What the data are
The tool combines two sources. Spending by function comes from Statistics Canada’s government finance statistics (table 10-10-0005), which classify every dollar of government expense by its purpose, following the international Classification of the Functions of Government (COFOG). It covers to . Health spending in more detail comes from the Canadian Institute for Health Information (CIHI), National Health Expenditure Database, : spending by who pays (public and private sectors, and provincial and territorial governments) and by use of funds, and provincial and territorial government spending by age and sex.
Governments
- All governments (consolidated): federal, provincial, territorial and local governments together. Transfers between governments (such as the Canada Health Transfer) are removed so that each dollar is counted once, where it is finally spent.
- All provinces and territories and each province or territory: provincial or territorial government spending consolidated with its local governments (municipalities and school boards). It includes spending paid for with federal transfers.
- Federal government: all governments less all provinces and territories. It is federal spending on federal programs (Old Age Security, Employment Insurance, the Canada Child Benefit, defence, public debt interest and so on), excluding transfers to other governments. Because it is a difference between two consolidated totals, a few small items are slightly negative.
Functions of government
Spending is grouped into ten functions, each with sub-functions: general public services (which include public debt interest), defence, public order and safety, economic affairs, environmental protection, housing and community amenities, health, recreation and culture, education, and social protection. Total spending is the sum of the ten. In Spending mix, the total breaks down into functions, a function into its sub-functions, and a CIHI health total into its uses of funds. Mix over time shows the same breakdown for one government across the years as stacked areas; as a composition, the areas add up to 100% of the total being broken down. Small negative items (residuals from consolidation in the federal series) are drawn as zero there.
Health spending (CIHI)
- All sources is total health spending in Canada, public plus private. Public includes provincial and territorial governments, federal direct spending (for example on First Nations and Inuit health, veterans and the military), local governments and workers’ compensation boards. Private is out-of-pocket spending, private insurance and other non-government spending.
- Provincial and territorial governments is what those governments spend on health, including spending financed by federal transfers. It is close to, but not the same as, the health function of all provinces and territories in Statistics Canada’s data (which also includes local governments and classifies some spending differently).
- Uses of funds are hospitals, other institutions (mostly long-term care), physicians, other professionals (dentists, physiotherapists and others), drugs, public health, administration, home and community care, other health spending, COVID-19 response funding and capital.
- CIHI’s figures for on are forecasts, marked with an asterisk (*).
Health spending and population aging
CIHI estimates provincial and territorial government health spending for 20 age groups of each sex, and spending per person in each group, from on. Dividing one by the other gives the population of each age-sex group (as CIHI counts it). For hospitals, other institutions, physicians, other professionals and drugs, CIHI allocates spending mainly using data on who uses each service. The rest of government health spending (public health, administration, capital and other) is shown as all other.
Spending per person in a province can rise because each age group costs more, or because the population shifts toward older, more costly ages. To separate the two, the tool holds the age-sex mix fixed at a base year you choose:
- Actual vs. with the base-year age mix shows both. The gap is spending due to the change in the age mix since the base year. Multiplied by the actual population, the second line is the counterfactual level of spending.
- Effect of aging is actual spending per person over spending with the base-year age mix, less one, in per cent.
- Demographic pressure index answers the reverse question: how much would spending per person have changed if spending per person in each age group had stayed at its base-year level? Base year = 100.
- Chained index measures the same thing one year at a time (each year’s age mix at the previous year’s costs) and links the steps together, so it doesn’t depend on which year is the base.
Comparing provinces with age-standardisation
Provinces with older populations need to spend more per person for the same care. Health by province removes that difference by applying each province’s spending per person in each age-sex group to Canada’s age-sex mix in the same year:
The bars show the age-standardised value and the markers actual spending. The table also shows a demographic need index: what each province would spend per person at Canada’s spending in each age-sex group, relative to Canada (Canada = 100). Above 100 means the province’s age mix is costlier than the national one. The territories’ age-standardised figures rest on small numbers of older residents and very high costs of delivering care in remote communities, so treat them with care.
The long series (experimental)
Statistics Canada’s functions-of-government data begin in 2008. The long series extends them back with two older Statistics Canada sources, which group spending into different, broader functions. It combines three sources:
- Public finance historical data (catalogue 68-512), covering consolidated spending of all governments and of provincial, territorial and local governments, .
- Financial Management System (FMS) data on consolidated government spending (table 10-10-0039), .
- Modern functions-of-government data, with estimated capital spending added, .
To link them:
- Eight broad groups. Several historical functions don’t match a single modern function, so the long series uses eight groups: general public services; defence, public order and safety; economic affairs; environment, housing and community amenities; health; recreation and culture; education; and social protection.
- An estimated concordance. Each historical function is assigned to the groups it can belong to. Where it could belong to more than one (for example, housing, or labour and employment), the shares are estimated by matching the older data to the newer data, by province, in the years where the sources overlap, while staying close to a conceptual starting point. Total spending in each year is unchanged; only its split across groups is estimated.
- Capital spending. The historical data include spending on capital assets, while the modern functions-of-government data record depreciation instead. To make the modern data comparable, the long series adds an estimate of capital spending, divided among the groups by estimated shares. Gross capital spending is estimated using year-over-year changes in nonfinancial assets plus consumption of fixed capital. It is an estimate, not a published measure of capital spending by function, so the modern line in the long series is higher than the Statistics Canada figures shown elsewhere in the tool.
- Years. The public finance historical data are labelled by the year in which each fiscal year begins (1965 is 1965/66).
- Governments. All governments (consolidated, excluding the Canada and Quebec Pension Plans), the federal government, and each province and territory with its local governments. All provinces and territories combined is available from the public finance historical data only. Before 1999, the Northwest Territories include Nunavut. In every source, the federal government is all governments less all provinces and territories (with local governments), as in the rest of the tool: its spending on its own programs, excluding transfers to other governments.
In Over time, each source is shown as a separate line (), and the years where sources overlap are shaded, so you can see how they compare. In Mix over time, the sources are joined into one series, using the newer source where they overlap: . The concordance rests on short overlaps and on judgement; treat it as illustrative, and be careful with changes across source breaks.
Units
- Per cent of total spending: a function as a share of the same government’s total spending. For CIHI data, a sector as a share of all health spending, or a use of funds as a share of its sector’s total.
- Dollars per person: divided by population (Canada’s for the federal and all-government series, the province’s own otherwise).
- dollars per person and millions of dollars: deflated by the consumer price index, with as the base year.
- Per cent of GDP: divided by nominal GDP (Canada’s, or the province’s own).
- Index, Canada = 100: a province’s value relative to Canada’s actual spending per person in the same year.
Population, GDP and prices come from the Finances of the Nation macroeconomic database. For the age-based health measures, per-person values use CIHI’s own population counts, so they can differ slightly from the per-person figures elsewhere in the tool.
Years
Years are as labelled by each source. CIHI reports calendar years, converting governments’ fiscal-year figures. Statistics Canada’s figures are by the reference year of its annual government finance statistics. The age-sex estimates run from to ; for the Northwest Territories and Nunavut they begin in 1999, since before then the Northwest Territories included Nunavut.
Comparability
Statistics Canada and CIHI measure health spending differently, so the health function and CIHI’s totals don’t match exactly. Provinces also organise and record spending differently (for example, how long-term care, home care and health authorities are classified), which affects comparisons of functions across provinces. Large one-time items, such as settlements of claims, can produce spikes in a single year.
Sources
- Statistics Canada, Table 10-10-0005-01, Canadian classification of functions of government, by consolidated government component.
- Canadian Institute for Health Information, National Health Expenditure Trends, open data Tables O.1 and O.2 ( edition).
- Statistics Canada, Public Finance Historical Data, 1965/66–1991/92 (catalogue 68-512), for the experimental long series.
- Statistics Canada, Table 10-10-0039-01 (consolidated government revenue and expenditures on the Financial Management System basis, to 2009) and Table 10-10-0147-01 (statement of operations and balance sheet), for the experimental long series.
- Finances of the Nation, macroeconomic database (population, GDP and consumer prices).
How to cite
Questions or comments? Please email Trevor Tombe (University of Calgary) at .
Licence
This tool and its dataset are licensed under a Creative Commons Attribution 4.0 International licence (CC BY 4.0). You may share and adapt them for any purpose, including commercially, as long as you give appropriate credit (see How to cite), link to the licence and say if you made changes. The underlying source data remain under their own terms: the Statistics Canada Open Licence, and the Canadian Institute for Health Information’s terms of use for its open data.