“Over the last 10 years, we've seen the growth in health-care spending over and above population growth and inflation,” said Chris Kuchciak, manager of health expenditures for CIHI. “However, what's different this year is that the growth rate in 2009 and 2010 seems to be decelerating.”
Taking inflation and population growth into account, actual per-capita health-care spending is expected to rise by just 1.4 per cent this year, Mr. Kuchciak said from Ottawa.
“The growth rate of 1.4 per cent is actually the lowest growth rate in the last 13 years.”
Mr. Kuchciak said a number of factors are likely behind the shrinking growth rate in health spending, including belt-tightening by provinces in response to the 2009 recession.
A similar squeeze on spending occurred during the mid-1990s, a period of restraint when the growth in health spending was either flat or negative, he said, noting that the trend was reversed in the late ‘90s when governments made a concerted effort to boost allocations to health.
“So there were significant investments in health care. But now fiscal positions have changed and we see that growth rate decelerating.”
The report shows health-care spending is expected to account for 11.7 per cent of Canada's gross domestic product in 2010, down from 11.9 per cent in 2009, but above the 10.7 per cent share of the GDP in 2008.
Mr. Kuchciak said hospitals, prescription and over-the-counter drugs, and doctors' services remain the three biggest-ticket items.
Hospitals are still the largest at 29 per cent, he said. “That's actually declined over the years. Twenty-five, 30 years ago, hospitals accounted for over 40 per cent of health-care spending.”
“What we've seen over time is a growth in the share attributable to drug spending – that's been growing – but also in the last four years, physician spending has actually outpaced the growth of drugs and hospitals.”
This year, drug costs are expected to carve out 16 per cent of the health-care spending pie, while physician services are predicted to take up almost 14 per cent.
“Yes, physician spending has grown faster than the other two categories,” Mr. Kuchciak said. “We know there are more physicians today than there were years ago. There's more demand for the use of physician services as well as compensation.
“Those are factors that could play into that increase in spending.”
The report also says government spending on health care this year is expected to reach $135.1-billion, while private-sector spending – which includes both private insurance and out-of-pocket expenses – will reach an estimated $56.6-billion.
For more than a decade, public- and private-sector health spending in Canada has been growing at about the same rate, with the public sector accounting for about 70 per cent of the total health-care bill and the private sector for the rest.
While Canadians over the age of 65 account for less than 14 per cent of Canada's population, CIHI found they consume almost 44 per cent of all health-care dollars spent by provincial and territorial governments. In 2008, the latest year for which data is available, the provinces and territories spent an average of $10,742 per senior, compared with $2,097 on those aged one to 64 years old.
For Canadians age 80 and older, health spending averaged $18,160 per person, more than three times the roughly $5,800 spent per senior under the age of 70.
However, the report shows that the share spent on those 65-plus has not changed significantly over the past decade.
“While it is true that care is costlier for people who are 65 and older, we have not seen a rise in the proportion we spend on seniors,” said Jean-Marie Berthelot, CIHI vice-president of programs. “An aging population may have an impact on health-care spending, but so far the average expenditure on seniors has not risen faster than for younger Canadians.”
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