December 10, 2001

A Little Perspective on $129.4 million in Cost Shifting

The Minister of Health is trying to downplay the size of his latest round of cost shifting - that's shifting from government and onto sick people. His own news release estimates the cost of the shifts at $129.4 million (and that is per year, each and every year forever). He has tried to say that private insurance will pick up some of the costs but picking up those costs would bankrupt private insurers unless they increased their premiums by the same amount (plus up to 25% more in order to cover administration).

The most recent Medical Services Plan Fee for Service Payment Statistics available on the government website are those for fiscal year 1999-2000. Page 15 of that report provides the following numbers:

Specialty	Practitioners	Services	Total Paid
Chiropractic	720	2,752,211	$29,706,624
Naturopathy	128	147,711	$1,430,944
Physical Therapy	1,222	2,626,524	$28,891,067
Podiatry	91	508,983	$9,781,986
Optometry	360	917,352	$37,676,930
Massage Therapy	1,299	2,191,211	$14,487,232
Dental (msp paid)	272	54,826	$5,893,820
All MDs	7,545	57,359,204	$1,592,081,461
Total: All Fee for Service	11,638	66,564,057	$1,720,132,047

For chiropractors alone, there were almost 3 million services provided and paid for by MSP in 1998-99. Of course, some folks visited more than once, but at 10 visits per person those numbers mean 300,000 people just lost out in the cost shift. A similar number or more lost out because of the shift on physiotherapy services.

In total there are 3,820 health care providers and hundreds of thousands of their patients who will feel the consequences of the shift in health costs. Those folks might want to phone their MLA's office, ask for an appointment and discuss their feelings. A list of MLA's and their office numbers can be found by clicking here. (new window)

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December 8, 2001

Dramatic Cost Shifting is Just the Start!

The shocking revelation that $129 million in health care costs will be shifted onto sick people is just the start of the bill for reckless tax cuts. Those who now face significant bills for chiropractors, physiotherapists and other practitioners may increasingly turn to physicians and hospitals putting even more pressure on the system.

Health Minister Collin Hansen admitted recently that the budget freeze for health will mean a $700 million shortfall for fiscal year 2002-03. That means there must be another $471 million in cuts just to stand still!

A voice clip from Hansen on CBC radio includes the Minister's assurance that some people will have the shifted costs picked up by private insurers through extended health plans. Hansen appears to be ignoring how much of that cost shift will go directly back on public sector employers. Most of the government's extended health plans for public sector employees are financed on a cost plus basis. That means all those shifted costs will immediately shift back onto schools, colleges, universities, hospitals, crown corporations and government ministries.

I have submitted a Freedom of Information Request to determine how much of the shifted health costs will be shifted right back onto public sector employers. If those estimates don't exist, it will show that the self styled good managers are in over their heads. Some insurers may be hit hard as fully insured plans receive this unexpected liability, but worst of all will be the plight of hundreds of thousands of people who get personally stuck with a choice of doing without or picking up the tab.

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September 8, 2001

Shifting costs isn't good management

If government cannot afford Pharmacare, then what is that government going to do about the problems that make Pharmacare unaffordable?

Shifting costs from government onto its citizens isn't good management, particularly when it chooses to shift those costs onto sick seniors. Shifting costs after cutting taxes is the same as saying that sick seniors should pay for the dramatic tax cuts given to the high income earners.

If drug costs are rising, then they will rise for private insurers and private payers just as much or more than when they rise for government. Government is in the best position to control those costs and to deal with physicians who may not engage in the best prescribing habits. Government is also in the best position to obtain the research to determine what new drugs help patients as compared to what new drugs just help the drug companies.

It is hard to manage. The drug industry spends $20,000 per year per physician to get them to write prescriptions for the things that make most money for the drug industry. It is not easy for government to correct bad prescribing habits when it is up against those resources. However, every hospital pharmacist does exactly that kind of work. In a hospital you get the best drug that works, not the drug that was most recently pitched to your family doctor.

In opposition the Liberals attacked the NDP for years saying that they were a bunch of incompetents. If the Campbell government now shifts costs rather than managing the health system, we'll see the real failures and incompetents.