On behalf of the Canadian Healthcare Association, I want to say that I am pleased to be here before the committee this morning.
The CHA is the federation of provincial and territorial hospital and health organizations across Canada. Our members represent the entire continuum of care, including acute, home, community, and long-term care. Representing over 900 hospitals and more than 4,700 health facilities, we bring a system-wide perspective—including the employer's point of view—to the discussion of how to secure Canada's place in a competitive world.
On the question posed by the committee of how to maintain the health of Canadians, the evidence is clear. All levels of government must continue to support a responsive, publicly funded health system, each according to its jurisdictional responsibilities and realities. Make no mistake, the federal government has a role to play. It must help to ensure access to a broad range of comparable health services for Canadians through appropriate funding linked to the Canada Health Act and pan-Canadian objectives.
In my remaining time, I would like to highlight six broad issues.
First, the health sector is an important contributor to the Canadian economy. Our publicly funded health system ensures the health of workers and provides a distinct competitive advantage to Canadian business. Look at the recent decision—and there are others—by General Motors to build the new Camaro in Oshawa. Lower employer health costs were a factor there. Health expenditures also create high-paying health sector jobs that in turn contribute to Canada's tax base
Second, health system expenditures are not spiralling out of control. In fact, the percentage of GDP expended on health services has remained relatively constant at approximately 9% to 10% over the last 15 years.
This brings us to the issue of the right balance of public and private funding. Three points, supported by statistics in our brief, are illustrative. Currently, approximately 70% of expenditures are publicly financed; 30% are private. Second, administrative costs are actually lower on the public side than on the private side. Also, inflation-adjusted private sector health spending has been growing more rapidly than public sector spending over the past 30 years, and this trend is accelerating.
The CHA does not regard private sector involvement as evil, but it is not a panacea to the challenges facing our health system. We support an evidence-based approach as to when and how private funding and delivery should occur. However, the private funding solution simply shifts a greater burden of health costs to the employers of this country and can harm our competitiveness, especially with the high dollar. As to private delivery, it depends on where and whether it's cost-effective and provides quality and accountability.
I should tell you that the American Hospital Association has expressed concern about private niche hospitals or clinics that achieve profit through cream-skimming or just doing the easy procedures and leaving patients who require complex care to full-service hospitals.
Turning now to wait times, this issue is complex and can be resolved only by using a multi-pronged approach. The solutions are included in our brief. Above all, we must look at not only the quantity of procedures but also quality and appropriateness. Should a wait times guarantee be included in the mix of strategies to reduce wait times, it would have to be carefully defined and travel adequately funded. It needs to be a safety valve, not an invitation to legal suits.
In the end—and we all know this—the real long-term solution to both wait times and managing public and private expenditures is to reduce demand by promoting wellness and managing chronic diseases. And we need to measure progress and performance in order to manage the future. For this I must signal the significant contribution of the Canadian Institute for Health Information in providing reliable data.
Looking beyond the issue of wait times, there is still unfinished business. One, substantial additional funding is needed for a comprehensive electronic health record. Two, home and community care for long-term or chronic populations, including support for family caregivers, needs to be addressed on a pan-Canadian basis. Three, increased support for the Canada social transfer as part of enhanced federal investments in the key determinants of health, such as education and social services, is needed. Four, we need a pan-Canadian health human resources strategy led by the federal government. Five, we've heard about research already. And six, we need to move quickly on a pharmaceutical program.
Detailed recommendations and amounts are in our brief. As well, we have some words on the fiscal imbalance issue, which I would ask you to review.
In conclusion, I'd like to say that a return to deficits is not an option, but this government does have the capacity to make the investments we recommend, and frankly, some other investments as well, but in the fiscally prudent manner that has become the hallmark of Canadian governments.
Thank you for your time. I look forward to answering questions.