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Another look at health care costs

In past months, we’ve heard a lot about how much our health care system costs, and the facts are the facts. Health care costs more per capita in New Brunswick than the national average. The government has set a price tag on this discrepancy: over $200 million could be saved if we could just get our costs down to the average. This is quite the statistic.

There are now two special government task forces examining how we can save money. We agree wholeheartedly with a periodic review of how services are provided to ensure we are getting excellent bang for limited bucks. As doctors, we are constantly told the reasons why wait lists are long, why tests can’t be provided quickly, why services that are badly needed can’t be provided: we don’t have the resources. Making excellent use of those resources is of great importance to us. But we’d also like to provide another side of the coin, so to speak. We also have some statistics which might shed light on why our health care system costs more than the national average by a simple headcount.

Everyone in New Brunswick knows a young person who has left for another province. Our ‘lost generation’ makes us the second-oldest population in Canada. Seniors have longer visits to the doctor, and have them more often. They require five times as many health care resources as younger people. In my town of Bathurst, seniors outnumber children by a 3:2 margin, one of the highest ratios in Canada.

New Brunswickers are among the unhealthiest people in the nation. 60% have at least one chronic disease; 13% of those people are on six or more medications. We have the second highest rate of disability in Canada. We have the third highest rate of diabetes, and the third highest rates of cancer. We are the second heaviest population, with two-thirds of us being overweight or obese.  Only half of us believe we are in very good or excellent health, but only half believe our health depends on how well we take care of ourselves, which is the second lowest rate in Canada.

So ultimately, we are far above the national average in our ages and illnesses. We can’t change our ages. Most of us can’t free ourselves from chronic diseases.  But everyone can understand that why we are “expensive” has less to do with “the national average” and more to do with how healthy we are.

What we aren’t hearing is how well the health system is doing, against the odds. New Brunswick provides some of the highest-quality services in the nation. A recent national report rated us on both cost and value. It found our costs were actually average, but our value for dollar was high. In fact, here’s another ranking: we got one of the highest ‘value-for-money’ scores in the country.

We see 20,000 patients every day. Their needs are hard to change by decree, or by funding cuts, or by ever-closer examination. The previous Minister of Health learned during her 2012 consultation tour that most people in New Brunswick think we can get better health results by eating less and walking more. Frankly, we think they're on to something.

Don’t get us wrong; there is definitely room for improvement. We will be full partners in improving the long-term sustainability of the system. But before we spend too much longer wondering why our health system is more expensive than the per capita “national average”, let’s have another look.

Robert Desjardins, MD FRCPC
President, New Brunswick Medical Society