HEALTH CARE: WHO WILL FIX WHAT'S BROKEN?

When the Ball government announced a cut of 93 positions in the health care system last week, for savings of $7.6 million, budget watchers expressed sympathy for the 56 employees actually let go but, otherwise, waited for the next shoe to drop.

And with good reason. 

Health care consumes 36% of an $8.5 billion operating account — spending on the day-to-day operation of programs and services (source: Budget Update). $1.58B of that sum constitutes deficit — the shortfall between cost and the revenues available to pay for them. The difference is financed by government’s borrowing program.

Health care’s proportionate share of the deficit this year — alone — amounts to $569 million. The sum is in addition to the borrowing done by the health Boards directly (several million) which only shows up on the government’s books in the “Total Debt”. And a full accounting of health care’s cost should include infrastructure — the amount applied to the capital account. Putting those sources of health care deficit together you would discover a shortfall well in excess of $600 million per year. 

But, for the sake of clarity, we'll just stick with just the operating deficit.

It would seem sensible to assume that other sectors of government can’t absorb overspending by health care. So what does this mean for the health care system?

DR. PARFREY'S REFRESHING FRANKNESS

Dr. Pat Parfrey

The number of people who turned out to hear well-known nephrologist (kidney specialist) and rugby coach, Dr. Pat Parfrey, kick off his lecture tour on behalf of a group called “Choosing Wisely NL” (CWNL) was far too small given that he had so many important things to say. 

CWNL, a program conducted by Memorial University's Faculty of Medicine in partnership with the Newfoundland and Labrador Medical Association, has been established to advance "the safe and appropriate use of health care resources," or what Parfey describes as the balance of benefits versus potential harms.

The small group of listeners belied the deepening concern over the financial crisis unfolding in our health care system, and its inescapable linkage with the even larger one facing the province. 

It is not often that the public, or even policy wonks, are treated to a blunt and politically unfettered chat about deep-seated problems and of an organized plan to fix some of them. But that is exactly what the long-practiced and straight-talking physician had on offer. Free of all the junk of professional ass-covering, the doctor’s frankness was refreshing.