This is a presentation I gave on Canadian Medicare at Hofstra University

1. Canadian Medicare
Financing & Spending
Presented by
Steven A. Rohinsky
Hofstra University MHA Program

2. Medicare
Financed by Provincial and Federal
Governments
75% Financed through the Public Sector
25% Financed through the Private Sector

3. Medicare Funding
 Funded through the revenue generated by taxing
personal and corporate income.
◦ Each Province has different Provincial tax Laws
 Funding also through user Premiums
◦ Premiums differ from Province to Province

4. Medicare
 Federal Government ensure “Basic Needs” are paid for.
◦ Hospitals
◦ Physicians
◦ administration
 Added benefits given by provincial government, Employer and
Private insurers.
◦ Eye Care
◦ Dentistry
◦ Home care (including Rehab unless done in hospital)
◦ Prescription Drugs

5. Financing
 What are governments and Canadians spending?
 Where is the growth?
 What are we spending it on?
 Whom do we spend it on?
 How does Canada compare?

6. Financing
Spending on health care by Governments and
Canadians is projected to be:
 $148 billion- a 5.8% increase from 2005
 10.3% of GDP
 $4,548 per person

7. Financing
7.0%
5.8%
6.0%
5.0% Increase Due to 2.1%
Inflation
4.0%
Increase Due to
Population Growth 0.9%
3.0%
Real Increase in
2.0%
Health Spending
2.8%
1.0%
0.0%

8. Financing
Total Health Expenditure per Capita,
Annual Growth Rates in Constant $1997
6.0%
Actual
5.0% Forecast
1976-2004 Average (2.5%)
4.0%
2.8% 2.8%
3.0%
2.0%
1.0%
0.0%
-1.0%
1976 78 80 82 84 86 88 90 92 94 96 98 00 02 04 2006
Year
Source: Canadian Institute for Health
Information.

9. Financing
Canada vs. United States
Total Health
Total Health Public Share of Public-sector Health
Expenditure
Expenditure Total Health Spending per Capita
per Capita
% of GDP Expenditure (in US$)
(in US$)
Canada $3,165 9.9% 69.8% $2,210
U.S. $6,102 15.3% 44.7% $2,727
Note: All numbers represent 2004 data. Spending per capita was converted to U.S. dollars using
purchasing-power parities for GDP.
Source: OECD Health Data 2006, October Edition.

10. Financing
12.0%
10.0% 10.3%
10.0%
8.3%
8.0% 8.9%
6.0%
4.0% Actual
Forecast
2.0%
0.0%
1975 78 81 84 87 90 93 96 99 02 05 2006
Year
Sources: Canadian Institute for Health Information;
Statistics Canada.

11. Financing
Private Health Private Sector
Insurance
12% Public Sector
Out-of-Pocket
15% P/T
Government
Non- Sector
Consumption 64%
3%
Municipal
Government
Sector
1%
Social Security
Funds Federal Direct
1% Sector
4% Source: Canadian Institute for Health Information.
Note: Data are for 2004.

12. Financing
Public- and Private-Sector Shares of Total Health Expenditure
(% share)
Source: Canadian Institute for Health
Information.

13. Financing
Total health expenditure forecast for 2006 = $148 billion
Hospitals
Administration 29.8%
3.9%
Capital
4.1%
Drugs
Public Health 17.0%
5.8%
Other Health
Spending
6.4% Other Physicians
Institutions 13.1%
9.4% Other Professionals
10.6% Source: Canadian Institute for
Health Information.

14. Financing
1976 2006
Hospitals and Physicians
13% LTC
20%
Hospitals and Physicians
9%
LTC 43% Other Professionals
9% 60% 17%
Other Professionals
Drugs Drugs
9%
Other Expenditures
11% 9%
Other Expenditures
Source: Canadian Institute for Health
Information.

15. Financing
Total Health
Spending
5.8% (6.6%)
(5.5%)
Physicians 7.1%
Drugs 6.0% (8.9%)
Other Institutions 5.7% (6.3%)
Hospitals 4.8% (5.1%)
Other Professionals 4.8% (5.7%)
0% 1% 2% 3% 4% 5% 6% 7% 8% 9% 10%
Note: Average annual growth in brackets.
Source: Canadian Institute for Health Information.

16. Financing
$6,000
$per capita
Public Private Canada $4,548
$5,000
$4,000
$3,000
$2,000
$1,000
$0
Que. P.E.I. N.L. N.B. B.C. N.S. Sask. Ont. Man. Alta.
Source: Canadian Institute for Health Information.
Y.T.: $6,669
N.W.T: $7,300
Nun.: $10,285

17. Financing
$6,000
$5,000 Public Private
$4,000
$3,000
$2,000
$1,000
$0
Que. P.E.I. N.L. N.B. B.C. N.S. Sask. Ont. Man. Alta.
Public Private
Source: Canadian Institute for Health Information. Y.K.: $5,297 $1,372
N.W.T: $6,545 $755
Nun.: $9,792 $493

18. Financing
16% 13.6%
14% 13.2% 13.5% 13.1%
12% 10.7% 10.8%
10.8% 10.6% 10.3%
9.8%
10%
8% 6.9%
6%
4%
2%
0%
N.L. P.E.I. N.S. N.B. Que. Ont. Man. Sask. Alta. B.C. Canada
Source: Canadian Institute for Health Information. Y.K.: 13.3%
N.W.T: 7.6%
Nun.: 27.5%

19. Financing
$10,000
$9,000
$8,000 1998 2004
$7,000
$6,000
$5,000
$4,000
$3,000
$2,000
$1,000
$0
<1 1–64 65+ Total
Age Group
Source: Canadian Institute for Health
Information.

20. Financing
60% <1 1–64 65+
54% 53%
50%
43% 44%
40%
30%
20%
10%
3% 3%
0%
1998 2004
Source: Canadian Institute for Health Information.

21. Financing

22. Financing
 Health spending is rising
◦ …but not as quickly as it was
◦ …and the public/private split is still close to 70/30
 Spending highest for babies and seniors
◦ Proportion spent on seniors has remained
relatively stable
 On the world stage
◦ Canada is among the world’s top 12 health spenders in terms
of health care spending per person
◦ Canada is on par with over half of comparable OECD countries
in terms of health care spending as a proportion of GDP
◦ Canada’s public share is less than many
comparable countries