Commission on the Reform of Ontario's Public Services

Chapter 5: Health
Indeed, quality and efficiency go hand in hand. Too often, treatment delayed is treatment
diminished. The stroke victim who cannot gain immediate access to necessary physiotherapy
may suffer permanent damage, with long-term costs to the patient, the family and the health
care system alike. An efficient system would not let this happen. The elderly person who is
stuck in an acute care hospital bed is not getting the best care, which would be possible if he
or she should instead be transferred to a long-term care facility or sent home with appropriate
support. An efficient system would not let this happen either.
We will recommend a number of ways in which this can be done. Before we get to those
proposals, however, we will sketch out what we regard as the most salient facts about health
care and the perspectives that we bring to the issue.
Background
Health care is the Ontario government’s single biggest spending program. In 2010–11,
the province spent $44.77 billion on health, 40.3 per cent of its total spending on programs.
Based on current trends, this share is likely to expand to more than 44 per cent by 2017–18.
The cost of health care is driven by inflation, population growth, aging, new technology and
the increasing use of procedures like hip and knee replacements. Rising costs —
and questions as to its sustainability — have been a subject of intense public attention and
discussion for at least two decades now. Public opinion surveys consistently show that health
care is one of the biggest issues of concern for Ontarians and other Canadians. Every
provincial government will soon take action to rein in rising health care costs as part of their
efforts to return to balanced budgets. The federal government is also a key player; a 10-year
agreement under which it finances a portion of provincial government health care costs is due
to expire in 2014. The Canadian government has recently committed to grow the Canada
Health Transfer (CHT) by six per cent from now until 2016–17, after which it will grow in line
with a three-year moving average of GDP, with a three per cent floor. Shifting to the GDP-tied
rate, the CHT is estimated to grow by about four per cent per year in 2017–18 and beyond.
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