Health care election promises unrealistic, says expert
Parties not addressing health-care cost drivers in Nova Scotia election, says Katherine Fierlbeck
A political scientist at Dalhousie University says the campaign platforms of Nova Scotia's political parties are too focused on cutting the number of health authorities and not addressing what's actually driving up health-care costs.
Katherine Fierlbeck, a political scientist who specializes in health policy, said one of the biggest cost drivers for health care is increased doctors' salaries — but no one's talking about that.
"No party, quite sensibly, will take on the doctors. No party is going to say doctors are overpaid and we've got too many of them and that I think is one reason why we have so much of an emphasis on administrators and administrative costs," Fierlbeck told CBC's Mainstreet.
"Nothing I have read says that a major cost driver for health care is a bloated health-care bureaucracy. That's simply not true. The cost drivers are health-care provider doctor salaries."
The Progressive Conservatives pledged in their campaign platform to reduce the number of health authorities from 10 to three, while the Liberals promised to go from 10 to two.
Fierlbeck said the "marginal gains" to be made from cutting the number of health authorities are "pretty irrelevant."
While many Canadians have seem their incomes stagnate, physicians have been getting an increase of about 6.8 per cent per year from 1998 to 2008, according to the Canadian Institute for Health Information.
Fierlbeck also points out Nova Scotia has more doctors per capita than any other province in Canada — 240 doctors per 100,000 people. By comparison, Saskatchewan has the fewest with 160 doctors per 100,000 people.
"If we have lots more doctors in the system, it's going to cost a whole lot more but health-care indicators probably won't budge significantly. Is this an efficient use of health-care dollars? I'd say not," said Fierlbeck.
"Maybe we should pay them handsomely. But we should be having that discussion and no party is going to come out and say that."
Fierlbeck said the New Democratic Party and the Progressive Conservatives seem to have the right idea by talking about moving toward more primary health-care professionals in the community.
"The NDP, for example, talk about nurse-managed clinics and the Progressive Conservatives talk about community care centres and both parties, again, are thinking about using lower costing health professionals to do things like check people's sore throats where we don't really need doctors on the front lines to do this kind of stuff," she said.
"There's a lot in the election platforms about 'We plan to have this plan.' 'We plan to have a plan on seniors. We plan to have a plan on chronic care. We plan to have a plan on diabetes.' All of which are great but you might want to give us a little bit more specifics on that."