Health costs threaten N.B. solvency: ex-minister

New Brunswick must begin arresting the dramatic growth in health-care spending or the province may risk becoming insolvent, says a former health minister.

Dennis Furlong, a family doctor in Dalhousie and a former Progressive Conservative health minister, says in an analysis for CBC News that politicians and voters must stop the normal election debate over health funding.

"We need to stop hearing promises of more spending," Furlong writes.

"We need to start hearing politicians say, 'Vote for me I will make sure health care is sustained by not overfeeding it with money.'"

When Furlong was named minister of health and wellness in 1999, the department's budget was $1.5 billion. The New Brunswick government is budgeting $2.46 billion for health spending in 2010-11, almost a $1 billion increase in 11 years.

'Simply put, if we don't control health-care costs we won't be able to control provincial solvency.' Dr. Dennis Furlong

The upward trajectory of health spending is also increasing cost pressures on other parts of the provincial budget. While the Department of Health drains the most provincial dollars annually, the province's debt payments are the fourth biggest item in the budget, costing taxpayers an estimated $625 million in 2010-11.

Without halting the growth of health funding now, Furlong writes the New Brunswick government could face even tougher financial decisions, especially if interest rates go up as debt payments will balloon faster.

"Simply put, if we don't control health-care costs we won't be able to control provincial solvency," Furlong says.

System reforms

The physician, who has written a book on reforming the health-care system, is outlining a complex prescription of reforms for the health system.

Some of the most pressing changes must start from within the existing system, he says.

Furlong estimates that 15 per cent of services delivered in the system are frivolous and must be eliminated. But he is also warning citizens tough choices must be made on what the publicly-funded system pays for in the future.

"Society has some tough choices to make. For example, we have to rethink doing sophisticated technological investigations on people in their 90s who are in palliative care," Furlong writes.

"Do those procedures make any difference in that person living or dying? No they don't, but they surely increase costs."

There are other internal ways the provincial government can reduce costs, such as pushing forward with electronic health records, Furlong says.The New Brunswick government has announced a series of contracts to begin implementing an e-health system, although it has not yet been set up.

Expanding primary care

Furlong operates a rural medical practice out of the northern community of Dalhousie. It's offices like his that must be expanded if the system is truly going to be reformed, he advises.

Furlong said many doctors' offices are open about six hours a day, five days a week. And people needing a doctor must either wait until the next day to try and book an appointment or wait for hours in an emergency room.

These situations clog up expensive emergency room resources when they could be more efficiently handled in a different setting, the doctor writes.

"We cannot take our whole primary care system and have it operate between 9 a.m. and 4:30 p.m. and tell people that outside of those hours it's up to them," Furlong says.

"We need to stretch primary care to cover at least 18 hours a day and take the pressure off emergency rooms."

'Social inequity'

When Furlong isn't working in his office or at the local health centre, he is a tireless advocate for physical fitness and wellness.

Another way to halt the financial pressure being exerted on the health system by older citizens is by teaching younger citizens about healthy living. By the time people are sick later in life, many of the problems could have been caught decades earlier, according to the doctor.

But the problem is governments are too focused on spending limited health resources on the wrong age demographic.

"We cannot justify the massive amount of money spent on the last five years of life compared to the small amount spent on the first five years of life. This spending difference is a social inequity," Furlong writes.