Friday, September 25, 2015

Health Care and Government Deficits

There is a very compelling battle taking place in Ontario between Ontario Physicians and the Health Ministry.  Spending caps and cuts to physician fee per service rates have enraged the Ontario Medical Association.  This is a complex topic that I will not pretend to explain in detail here (or even fully understand).  What I am interested in discussing is how did the Ontario Liberals get to this point where they have put Ontario Physicians squarely in the cross-hairs of health care cuts?

If you check out the Ontario debt clock; the Ontario provincial debt is in the $291 Billion dollar range.  That's Billion with a "B".  The interest on that debt is a staggering $11 Billion.  That interest payment could go along way toward paying for Doctors and Nurses.

Many who argue for running deficits to pay for much needed social services will state that government debt is not the same as household debt and there is some truth to that.  However, there is one thing that massive, out of control, debt of any kind will do.  It limits the options of what the government can do and what it can spend it on.  If debts get our of control gavernments at some point are forced to make cuts; this is the case in Ontario.

Unchecked government debt is a cancer on the public purse.  It is also something that NDP and Liberal provincial governments seem to be OK with if it is in the interest of the public good.  That logic can only be sustained for so long.  Eventually the mounting debt and crippling interest payments begin to snowball and force the most ardent champions of social justice to pay the "financial piper."

This has what has happened to the provincial Liberals in Ontario and is certainly the case for the Manitoba NDP.  They can't ignore their debts any longer.

The challenge in formulating any budget is finding a balance.  You have to find balance between fiscal restraint, public safety, and maintaining all forms of infrastructure that government are relied on to maintain.  This is not easy. So who has the Ontario Liberals targeted.  Ontario Doctors.  Why?

During the federal election and in any election for that matter we hear many on the left say the "rich" should pay their "fair" share.  We have heard this from Barak Obama, Kathleen Wynne, and most recently from Tom Mulcair and Justin Trudeau.  They 1% can certainly afford to pay a little more.  These comments do resonate with the public because most of the public do not identify with the 1% crowd.  This may be why Ontario physicians have become targets.

It is difficult to ascertain what an average physician earns in Canada.  The calculation and data make that determination somewhat challenging.  Some estimates put the average salary of a physician in the $240,000 range.  What is interesting about that is the $240 K is significantly higher than the threshold of the rarefied air of the 1% earners. In Canada, the top 1% earn about $191000 annually.   The "rich" "1 %" that the NDP and Liberals want to make "pay a little more" in many cases are physicians.  The recently announced cuts to Ontario physician's is not surprising as it is part of the Liberal platform; as advertised.  This should not come as any surprise.  This is what happens when uncontrolled spending meets harsh fiscal reality.  Difficult decisions need to be made and high income earners will be the first to feel the squeeze.  No matter how socially conscious you are, eventually snowballing debt will catch up with you.  It is a fiscal trap.

Doctors are some of the most mobile professionals out there.  There are many employment options for physicians.  They are not limited to practising in one province.  Our family has been a victim of this.  In recent years we lost our nephrologist to BC Children's Hospital and we nearly lost our cardiologist.  Create a hostile work environment and pay substandard wages.  Doctors will leave.

Health care is important to all of us.  In order to have a healthy health care system requires a great deal of money and the amount of money required to sustain health care is only going to get bigger.  So when you see a tweet, face book post, or advertisement stating that when you vote in the next election to consider health care.  Perhaps what you should be doing is thinking about who is best suited to manage the economy.  A strong and growing economy creates many more opportunities to invest in health care than trying to manage a mountain of debt.


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