Health and education | A wobbly Quebec-Ontario comparison

It is always dangerous to compare Quebec to other provinces or countries without taking into account our particularities. Comparing yourself is essential, but sending the wrong signal doesn’t help anyone.

Posted at 6:30 a.m.

This danger of comparisons, of course, also applies elsewhere, not just in Quebec.

The topic came to mind while reading the report Interprovincial comparison, published by Ontario’s serious Financial Accountability Office (FAO). This office is the equivalent of the Parliamentary Budget Officer in Ottawa (which has no equivalent in Quebec). It reports to the Legislative Assembly of Ontario.

In its report released on April 6, the FAO says that Ontario has the lowest program spending in Canada, at $11,794 per capita, far from Quebec, at $15,124, which would arrive at the 2and rank of top spenders. 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%! wow!

When I read the figures, based on Statistics Canada data, I said to myself that we were really rotten in Quebec. Especially since our services are often not up to our expectations, especially compared to our neighbours, including Ontario.

Same thing for education, where Quebec would spend more than Ontario per capita, whereas I always thought the opposite.

Quick, reforms!

Not so fast, actually. To get to the bottom of it, I notably made a phone call to experts in the field, from the Chair in Taxation and Public Finance (CFFP) at the University of Sherbrooke, headed by Luc Godbout.

Quickly, Luc Godbout and research professional Michaël Robert-Angers, of the CFFP, saw the mistake.

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

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

Thus, with the flawed approach of the BRF, Quebec seems to spend 24% more than Ontario for its health expenditure per capita. With that of the CFFP, the gap is reduced to 6%, with expenditures in Quebec of $5,754 per inhabitant. Quebec goes from 2and ranked 4th highest health spender in Canadaand rank and its difference with the Canadian average is reduced to 2% rather than 12%. It definitely changes the picture.


Same phenomenon in education: the new comparable figures put Quebec at $2,498 per inhabitant, clearly below Ontario (13% difference), while the comparison of the BRF put us 3% above.


Obviously, there are many other elements that could be taken into account. In education, private schools in Quebec reduce government spending, with the contribution of parents. Our school daycare services add to the bill, however. And there are also our CEGEPs, which come with huge expenses. This is without taking into account university tuition fees which are much higher in Ontario than in Quebec. Added to this are other intangible elements that are more difficult to measure.

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

That said, according to figures from the CFFP of the University of Sherbrooke, Quebec still has higher health expenditures than Ontario, in the end ($5,764 versus $5,419). And you have to see it.

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

The objective is not to affirm that we spend less or better, far from it. On the contrary, given our lower collective wealth, measured by GDP, our health expenditures are heavier (11% of GDP in 2020 compared to 9.2% in Ontario, according to the CFFP). The solution therefore does not involve a new injection of funds.

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

I contacted the director of the BRF, Peter Weltman. He acknowledges that local government health expenditures were excluded from the analysis and indicates that his mandate was to compare exclusively provincial expenditures, close to public accounts figures.

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


source site-55