A few weeks ago, I wrote about how this provincial election is about oil, and the impact its falling revenues have had, and will have, on the next government’s ability to spend money.
That covered the revenue side. I neglected to mention, however, the expenditure side. To that end, this election is about health care.
To this point, health care hasn’t received a huge amount of attention; probably even less than usual. That is a mistake. In more ways than one, health care trumps all.
Last week I attended the local all-candidates debate in Estevan, sitting in the back since I would not be reporting on the actual debate. What struck me was how all the questions and debating points really had one underlying theme, although most of the members of the public didn’t realize it, and the politicians were reluctant to acknowledge it.
The public asked about declining funding to universities, twinning highways, water quality and primary education. They got the usual answers. But then, at the end, I asked my question, the one I started asking around 2004 of finance ministers and premiers, both NDP and Saskatchewan Party. Noting how health care has continually been eating up a larger share of the provincial budget every year, and is in the 40-per-cent range now, at what point does the government say there is no more? Is it 45 per cent? Fifty-five per cent? Where do they draw the line?
I laid out the third rail of Saskatchewan politics, and no one wanted to touch it.
Oh, one candidate, who had been on the local health board, said they were told to live within what they had. Another thought was that there should be no limit. But no one, as usual, would give me the specific number at which they would draw the line.
The reality is that nearly all the concerns raised during the debate were slowly being starved of money because the health-care budget absorbs pretty much any growth in revenues. Revenue sharing with municipalities? It’s a rounding error compared to health.
(Before anyone goes ballistic, I am not against socialized health care. I would have died several times in the past few years without it.)
In the 2002 budget, health care was $2.3 billion out of $6.3 billion in expenditures – 37 per cent. In 2006, it was $3.2 billion out of $7.7 billion – 42.3 per cent. By 2011, health was $4.5 billion out of $10.7 billion – 41.8 per cent. In 2015, it was $5.1 billion on a $12.2 billion budget – 42.1 per cent.
Health care under the NDP kept growing and growing as a percentage of the provincial budget. Under the Saskatchewan Party, it levelled off at around 42 per cent and stayed there.
Why was LEAN, an initiative to address costs within the health care system, attempted? The government had to do something, anything, to keep that 42 per cent from rising. How successful it was up for debate, but maybe it made some difference – perhaps by keeping that number from going up to 43 per cent.
Each percentage point is roughly $121 million in annual expenditures, about what we spend on the labour and parks ministries combined. If health climbed to 47 per cent, that would be the equivalent of getting rid of the entire justice department – you know, cops, judges and jails.
I’ve harped about this for years. In going through the numbers, I was honestly surprised to see that the Wall government did finally put a ceiling on health care expenditures, at 42 per cent, throughout its administration.
If you want to know why there’s not a lot of money to go around for other programs, health is the reason. While no longer growing as a percentage, it still takes up the lion’s share of expenditures. Unless you’re willing to tackle that sacred cow, you’re not likely to see any change, either.
