Reality Check

The NDP and price of doctors

Fri, 29 Apr 2011 16:08:20 -0500

When it came to health care, there was one thing the Conservatives, NDP and Liberals all agreed on - maintaining the annual six per cent funding increase to the provinces for the foreseeable future.

But there was plenty they disagreed on, too, as they tried to outdo each other with their promises.

The NDP, whose platform has come under closer scrutiny of late, maintains that it is the party Canadians should trust to strengthen our health-care system.

Leader Jack Layton has been critical of his opponents' promises to forgive portions of student loans for those new doctors and nurses who are willing to practice in rural areas, saying these do nothing to address the shortage of health-care workers. 

His platform contains a pledge to address this shortage "by training 1,200 new doctors over the next 10 years, adding 6,000 new training spaces for nurses over six years and substantially increasing the number of training spaces for other health professionals."

How exactly is the NDP going to get more health workers on the front lines. And how much is this going to cost? Here's a closer look. 


The NDP plan

In the first year of its four-year fiscal plan, the NDP is budgeting $145 million for front-line health-care workers.


It breaks down this way: $25 million for training; $20 million for a repatriation fund to bring back Canadian doctors working abroad; $20 million for an "equity program" to support low-income, rural and aboriginal medical students; and $80 million for infrastructure needs for medical and nursing schools to help increase capacity.

Like the Conservatives and Liberals, the NDP also plans to forgive student loans for professionals who stay in a family practice for 10 years. But they now say that program is at least four years down the road and so is not included in their current fiscal plan.

Over the next decade then, the NDP says it will get 1,200 more doctors into the workforce through a combination of these initiatives to create new spaces in medical schools, bring Canadian doctors home, speed up credential recognition for foreign-trained physicians and improve access to medical school for disadvantaged groups.

Layton has slammed the Conservatives for trying to boost the doctor workforce by only 100, saying thousands of doctors are needed now to fill the gaps.


Before the election was called, the government announced $40 million to create about 100 new residency spots across the country, the bulk of them in Ontario.


The NDP plan - 1,200 versus 100 - is over a span of 10 years. That's roughly 120 a year if spread evenly over the decade.


Added costs

But whether it's $40 million or $145 million a year to get more health-care workers on the front lines, the long-term costs probably have to be recognized as well.


The federal government can spend its money to help the provinces get more doctors. But the provinces will be on the hook for paying their salaries for years to come.


Rising drug costs are often blamed for bulging health budgets. But according to a 2010 report from the Canadian Institute for Health Information, expenditures for physician services represent the fastest-growing category of health spending.

The average family doctor billed the system $235,420 in 2009, according to CIHI, while total, payments to doctors exceeded $17 billion that year.


That represented a 9.6 per cent increase in the total amount at least partly because of an overall increase (2,700 more than 2008) in the number of doctors, CIHI said.


Let's do a little math. Let's assume family doctors continue to bill $235,420 a year and let's assume the NDP plan would add 120 more doctors per year.


That's an extra $28 million coming out of provincial health care budgets every year to pay doctors, not including what they will cost the system in ordering tests and other services. That's a lot of money


Now, perhaps, as more doctors are added the patient load per doctor will decline and individual physicians will be billing the system less.


On the other hand, the population is growing and aging, and even adding 100 doctors a year may not keep up with future demands, so that overall cost could be much higher.

Bottom line? More health-care providers isn't a bad thing, but failing to calculate their costs in the long-term is.

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