Health care ‘voodoo’ economics

Would somebody please explain the New Brunswick (and while you are at it the Canadian) health care system to me? Specifically, the economics of it. I have an MBA and graduate level education in economics but I can’t figure it out.

Over the past eight years or so, the New Brunswick government has put billions more into the health care budget -this despite the fact that the population has actually declined slightly. The health care sector is the fastest growing in New Brunswick – adding thousands of more workers in that eight year period. The total health care budget today is $1.926 billion. That means the government spends about $8,600 per family for health care in New Brunswick. Now, you then need to pile on private costs of health care which in my case adds another $2,000+ per year. So, on average, it costs over $10,000 per year to provide health care for my family – or about the amount of a good HMO in the U.S.

The health budget was $1.319 billion in 1999 – roughly a $610 million increase per year – or about $2,800 per New Brunswick family.

Keep in mind there has been a slight decrease in population during that same eight year period.

Now with all that background, my wife goes to the doctor and the doc orders a routine test. We get a letter in the mail confirming the appointment in June. My wife calls them to say we will be on vacation in June, can we reschedule for July or August. She is told that the notice said June 2008 so she would not have to reschedule.

June 2008 for a routine test. A test she could get in Brazil (her home country) for $80 and in 2-3 days.

$600 million more spending. Same population base. Thousands more health care workers.

And the wait times for routine tests are up by 2-3 times what they were eight years ago.

Somebody explain this economics to me, please.

This is not just another person complaining about health care (well, actually, yes it is). There are a few serious considerations here.

The first is near and dear to my heart. Former Premier Lord bragged at great length about his ‘investments’ in health care. 80% of all new money, he said. $2 billion more since 1999, he said.

And what did he get for it?

Longer wait times, thank you very much.

Divert money out of economic development and strategic infrastructure into health care and get worse outcomes.

Makes sense to me.

Secondly, can we really expect people to move here (you know, the whole self sufficiency thing) when they have to wait 14 months for a routine exam?

This is a serious issue.

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0 Responses to Health care ‘voodoo’ economics

  1. Broadcastnb says:

    It’s very serious, but it depends what is the test. Some tests are organized very quickly, others not. Keep in mind you are dealing with a bureaucracy, so the louder you squeak about it the quicker reaction you’ll get.

    However, I seem to remember the government had a website that tracked waits, but they seem to have quietly taken it down. Keep in mind that the federal government is putting its priorities into wait times, which means funding goes into programs meant to reduce them.

    However, again, depending on the tests, it highly depends where you are because health care is diverted into regions. Moncton is growing extremely fast, and one important statistic you dont mention is that the population is aging. That’s when most people milk the health care system the most.

    Put all that together, and, well, yes, you’ve definitely got a huge issue, but one that shouldn’t always be personalized. There is no doubt that that is an unacceptable wait and that should be challenged What other regions offer it? Why is the wait so long? What are the hours of the office doing the tests? If that test takes one hour to do, and the office is open typical hours, then even treating one person an hour results in 2000 people being in front of her.

    That seems a little odd, for one thing, its improbable that the system is that inefficient.

    But as more than one commentator has mentioned, the entire system is DESIGNED to be inefficient so that people like you and others who use it only occasionally-and have money to use it elsewhere, will demand that it be privatized.

  2. Anonymous says:

    From Wikipedia:
    Investment or investing[1] is a term with several closely-related meanings in business management, finance and economics, related to saving or deferring consumption. An asset is usually purchased, or equivalently a deposit is made in a bank, in hopes of getting a future return or interest from it.

    Since the phrase ‘investment in health care’ is readily used, one would think of:
    – investing in scheduling software to optimize equipment and staff
    – investing in training to maximize capacity
    – investing in equipment that reduces costs and improves efficiency
    – investing in preventative health care measures and educating the general public about personal health
    – investing in electronic filing and data exchange to reduce labour and storage needs and improve access to information
    -etc

    Generally, none of these things are the focus of the ‘investments’. The focus is to do more of the same which we know is ineffective and not affordable. If anything different is suggested, the government(s) buckle to public political pressure.

    Investing in health care in NB really means:
    – using health care as a political tool and responding to political pressure
    – encouraging bad habits by dumping more money into inadequate, inefficient systems
    – avoiding the reality that we cannot afford to keep doing the things we are doing

    To truly invest, we must be open to new ideas and changing what we are doing. This means we must be open to changing our expectations. This means reducing duplication and redundancy in the interest of providing premier health care. The government is not investing in health care because of the political capital it would cost them;we need to change our attitudes and allow investments.

  3. David Campbell says:

    I am not demanding privatization. I am saying that we need to find a way to have a health care system that doesn’t require a 13 month wait for a routine exam. It is routine but if they found something, I suspect my wife wouldn’t be a happy camper. I do think some form of co-pay for those who can afford it should be considered if it leads to a better health care system. But the evidence of the last eight years or so is clear, more money does not equate to a better system. It’s actually a bit ironic. When we were coming through that recession in the 1990s, there was all that belt tightening but I don’t recall that the wait times were as bad then as now after flushing in all that cash.