Health and Education | A shaky comparison between Quebec and Ontario

It’s always dangerous to compare Quebec to other provinces or countries without considering our specificities. Comparing is important, but sending the wrong signal doesn’t help anyone.

Posted at 6:30am

Of course, this risk of comparison also applies elsewhere, not just in Quebec.

The subject came to mind as I read the report Interprovincial Comparisons, published by Ontario’s reputable Financial Accountability Office (FAO). This office corresponds to the Parliamentary Budget Officer in Ottawa (which has no equivalent in Quebec). It reports to the Ontario Legislative Assembly.

In its report released on April 6, the FAO says Ontario has the lowest programming spend in Canada at $11,794 per capita, far behind Quebec at $15,124, which was on April 2e Rank of top donors. In particular, the FAO suggests that Ontario is extremely efficient in healthcare, with per capita spending of $4,800 – the lowest in Canada – or $1,938 less than Quebec, or 19%! Impressive!

When I read the numbers, which are based on Statistics Canada data, I thought to myself that we really sucked in Quebec. Especially since our services often fall short of our expectations, especially when compared to our neighbors including Ontario.

Ditto for education, where Quebec would spend more per capita than Ontario, while I always thought the opposite.

Hurry, reforms!

Actually not that fast. Specifically, to get to the bottom of the matter, I phoned experts in the field from the University of Sherbrooke’s Chair of Taxation and Public Finance (CFFP), led by Luc Godbout.

Luc Godbout and CFFP research expert Michaël Robert-Angers quickly spotted the error.

In Ontario, a non-negligible part of health services is the responsibility of the municipalities, which is not the case in Quebec.

In other words, it is impossible to properly compare provinces without taking provincial and municipal health expenditure together, which the Ontario FAO has not done. In doing so, the ranking changes radically, again thanks to data from Statistics Canada.

Thus, with the flawed approach of the BRF, Quebec appears to be spending 24% more than Ontario on its per capita health care expenditures. With the CFFP, the gap is reduced to 6%, with Quebec spending $5,754 per capita. Quebec goes from 2e 4th highest health care expenditure in Canadae Rank and its difference from the Canadian average is reduced to 2% instead of 12%. That definitely changes the picture.

Same phenomenon in education: the new comparative figures put Quebec at $2,498 per capita well below Ontario (13% difference), while the BRF comparison places us 3% above.

Obviously there are many other elements that could be considered. In education, private schools in Quebec reduce government spending with parents’ contributions. In addition, there are our school day-care centers. And then there are our CEGEPs, which come with huge costs. This is without considering tuition fees, which are much higher in Ontario than in Quebec. There are also other intangible elements that are more difficult to measure.

In short, a comparison is not easy, but comparing the CFFP seems much more realistic than that of the BRF. Suffice it to say that the Ontario government’s interest burden would be $834 per capita according to the BRF, half that of Quebec’s ($1,702), while Quebec now has a lower net debt than Ontario ($23,200) according to the two governments’ data. per capita versus $26,800). Find the mistake.

However, at the end of the day, Quebec still has higher healthcare spending than Ontario ($5,764 vs $5,419), according to the University of Sherbrooke CFFP. And you have to see that.

Different reasons could explain the difference without me being able to measure it exactly. Quebec has a prescription drug insurance plan while Ontario does not. Our population is aging and therefore costs more in healthcare. And there is the remuneration of Quebec doctors, which has become increasingly juicy over the years (but will be stable for the next few years, depending on the agreement).

The goal is not to claim that we spend less or better, quite the opposite. On the contrary, given our lower collective wealth as a percentage of GDP, our healthcare spending is higher (11% of GDP in 2020 compared to 9.2% in Ontario, according to the CFFP). The solution therefore does not include any new cash injection.

The fact remains that the differences are far from those presented to us by the Ontario BRF. And that the determination of the BRF does not help Quebec, Ontario or the other provinces.

I contacted the director of the BRF, Peter Weltman. He acknowledges that local government health spending was excluded from the analysis and notes that his mandate was to compare only provincial spending that closely approximates public finance figures.

He explains to me that no journalist has asked such specific questions. He acknowledges that FAO has taken a certain approach and indicates that he will take my suggestions into account in the next comparative analysis.

Leave a Comment