Building better health care: Policy opportunities for Ontario

Released April 2014

Ontario must re-think how it delivers and finances health care. In Working Paper 20, Building better health care: Policy opportunities for Ontario, the Institute examines how the performance of the Ontario health care system compares internationally on dimensions of efficiency and equity. Ontario is among the jurisdictions with the highest total per capita health care spending in the OECD, yet the province trails international peers in overall health care performance.

Over the last decade, public expenditures on health care have continuously outpaced the province’s economic growth rate and its ability to raise revenue. If major changes are not made now, rising health care expenditures could lead to further deficit financing, rationing of health care, and higher tax burdens on the working age population.

Ontario needs to tackle the main cost drivers. Institute research shows that population aging is a contributor to rising health care cost, but its significance may be exaggerated. There is a need to control age-specific cost increases, and attention related to end of life care is critical. Advances in technology, primarily drugs, increased service utilization, and physician compensation growth are more influential causes behind rising health care spending, but that remain largely unaddressed in current policy initiatives.

The Institute offers eight policy opportunities for Ontario to make headway in realizing greater efficiency and equity in health care. These include:

  • Strengthening primary care
  • Engaging physicians to drive change
  • Accelerating the deployment of IT
  • Implementing a pharmacare program
  • Scaling up policy focused on end of life care
  • Strengthening the revenue base by introducing a savings plan for prefunding drugs
  • Implementing a co-payment model
  • Abolishing the tax subsidy for employer health insurance benefits
Topics: Social policy