The province’s health care budget in 2013-14 will see zero growth for the first time in recent memory, Finance Minister Blaine Higgs announced on Tuesday.
The Department of Health’s budget will remain at $2.58 billion, the same as what was budgeted last year, he said.
Health care spending represents about 40 per cent of the provincial budget and more per capita than the national average, Higgs said.
"This situation cannot continue," he said.
Premier David Alward’s Progressive Conservatives promised during the 2010 provincial election to increase health spending by a minimum of three per cent per year.
Instead, the government plans to make cuts or hold the line on doctors’ billings, drugs and hospital food and housekeeping services.
Medicare billings for doctors will be cut by $18.8 million and the amount fee-for-service doctors can bill will be capped at $425 million for the next two years, Higgs said.
The cap will be calculated quarterly and if a doctor goes over, the amount will be clawed back in the next quarter.
"Implementation of that will not affect service levels," Higgs stressed.
Salaried doctors are already subject to the zero per cent increases as other public service employees.
The government will also undertake a review of financial incentives related to the recruitment and retention of physicians, he said.
Could drive doctors away
The president of the New Brunswick Medical Society contends cabinet approved the cut while still at the negotiating table with doctors.
Capping Medicare billing "is limiting access to medical services," Robert Desjardins said in a statement.
"It also means that new doctors graduating this year in New Brunswick will look elsewhere to practice, at a time when thousands of New Brunswickers have no family doctor, or wait for surgery," he said.
Doctors want to work with the government on sustainable health care and have dozens of ideas, said Desjardins.
"Short-term, short-sighted cuts that reduce access to care are not in patients' best interests," he said.
NDP Leader Dominic Cardy said he is also "very concerned" about the health care cuts, calling them an "irresponsible offloading of health care reform onto doctors."
"I think that this is asking doctors, based on our quick estimates, to work essentially at the moment, based on the current billing practices, for three months and two weeks of the year for free," said Cardy.
"So where exactly is all that time going to come from when the doctors come into mid-September and suddenly realize that ‘Well, according to my own government, who pays my bills, I’m done. I’ve already spent my budget for this year.’ So are we going to see people going more out of province for health care? We’re certainly going to see doctors going off to work in Amherst in Nova Scotia and Houlton in Maine."
Cardy says the cap will also hurt the province's ability to recruit new doctors.
No money for drug program
The budget includes no new money for a proposed new drug coverage program that would include catastrophic drugs.
Higgs told reporters the issue will get further discussion "as it actually gets defined."
Health Minister Ted Flemming provided a general sketch of the program before Christmas and promised details in the new year, but he hasn’t provided them yet.
An independent report by former health minister Dennis Furlong estimated the program could cost $25 million.
The price of generic drugs will also be reduced by 10 per cent to 25 per cent of brand price, effective on June 1, and the dispensing fees paid to pharmacies will be adjusted to specify frequency of dispensing timelines for various pharmaceuticals.
Meanwhile, the Horizon and Vitalité health networks will undertake a review to determine how New Brunswick health services measure up against similar jurisdictions, said Higgs.
In addition, the government will work with the regional health authorities to look for service efficiencies in non-clinical areas, such as food and housekeeping services.
FacilicorpNB will look for similar savings in hospital-based laundries, he said.