Breaking Down Saskatchewan's COVID-19 Health Care Funding
Great news: Saskatchewan has TOO much money in health care. So then what's the problem? Who's the problem?
On April 14, 2021, Saskatchewan’s Minister of Health Paul Merriman dislocated all of his joints.
I’m assuming he did, anyway, given how hard he pretezeled himself trying to explain how he and Scott Moe used federal COVID-19 funds for health care during the pandemic.
So let’s start with the punchline - in its 2020-21 financial report, the Saskatchewan Health Authority reported a $1.5-billion surplus. At the end of that fiscal year, $366-million of that surplus was cash; $352-million in the bank and another $14-million in investments.
In the first full fiscal year of the pandemic only, the SHA carried a $120-mil (cash) surplus and an $80-million capital surplus. A total of $1.5-billion, when added to the SHA’s $1.3-bil accumulated surplus, which in addition to the cash is primarily comprised of its tangible assets (property).
I don’t think it can be overstated: at the end of fiscal year 2021, after twelve full months of pandemic chaos, including the rapid construction of two field hospitals, astronomical ambulance bills, half-dead workers and payment of hundreds of millions of dollars of health care worker overtime, $120-mil remained unspent in the Saskatchewan Health Authority’s budget.
Tangible capital assets, free and clear of debt, are a good thing. We get that.
A reasonable but low annual operating (cash) surplus, offset by the odd reasonable annual operating deficit, is also a good thing.
But the SHA holding cash in reserves equivalent to ten percent of the amount it receives annually from the General Revenue Fund (the taxpayer) seems like a bit much. Once again, it also seems highly unlikely that in what was a record-breaking, infrastructure-crushing year in Saskatchewan health care, the provincial health authority couldn’t find a way to spend $120-mil.
The SHA only has four sets of fiscal-year financials (available at this poorly-organized link), because it’s only four years old, but that’s enough to get a sense of how it manages its budget.
In 2017-18 and 2018-19 the SHA ran operating deficits of $7-mil and $29-mil.
On March 31, 2019 it had $206-mil cash on hand and $15-mil in investments.
In 2019-2020 and and 2020-21 the SHA ran operating surpluses of $65-mil and $200-mil.
On March 31, 2021 the SHA had $351-mil cash on hand and $14-mil in investments.
In 2020-21, the first fiscal year of the COVID-19 pandemic, the SHA ran approximately $650-mil over budget on its revenue forecast and $500-mil over budget on expenses.
There’s your unbudgeted surplus.
The SHA’s 2020-21 unbudgeted revenue came from the Ministry of Health, which got the funding from the federal government midway through 2020-21 (remember, the federal government’s Safe Restart funding program wasn’t launched until late summer of 2020). The SHA’s unbudgeted expenses in 2020-21 were all over the map, but prominently fell under acute (hospital, ER etc) and support services.
That all makes sense, because both the federal funding and hospitalization rates for COVID-19 didn’t start flowing until months after the SHA would have finalized its budget for that year. Without a doubt, however, the $120-mil operating surplus in 2020-21 was funded by federal cash.
Don’t just take my word for it.
This is Paul Merriman’s long-time deputy minister of health, Max Hendricks, jumping in when Vicki Mowat tries for the umpteenth time that evening to get a straight answer out of Merriman:
“…cost experience might differ…” 🧐
“…rough accounting….” 🤨
“…as long as we’re able to say…” 🤦🏻♀️
“…generally good with that…” 🤯
“… not really making an effort to align” 😂
My goodness gracious... have you ever heard such bureaucratic bafflegab in your life?
It’s a six-figure salaried public servant’s way of saying the Ministry of Health took a “bucket” of money from the feds and spent it where, when and however they wanted. Fine, but let’s be clear that any surplus healthcare cash came from the federal government.
By the way, Mowat’s reference in the meeting to $218-million reflects at least the fourth differing dollar amount provided by Hendricks or Merriman in that meeting, when trying to explain where they spent federal money.
I wanted to know how other provinces fared in the deficit vs surplus bracket.
(I’ve provided links to other province’s health care pages if you’d like to check my numbers, which I gathered from each province’s financials. Some provinces, like BC and Manitoba have half a dozen health regions, so I’m not linking to every report. Trust me or have a look yourself.)
Ontario Health has ran operating deficits or miniscule surpluses for the past four years. So has New Brunswick’s system and Manitoba’s.
Alberta, which operates under one health authority, ran moderate operating surpluses in 2016-17 and 2017-18, deficits in 2018-19 and 2019-20 and held on to a record surplus of $100-mil in 2020-21.
All of BC’s health regions ran cash surpluses that are four and five times higher than what they have in recent fiscal years.
This means in 2020-21, the first fiscal year of COVID-19, the feds gave BC, Alberta and Saskatchewan more additional funding for health than they could spend. There was no need for any province’s health authorities to hold on to cash as they all have plenty in reserves, though with $351-million, Saskatchewan’s health cash surplus is exponentially higher than any other province’s.
Yet BC, Alberta and Saskatchewan are the three premiers leading the charge at next week’s annual meeting of Canada’s premiers to demand even more money for health from the federal government? How dishonest is that?
To me, it feels like Kenney, Horgan and Moe know their health care systems are roaring dumpster infernos and are setting up the blame game.
At this point it’s worth mentioning that what these premiers are really asking for is more money from you. There is one taxpayer… yep, that’s you. It doesn’t make a goddamn bit of difference where provincial health authorities get their funding, because every penny of it came from you.
I think it’s also worth noting that once upon a time, that funding would have flown from the Ministry of Health to each Saskatchewan health region and that was where the political influence of the Minister and Ministry essentially began and ended.
Ministry-meddling in the actual operations of health care was unheard of until the Sask Party created the SHA four years ago, because the government doesn’t hire health care or medical experts to work in its Ministry of Health, it hires government employees.
That’s how Max Hendricks moved from the Ministry of Health to the Ministry of Finance - his government experience qualifies him to go there, not his health care experience.
Elected politicians, Cabinet Ministers in Saskatchewan used to recognize their limits. They recognized they were elected to do a very specific job, that does not involve political overreach into the daily operations of our infrastructure.
They recognized that single-handedly f**king up the health care system to the point of killing people isn’t exactly great for party or personal legacies. It’s not great for the history books, the writing of which we control, not them.
Congratulations Paul! The name “Merriman” will be famous around this province for years to come. Your dad must be so proud.
According to this May 27, 2022 story from Saskatchewan CBC, “Moe said the provinces are working to make the federal government "a fair and full funding partner in health-care delivery services across the nation.""
Cool, that’s awesome Scooter.
Now let’s talk about the fair and full funding of health care delivery services, or lack thereof, by your government.
At this point I’d normally share quotes from the Minister on the issue, which I would find in Hansard. I can’t do that for this piece. Parsing the sheer volume of bullshit that spilled out of Paul Merriman’s mouth in one of the only meetings in the last two years in which he’s had to publicly discuss COVID-19 funding would take way more effort than it’s worth.
I’ve referenced it extensively already. The meeting was on April 14, 2021 and you can read the transcript yourself if you like, but be warned that you’ll be exponentially stupider when you’re done.
No matter how many times he was asked, Merriman could not articulate how much money was spent on his Ministry of Health’s COVID-19 response. I’m pretty sure he couldn’t even articulate his first name in that meeting, actually.
Unfortunately, that’s it. That’s the uncomplicated story of federal funding for COVID-19 health care in Saskatchewan: we got money from the feds, we inexplicably didn’t spend all of it… but we’re demanding more.
“The finish line is in sight, and $90 million will be dedicated to continue to protect Saskatchewan people and provide ongoing robust, comprehensive COVID-19 response.” - that was how Paul Merriman described his government’s plan for the 2021-22 fiscal year.
He goes on to state that the funding was really only intended for the first six months of fiscal 2021-22, because in April 2021, as far as Merriman and Moe were concerned, the pandemic in Saskatchewan would be over by the fall of that year, after everyone had their second booster.
Yeah.
What a mess.
Bottom line is today Saskatchewan’s health care system is a smouldering pile of rubble and in classic Sask Party fashion, even after fifteen years in government running that health care system, they’re looking for a scapegoat.
Moe and Merriman are setting up a political defence for the inevitable flood of health care horror stories we’re going to start hearing, worse than any we’ve heard before.
It’s not governance, it’s political self-preservation… and people's lives have been lost unnecessarily for that self-preservation.
I’ve been writing about this government for seven years. I knew it was bad, but even I would never have predicted that I would write that the Sask Party would turn their backs on a single Saskatchewan resident and let him or her die, just so they could keep votes.
Worse yet, the Sask Party may be withholding funding from critical services like hospitals and health care in Saskatchewan, just so they can beef up their case that the Canadian Prime Minister is the root of all evil.
Starving out Saskatchewan health care and innumerable preventable deaths of Saskatchewan people, to own the Libs.
It’s appalling and if Saskatchewan residents accept that at face value and allow it to remain unchecked, well, then we’ve got the government we deserve.
The SHA’s financial report for 2021-22, which is due out any minute, and the accounting for the oil well reclamations will comprise the third part of this series, which will be out once the report comes out.
Have a great weekend,
