receive our email digest with links to our most recent stories.<br \/>\nLocal news in your inbox three times per week!<\/strong><\/p>\n<p style=\"text-align: center;\"><broadstreet-zone zone-id=\"45657\" keywords=\"\" soft-keywords=\"true\" zone-alias=\"\"><\/broadstreet-zone>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>By Ross Maund and Dave Wilkin This is the first article in our series on the Big Challenges facing Canadians in the decades ahead. We begin with some key [&#8230;]<\/p>\n","protected":false},"author":13,"featured_media":7977,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[5],"tags":[26,2003,1923],"class_list":["post-79247","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-commentary","tag-breaking","tag-dave-wilkin","tag-ross-maund"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v25.8 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>The Big Challenges series: Escalating health-care costs - Huntsville Doppler<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/doppleronline.ca\/huntsville\/the-big-challenges-series-escalating-health-care-costs\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"The Big Challenges series: Escalating health-care costs - Huntsville Doppler\" \/>\n<meta property=\"og:description\" content=\"By Ross Maund and Dave Wilkin This is the first article in our series on the Big Challenges facing Canadians in the decades ahead. 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