Last year, I posed the question : “What new approaches will Canadian provinces bring to improving health care?”. Given the completion of 13 agreements between the federal government and the provinces and territories last spring, we now have information to answer that question. I worked from the strategies proposed by the Globe and Mail in 2022. In particular, I gave provinces and territories one point each for investing in :
- Nurse practitioners
- Specialized day surgery centres
- More efficient digital referrals or diagnostics
- Transitional care units for patients with less urgent post treatment needs
- Talk therapy for everyone who needs it
I recognize that the funding offered by the federal government was sorely needed and that each province and territory has different needs but I wanted to gauge how much thought was given to “bending the cost curve” rather than surviving the current crisis.
| Province/Territory | Cost-saving initiatives | Notes |
| BC, New Brunswick, Quebec | 4 | Unique contributions: BC- Hospital at Home, NB – Specialized surgeries, QC – respite care for parents |
| Alberta, Newfoundland, Nova Scotia, Ontario, Saskatchewan | 3 | Mainly nurses, digital referrals and more talk therapy. In Nfld, a physician’s assistant program is proposed |
| PEI, Yukon, Nunavut | 2 | Due to smaller populations, there is less pressure to develop digital referrals |
| Manitoba, Northwest Territories | 1 | Talk therapy only |
Table 1 summarizes the initiatives described in the press releases for each of the health care agreements. There are, of course, more details to be found in the agreements themselves, including targets for improving health care over the next three years. Notably absent from the table are any attempts to free up hospital beds with transitional care units. These may be found in the parallel agreements with the federal government on “Aging with Dignity“. It is also worth mentioning that the Manitoba press release is the only one to appear on the Prime Minister’s web page as opposed to Health Canada’s page. It may have lost some details of the plan as a result.
Overall, it is encouraging that 8 out of ten provinces are applying the majority of the expert-recommended approaches for making health care more efficient. It is, however, humbling to realize how many disparate factors contribute to the cost of health care and to our sense of security that health care will be available when we need it. At the current rate of inflation, the federal government’s commitment to a 5% annual increase in health transfers over the next ten years will necessarily increase the proportion of Canada’s GDP dedicated to our health security. Will we start to feel more secure?