What doesn’t the NDP get about healthcare spending? Do they deliberately twist things, or are they just unable to understand?

The Premier’s priorities by Dorothy Dobbie
The Premier’s priorities by Dorothy Dobbie


“Why doesn’t Wab Kinew grasp the facts about health care when they are presented to him?” asked a frustrated Heather Stefanson, fresh from Question Period when we began this month’s interview.

She was speaking of the Opposition Leader’s insistence that the current government has cut health care spending when, in fact, health care budgets have been consistently increased, year over year, since this government took office. The last NDP budget in 2014/2015 had health care pegged at $5,653,292. This last budget, including Mental Health and Seniors (so we are comparing apples to apples), is set at just over $7 billion. 

Furthermore, the Opposition leader seems to have mixed up a ministerial working group with the Diagnostic and Surgical Recovery Task Force that is addressing the COVID-19 backlog and reporting their findings to government. He claimed there are no doctors on the task force, which is made up of a team of highly respected local healthcare professionals and doctors, when he might have meant the ministerial working group which, of course, has no doctors on it.

The Winnipeg Free Press seems to be just as confused – or they don’t do their homework – but CBC has it right. They report that the COVID-19 backlog has been eliminated for 10 of 30 procedures, backing up what the Premier said in that same Question Period when she noted that 32% of the total backlog had been reduced and that the diagnostic backlog was down by 31%. Some of the backlogs such as CT scans, cataract surgeries, urology tests, oral surgeries and ultrasound tests have been eliminated entirely. Backlogs for procedures such as cardiac surgery and adult allergy testing have been reduced more than 50%.

As Dr. Ed Buchal of Doctors Manitoba and the lead member of the Task Force, which is chaired by Dr. Peter MacDonald, said, there is a difference between the backlog and the wait times – and while he agreed that wait times must also be brought under control, those wait times existed long before this government took office. Nevertheless, that is their next target, and the Task Force is determined to deal with this.

Perhaps what is irking the NDP is that the Premier is sensibly looking for ways to relieve Manitoban’s of their pain by purchasing the services of private sector diagnostics and surgeries in areas where there is no need for overnight stays, but where day surgeries such as oral surgeries or diagnostics such as CT cans and ultrasound tests, can be performed in an office without overnight care. 

“Care requiring overnight stays have to be managed in hospital to comply with the Canada Health Act, but day surgeries do not,” she says.

This makes sense and indeed, contracting private services for some procedures was started under the NDP when the premier was critic for Health in Opposition under Gary Doer. At her urging, he ultimately allowed three private clinics. The Maples Clinic and Western Surgery Are still operating privately, so contracting private services is not an unknown concept under the NDP.

“It promotes efficiency,” says the Premier. “When private practices have to compete with each other, not only do they make sure they are counting every dollar for the sake of offering the most affordable product, but they compete to be the safest and best run operation they can.” 

This frees up dollars for other health care priorities, relieves the burden on the public system and does not cost the patient a penny out or pocket because the services are paid for by the Health Department. 

“To stay in business, the private sector has to be accountable for every dollar they spend,” she adds. 

“Look, there is an inherent conflict of interest in a system where the provider and the purchaser are the same. In our public system they can’t even really estimate the cost of a simple hip surgery,” she says. “They can’t account for waste or lost time or any of the variables that can happen in a huge bureaucracy. But a private operation has to account for everything and the higher the production the more money they make so everything moves along faster.” 

As many people have noted, there are no wait times for privately run veterinary services where you can get a scan or an operation immediately for your pet’s injury.

Of course, the NDP derives much of its funding through unions who jealously guard jobs for their members. This is understandable, but sometimes it is to the detriment of the public good. They have even been known to reject volunteer services for the same reason. There must be a balance and Premier Heather Stefanson is trying to find it.

“We are making headway in fixing health,” she says, “but it cannot be fixed overnight.” 

That said, she is not expecting patients to wait in pain. Arrangements have been made with a wide number of providers out-of-province to help fill in the gaps, especially those that have occurred during the pandemic. All you need is your doctor’s referral to qualify. 

Check here for further information: https://www.gov.mb.ca/health/dsrecovery/options.html 

Manitoba Health pays all out-of-province fees to the surgeon and hospital directly and will reimburse any eligible expenses incurred by the patient.

So far, this plan has provided relief to 23,500 patients in our province, says the Premier. She feels the urgency of those who have not yet been helped and she is determined not to let political doctrine deter her from making that happen.

A 2017 report from the University of Ottawa, pointed out:

“Manitoba’s health care system is expensive and has poor outcomes relative to its peers, despite the provincial government having consistently spent more than would be suggested by the macroeconomic cost drivers.”

It continued, “As a result, Manitoba has one of the highest per capita costs of health care in Canada. According to the Canadian Institute for Health Information (CIHI). But, despite this spending, according to the Conference Board of Canada, Manitoba still receives one of the lowest grades for health status.”

They pointed out that, “From 2010 through 2014, average total health care expenditure growth in Manitoba was constrained to 3.5% annually. The savings were primarily the result of a contraction in investment in capital (-5.3%), as well as slow growth in spending on administration (0.5%) and drugs (1.1%). Meanwhile, spending on health professionals (6.4%) and other health spending (5.7%) advanced at a pace that exceeded the national average.” In effect, labour costs were increased at the expense of capital investment, exactly what one would expect from the Selinger government of the day.