The “Sustainability” Myth

The assertion that Medicare is “unsustainable” has been repeated so many times[1] that in some circles it has become accepted as indisputable fact. Critics[2] of Medicare assert that the cost of our public health care system is growing at an alarming pace. They are joined by provincial Premiers who are concerned that health care is taking up an increasing proportion of provincial budgets.[3] They claim that the cost of health care is rising faster than the pace of inflation and taking up an increasing share of provincial budgets. Extrapolations of future costs, based on these trends, lead to alarming assertions that health care could consume 70% of provincial tax dollars by 2022[4] and 80% of provincial budgets by 2030[5]. Critics warn that the depth of the crisis will inevitably increase, with a tidal wave of health care demand sweeping across the nation as baby boomers become seniors and overwhelm the system. With this supposed crisis looming, provinces have been forced, say critics, to reduce commitments to education[6] and municipalities[7]. 

These fears consistently lead to the claim that the only “adult” response is to break with what has for many decades been a fundamental priority in Canadian political life: the preservation of universal, publicly funded health care. Pundits claim that governments must “relinquish their monopoly over the market for medical insurance … raising funds from the private sector through private insurance, co-payments for publicly insured medical services, and deductibles linked to utilization”.[8] In short, critics assert there is no way forward but a repeal of the legislation that preserves our health care system – the Canada Health Act. 

Without such changes, critics tell us that governments will need to ration health care by increasing wait times and barriers, and by cutting quality, to make ends meet until they finally face “the facts”.[9]

While this argument is sufficiently compelling to have won it widespread repetition in newspaper reports and public commentary, it is not substantiated by the available evidence. In fact, it flies directly in the face of most reliable data on health care. As the flurry of media coverage and public debate accelerates around this cavalcade of inaccurate platitudes, it is hard not to be reminded of what H.L. Mencken warned many years ago, “There is always an easy solution to every human problem – neat, plausible, and wrong.”[10]

Download the full report here: Neat, Plausible and Wrong: The Myth of Health Care Unsustainability