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Swallowing the costs

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According to a Canadian Medical Association report card, respondents to a poll gave the overall quality of health care in Canada a "B."

"The reality is that once you get into the system the service is good and the satisfaction rate is high," said CMA President Barrett of the results. However, "There is still a sense that the system is in decline and that this decline is a major problem."

While the rhetoric from all sides of the issue is almost too strong to figure out exactly where Medicare stands compared to the past, and to other health care systems around the world, one thing is irrefutable – per capita health care costs are going up, both for the government and for the people who require services.

Part of that is attributable to fallout from the baby boom, part is attributable to lost funding, but there’s another part of the equation that federal and provincial governments are only beginning to get a handle on – the price of health care has simply gone up.

The costs of diagnosing and treating patients has soared in recent years, for example, with the use of expensive technologies like orthoscopics, ultrasound, and magnetic resonance imaging.

While the costs of operating a hospital and maintaining a staff have also increased, the costs are at least tied to inflation and market values.

One health care cost that is growing in leaps and bounds, however, is the cost of pharmaceuticals.

According to Health Canada, drug expenditures are increasing by about 12 per cent annually. Drug expenditures as a proportion of total health expenditures have increased from 9.9 per cent in 1982 to 15.6 per cent in 1998… from $1.1 billion in 1975 to $9.2 billion in 1994. Prescription medicines account for about three-quarters of all drug spending.

We currently spend more money on drugs (14.5 per cent of total health expenditures) than we do on physicians (14.2 per cent). It’s second on the list to hospitals, which account for 32.5 per cent of all expenditures.

In 2000, the year of the last study available, we spent $14.7 billion on drugs, which is up from $11.3 billion in 1987.

About 40 per cent of this total is paid for by taxpayers, while 60 per cent is paid for by patients or non-government health insurance. Seniors are particularly hard-hit, with monthly drug bills that can run into the hundreds of dollars.

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