1

Canadian Institute for Health Information

2

National Health Expenditure Highlights

3

The National Picture

4

Health Spending in Canada

• How much are governments and Canadians spending?

• What are we spending it on?

• Whom do we spend it on?

• How does Canada compare?

5

2012 Health Spending Forecasts

• Spending on health care by governments and Canadians is projected to be

– $207.4 billion, a 3.4% increase

– 11.6% of GDP (versus 11.7% in 2011)

– $5,948 per person

– 0.4% above inflation and population growth in 2012

6

Health Expenditure Continues to Rise

1975

1977

1979

1981

1983

1985

1987

1989

1991

1993

1995

1997

1999

2001

2003

2005

2007

2009

2011

f0

50

100

150

200

250

Actual Spending Inflation-Adjusted Spending ($1997) Forecast

Bill

ion

s o

f D

olla

rs

2012f

Average Annual Growth Rates

Actual Spending Inflation-Adjusted

Spending1980s 10.8% 4.2%1990s 4.5% 2.5%2000–2010 7.0% 4.2%

SourceNational Health Expenditure Database, CIHI.

7

Health Care Spending Outpacing Inflation and Population Growth

1976

1978

1980

1982

1984

1986

1988

1990

1992

1994

1996

1998

2000

2002

2004

2006

2008

2010

2012

f-1%

0%

1%

2%

3%

4%

5%

6%

0.3%0.4%

Total Health Expenditure per Capita, Annual Growth Rates, Constant 1997 Dollars

Actual Forecast 1975–2010 AAG (2.5%)NoteAAG = average annual growth.SourcesNational Health Expenditure Database, CIHI; Statistics Canada.

8

Components of Growth in Total Health Spending, 2012 and Average Annual Growth (2000 to 2010)

AAG 2012f0%

2%

4%

6%

8%

10%

2.7%1.9%

1.2%1.1%

3.1%

0.4%

Increase Due to Inflation Increase Due to Population GrowthReal Increase in Health Spending

3.4%

7.0%

Notesf = forecast.AAG = average annual growth.SourcesNational Health Expenditure Database, CIHI; Statistics Canada.

9

Total Health Expenditure as a Proportion of GDP

19751977

19791981

19831985

19871989

19911993

19951997

19992001

20032005

20072009

2011f6%

7%

8%

9%

10%

11%

12%

8.1%

9.7% 9.7%

11.9%

Actual Forecast

2012f

Notef = forecast.SourcesNational Health Expenditure Database, CIHI; The Conference Board of Canada.

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Who Spends What?

Other Private3.3%

Out of Pocket14.5%

Private Health In-surance11.7%

Provincial-Gov-ernment Sector

65.2%

Other Public5.3%

Note2010 actual data.SourcesNational Health Expenditure Database, CIHI; Statistics Canada.

Public Sector

Private Sector

11

Public/Private Split

1975

1977

1979

1981

1983

1985

1987

1989

1991

1993

1995

1997

1999

2001

2003

2005

2007

2009

2011

f0%

10%

20%

30%

40%

50%

60%

70%

80%

90%77.0% 76.1%74.0%

69.7%

23.0% 23.9% 26.0%30.3%

Public- and Private-Sector Shares of Total Health Expenditures, 1975 to 2012

Public-Sector Share Private-Sector Share Forecast

2012f

Notef: forecast.SourceNational Health Expenditure Database, CIHI.

12

Public Share of Total Health Expenditure, 30 Selected Countries, OECD, 2010

Mexico

Korea

Slovak Republic

Switzerland

Australia*

Poland

Turkey†

Finland

Austria

France

Iceland

Sweden

United Kingdom

Luxembourg*

Norway

0% 10% 20% 30% 40% 50% 60% 70% 80% 90%

47.3%48.2%

58.2%60.5%

64.5%64.8%65.2%65.8%

68.5%71.1%71.7%72.8%73.0%

74.2%74.5%75.6%76.2%76.8%77.0%

78.9%80.4%80.5%81.0%

83.2%83.2%83.8%84.0%85.1%85.5%85.7%

Average: 73.2%

Notes* Data for 2009; † Data for 2008; § Current Expenditure (capital excluded).SourceOECD Health Data 2012, June edition.

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What Are We Spending On?

Hospitals29.1%

Drugs15.9%

Physicians14.2%

Other Profes-sionals10.6%

Other Health Spending

6.0%

Public Health5.4%

Administration3.2%

Capital5.2%

Other Institutions10.4%

Note2010 actual data.SourceNational Health Expenditure Database, CIHI.

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Changing Look of the Health Care System

60%

9%

9%

9%

13%

1975

Hospitals and Physicians Drugs Other Professionals Other Institutions

Other Expenditures

SourceNational Health Expenditure Database, CIHI.

2012

44%

16%

11%

11%

19%

15

Annual Growth on Selected Services, 2012 Versus Average Annual Growth (2000 to 2010)

Other Institutions

Hospitals

Physicians

Other Professionals

Drugs

Total Health Spending

0% 1% 2% 3% 4% 5% 6% 7% 8% 9% 10%

0% 1% 2% 3% 4% 5% 6% 7% 8% 9% 10%

6.4%

6.8%

7.6%

5.9%

7.3%

7.0%

5.2%

3.1%

3.6%

3.5%

3.3%

3.4%

2012f AverageNotef: forecast.SourcesNational Health Expenditure Database, CIHI; Statistics Canada.

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Provincial Variations

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Total Health Expenditure per Capita, Provinces and Territories, 2012 (Forecast)

Que. B.C. Ont. N.B. P.E.I Sask. N.S. Man. Alta. N.L.$4,000

$4,500

$5,000

$5,500

$6,000

$6,500

$7,000

$7,500

$5,469$5,700

$5,849

$6,318 $6,336$6,481 $6,497 $6,518

$6,754

$7,057

Dollars per Capita Canada $5,948Y.T. $8,916.2N.W.T. $9,852.9Nun. $13,250.1

SourcesNational Health Expenditure Database, CIHI; Statistics Canada.

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Total Health Expenditure, Public- and Private-Sector Shares, 2012 (Forecast)

Ont. N.S. B.C. N.B. Que. Alta. P.E.I. Man. Sask. N.L. Canada

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

67.8% 68.7% 69.1% 69.3% 69.3% 72.5% 73.6% 73.9% 76.4% 76.5%69.7%

32.2% 31.3% 30.9% 30.7% 30.7% 27.5% 26.4% 26.1% 23.6% 23.5%30.3%

Public Share Private ShareSourceNational Health Expenditure Database, CIHI.

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Health Spending on Younger and Older Canadians

20

Total Provincial/Territorial Government Health Expenditure per Capita, by Age Group, 2010

<1 1–4

5–9

10–

14

15–

19

20–

24

25–

29

30–

34

35–

39

40–

44

45–

49

50–

54

55–

59

60–

64

65–

69

70–

74

75–

79

80–

84

85–

89

90+

$0

$5,000

$10,000

$15,000

$20,000

$25,000

$30,000

$9,2

64$1

,496

$1,2

76$1

,282

$1,5

38$1

,708

$2,0

12$2

,156

$2,1

48$2

,206

$2,4

38$2

,917

$3,5

36$4

,380

$6,2

23 $8,7

21 $12,

050

$15,

768

$24,

111

$25,

970

Expenditure per Capita Average: $3,692

SourcesNational Health Expenditure Database, CIHI; Statistics Canada.

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Distribution of Provincial/Territorial Government Health Expenditures, by Age Group, 2000 and 2010

2000 20100%

10%

20%

30%

40%

50%

60%

2.9% 2.9%

53.3% 52.1%

43.8% 45.0%

<1 1–64 65+

SourcesNational Health Expenditure Database, CIHI; Statistics Canada.

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How Does Canada Compare?

23

Total Health Expenditure per Capita, U.S. Dollars, 30 Selected Countries, 2010

Turkey†

Estonia

Hungary

Korea

Slovak Republic

Portugal

Japan*

Finland

United Kingdom

Sweden

France

Austria

Denmark

Netherlands

Norway

$0 $1,000 $2,000 $3,000 $4,000 $5,000 $6,000 $7,000 $8,000 $9,000

$913$916

$1,294$1,389

$1,601$1,884

$2,035$2,071$2,095

$2,428$2,728

$3,022$3,035$3,056

$3,251$3,309

$3,433$3,670$3,758

$3,969$3,974

$4,338$4,395$4,445$4,464

$4,786$5,056

$5,270$5,388

$8,233

Average: $3,340

Note* Data for 2009; † Data for 2008.SourceOECD Health Data 2012, June edition.

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Total Health Expenditure as a Percentage of GDP, 30 Selected Countries, 2010

Turkey†

Estonia

Korea

Israel*

Luxembourg*

Slovak Republic

Australia*

Norway

Sweden

United Kingdom

Belgium

Austria

Switzerland

Germany

Netherlands

0% 2% 4% 6% 8% 10% 12% 14% 16% 18%

6.1%6.2%6.3%

7.0%7.1%

7.5%7.5%

7.8%7.9%

8.9%9.0%9.0%9.1%9.3%9.4%9.5%9.6%9.6%9.6%

10.1%10.5%10.7%

11.0%11.1%

11.4%11.4%11.6%11.6%

12.0%17.6%

Average: 9.5%

Note* Data for 2009; † Data for 2008.SourceOECD Health Data 2012, June edition.

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Public-Sector Health Expenditure per Capita, U.S. Dollars, 30 Selected Countries, 2010

Mexico

Poland

Hungary

Israel*

Czech Republic

Portugal

Finland

Australia†

Iceland

Belgium

France

Germany

Switzerland

United States

Netherlands§

$0 $500 $1,000 $1,500 $2,000 $2,500 $3,000 $3,500 $4,000 $4,500 $5,000

$433$667

$995$1,020$1,037

$1,185$1,254

$1,351$1,578

$1,768$1,795

$2,267$2,422$2,443

$2,515$2,515

$2,662$2,857

$3,000$3,046$3,061

$3,158$3,331$3,349

$3,437$3,800

$3,967$4,021$4,050

$4,607

Average: $2,453

Notes* Data for 2009; † Data for 2008; § Current Expenditure (capital excluded).SourceOECD Health Data 2012, June edition.

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Canada and Comparable G7 Countries, 2010

Total Health Expenditure per Capita

(USD)

Total Health Expenditure

(Percentage of GDP)

Public Share of Total Health Expenditure

Public-Sector Health

Spending per Capita (USD)

Canada 4,445 11.4% 71.1% 3,158

U.S. 8,233 17.6% 48.2% 3,967

Germany 4,338 11.6% 76.8% 3,331

France 3,974 11.6% 77.0% 3,061

U.K. 3,433 9.6% 83.2% 2,857

NoteAll numbers represent 2010 data. Per capita spending was converted to U.S. dollars using purchasing power parities for GDP.SourceOECD Health Data 2012, June edition.

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The Road Ahead . . .

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Thank You