As a follow-up to a previous post, I’d like to provide some more of my views on a possible re-alignment of universities in New Brunswick. Recent statements by politicians, newspaper editorials, and others have underlined the importance of research and development (R&D) to the future of the province. R&D is a source of innovative goods and services that can be exported globally and create high-wage jobs – something the province desperately needs. But how do we get more R&D investment in a province that is hard-pressed financially? In my opinion, we can get start down that road by re-designing the university system. But before we get to that, let’s look at some background information.
The Maritime Provinces Higher Education Commission (mphec.ca) provides data on student populations for all Maritime universities. Over the past decade, there has been a general downward trend in total (undergraduate and graduate) enrolment at New Brunswick universities. This trend can be seen in the chart below, where data for Université de Moncton (UDM – campuses at Moncton, Shippegan, and Edmundston combined), Mount Allison University (MTA), Saint Thomas University (STU), and the University of New Brunswick (UNB – Fredericton and Saint John campuses combined) are shown.
Ted Flemming, Minister of Health, has certainly received plenty of press recently. Praise from some, condemnation from others, and befuddlement from a few. He has engaged in a dispute with the province’s doctors over billing practices and wants to cap billing. What is he up to? It seems to me that Flemming is trying to portray doctors (who, let’s face it, earn far more than the average New Brunswicker) as major players in driving health care costs upwards. However, if we examine the inflation-adjusted data, physician payments have been fairly steady over the past few years. His other target, administration costs, also do not appear to be increasing, and, in fact, represent about 2% of the total health care expenditure. Drug costs and nursing home costs appear to be the major contributors to increasing health care expenditures over the past decade, although the largest proportion of the bill comes from hospital operations.
Doctors and administrators do share one thing – they are both seen as well-paid positions and thus are targets of populist anger. So is Flemming after credibility with the volatile populist voter? Is he trying to build up support amongst the public for a future bid for the Premier’s Office? Or is he just a loose cannon? We will have to wait and see, I guess.
Some observers have claimed that Flemming’s comments and his now – abandoned plan to eliminate student intern positions from doctor’s practices will discourage doctors from working in NB. That might be the case, and it might be a deliberate, albeit Machiavellian, strategy. After all, fewer doctors means fewer patients being examined and fewer tests being ordered. Perhaps the media should be asking some health care economists to weigh in on the issues of physicians per capita and salary vs fee-for-service as they relate to holding down health care costs.
Meanwhile, back at the Department of Health, I expect that those in charge of the two remaining health regions are occupied with things other than doctor remuneration. They have a mandate to hold costs down and their largest target is hospital operations. So, while Mr Flemming is entertaining the media with his ‘blunt talk’, they are deciding which ERs and which hospitals to close.