The Higgs’ government will issue its first budget next week. The premier has made it clear that balancing the province’s finances is one of his top priorities. While certainly a worthwhile goal, it concerns the physicians of New Brunswick that Finance Minister Ernie Steeves has said balancing the budget will likely require cuts to the province’s biggest departments, including health.
New Brunswick already spends much less on health as a percentage of overall spending than other provinces (Canadian Institute for Health Information, 2016). And what do we have to show for it?
Here are the facts: 61 per cent of New Brunswickers are battling at least one chronic health condition (New Brunswick Health Council, 2017), 70 per cent of adults in New Brunswick are either overweight or obese (Statistics Canada, 2017), and at 20.8 per cent, New Brunswick has the largest proportion of seniors in the country, far more than the Canadian average of 17.2 per cent (Statistics Canada, 2018).
The challenge is real — the health of our population is in a precarious state.
New Brunswick’s health-care system has numerous gaps and systemic challenges that prevent us from improving our population’s health. A poll conducted on behalf of the New Brunswick Medical Society (NBMS) last year showed that more than 44,000 New Brunswickers do not have a family physician. Many of those who do have family physicians experience lengthy wait times before they can see them. We also have a shortage of specialists, leading to more delays for patients. And as we all know, waiting is a familiar theme in our province’s emergency rooms.
In addition, many of our hospitals are chronically overcrowded, and we have seen nursing shortages shut down entire hospital departments.
These are critical health-care delivery challenges that we cannot address through budget cuts.
Past governments have defended health-care cuts by arguing that spending per capita on health care in New Brunswick was “above the national average.” However, this thinking ignores the reality that New Brunswick has an older population, one that is aging faster than other provinces. Seniors require much more health care than younger people. Simply put, “older” provinces must spend more than “younger” provinces to get the same result.
We are not spending less because our system is efficient, we are spending less on the backs of our province’s ill and most vulnerable.
The Higgs government has committed to “making public health care accessible and dependable.”
We cannot achieve this by cutting health-care spending. Instead of trying to cut from the health budget, government would be wise to examine the results we are getting with the dollars already being spent on health care.
Are we getting the return on investment that we need — healthier New Brunswickers — based on what is currently being spent? The trends that physicians are seeing in this province would suggest that is not the case.
Government needs to take a hard look at what is working in our current system and what is not — where are we succeeding and where are we failing? And how might we reallocate existing resources to yield better results?
We must find efficiencies and invest smartly so that we may have healthier future generations. Our health system needs to be more proactive, with an aim to prevent disease and sickness, instead of just reacting to it as we have done for generations.
We cannot continue to accept the current state of our health-care system or its impact on the health of New Brunswickers.
We need more physicians and nurses to address current shortfalls, but we also need to look at investing in technology so that health-care practitioners can care for patients remotely, keeping more New Brunswickers at home and eliminating travel costs and ambulance transfers.
By innovating, collaborating, reducing silos and by finding efficiencies, we can improve the health of our population.
Dr. Serge Melanson is president of the New Brunswick Medical Society and an emergency room physician in Moncton.