National Health Expenditure Trends, 1975 to 2016 Briefing Deck | December 2016 National Health Expenditure Trends, 1975 to 2016

The following slides are provided for reuse in your own presentations. Please cite as follows: Canadian Institute for Health Information. National Health Expenditure Trends, 1975 to 2016: Briefing Deck. Ottawa, ON: CIHI; 2016. Additional resources The following companion products are available on CIHI’s website: Report Data tables Infographics Talk to us For data-specific information: nhex@cihi.ca For media inquiries: media@cihi.ca cihi.ca

This presentation Key findings Looking forward How much is being spent on health care? How does health care spending compare across Canada? How does Canada compare internationally? Looking forward Issues to monitor in the future (Insert notes here)

Key messages: 2016 Modest growth trend continues, since 2011. Total health expenditure is expected to grow by 2.7%, reaching $228 billion in 2016, or $6,299 per person. The growth rate in health spending has barely kept pace with inflation and population growth combined. Provincial/territorial per capita health expenditures vary. In 2016, total health expenditure per capita ranged from $7,256 in Newfoundland and Labrador and $7,120 in Manitoba to $6,144 in Ontario and $5,822 in Quebec. Canada’s health care spending per capita is among the highest internationally.

Modest growth since 2011, similar to that experienced in the mid-1990s Notes * Calculated using constant 1997 dollars. See data table A.1 in the companion Excel file. Source National Health Expenditure Database, CIHI.

Health spending continues to vary across Canada

International comparisons: Fast facts Canada’s health care spending per capita is among the highest internationally. Canada is above the Organisation for Economic Co-operation and Development (OECD) average. The United States is the highest spender overall. Since 2009, the ratio of health spending to GDP has stabilized or been below its peak in most OECD countries. Canada’s experience is similar to that of other OECD countries, where the ratio is below its peak. The share of health spending financed by the public sector in Canada (71%) is lower than the OECD average (73%).

How does Canada compare internationally?

Looking forward

Population aging a modest but steady cost driver Notes AAG: Average annual growth. Total might not add up due to rounding. f: Forecast. Health spending data by age and sex is available up to 2014. Sources National Health Expenditure Database, CIHI; Statistics Canada.

Things to keep an eye on Modest economic growth, continued government deficits and reduced rate of growth in the Canada Health Transfer are potential dampeners of future health spending growth. New specialized drugs such as biologics and antivirals are putting significant pressure on both public and private drug programs. Population aging is a modest but steady cost driver. We may see both more rapid growth in the supply of physicians and higher demand for physician services from an aging population. There is a continued shift from hospital inpatient to outpatient care delivery.

More information The report National Health Expenditure Trends, 1975 to 2016 provides updated information on health expenditure in Canada. The annual report, infographics, presentations, methodology notes and up-to-date data tables are available at www.cihi.ca/nhex. Feedback and questions can be sent to nhex@cihi.ca.

The following slides present text alternatives for the images in this presentation for visually impaired users.

Text alternative for slide 5: Modest growth since 2011, similar to that experienced in the mid-1990s Average annual growth of total health expenditure per capita in Canada can be classified into 4 distinct periods of growth and decline, as described below: 1975 to 1991: This was a period of sustained growth in health spending. The average annual growth rate was 2.7%, with a spike of spending growth in the early 1980s. Mid-1990s: Total health expenditure declined by an annual average rate of 0.5% during this period of fiscal restraint. Late 1990s to 2010: This period of reinvestment in health care saw health spending increase by an average rate of 3.3% per year. 2011 to 2016: In this period of fiscal restraint, total health expenditure has declined by an annual average rate of 0.1%. 

Percentage of per capita growth Text alternative for slide 6: Health spending continues to vary across Canada Province/territory Cost per person Percentage of budget Percentage of per capita growth Canada (average) $6,299 38% 1.7% Newfoundland and Labrador $7,256 41% 2.6% Prince Edward Island $6,389 2.0% Nova Scotia $6,643 46% 1.0% New Brunswick $6,421 2.4% Quebec $5,822 30% 1.4% Ontario $6,144 1.1% Manitoba $7,120 42% 3.9% Saskatchewan $6,838 3.3% Alberta $6,995 1.9% British Columbia $6,214 43% 2.3% Yukon $12,429 22% 9.4% Northwest Territories $15,065 25% 2.7% Nunavut $14,301 27% 3.1% Notes Cost per person includes public- and private-sector spending, forecasted for 2016. Percentage of budget: Provincial/territorial government health spending as percentage of budget, forecasted for 2015. Source National Health Expenditure Database, Canadian Institute for Health Information.

Text alternative for slide 8: How does Canada compare internationally? Country Cost per person (Canadian dollars) Percentage of GDP Percentage public Percentage private OECD (average) $4,463 9.0% 73% 27% United States $11,126 16.6% 49% 51% Sweden $6,245 11.2% 83% 17% France $5,384 11.1% 79% 21% Germany $6,311 11.0% 85% 15% Netherlands $6,505 10.9% 81% 19% Canada $5,543 10.0% 71% 29% United Kingdom $4,896 9.9% 80% 20% New Zealand $4,361 9.4% Australia $5,187 67% 33% Notes Total current expenditure (capital excluded). Expenditure data is based on the System of Health Accounts. OECD: Organisation for Economic Co-operation and Development. 2014 is the most recent year of data available. Source OECD Health Statistics 2016 (June edition).

Text alternative for slide 10: Population aging a modest but steady cost driver Period General inflation Population growth Aging Other 2000 to 2010 AAG 2.4% 1.0% 0.9% 2.7% 2010 to 2014 AAG 2.0% 1.1% -1.3% 2015f 0.1% 0.5% 2016f 0.7% -0.4% Notes AAG: Average annual growth. Total might not add up due to rounding. f: Forecast. Health spending data by age and sex is available up to 2014. Sources National Health Expenditure Database, CIHI; Statistics Canada.