This column was published in the New Brunswick Telegraph-Journal on July 18, 2019. 

During Bill Clinton’s 1992 presidential campaign, he ran on two foundational policy ideas: “(it’s) the economy, stupid” and “don’t forget health care.” They’re simple concepts. And they’re connected.

 That campaign headquarters in Little Rock, Arkansas, was about 3,000 km from Fredericton, but how true those words are in New Brunswick today. The province is facing health-care delivery challenges, which, due to an aging population, are likely to worsen. When looking for solutions, we should keep in mind that at the root, it’s the economy.

New Brunswick is facing a nursing shortage and it’s struggling to keep doctors let alone recruit them. Surgical wait times frequently double the national benchmark.

Nine out of 10 knee replacements take 454 days, compared to the national benchmark of 182 days. Based on your location within the province, the wait times could be even worse. In Miramichi, data shows it takes 692 days for nine out of 10 knee surgeries to be completed. For hip replacements, living in Fredericton will take your wait time to 629 days. That’s a lot of unnecessary suffering for New Brunswickers.

The New Brunswick Medical Society states that as of last year, more than 44,000 New Brunswickers don’t have a family doctor, and Medical Society CEO Anthony Knight says the province is at risk of losing doctors to the U.S. or U.K.

Among other issues, Knight cites New Brunswick’s high taxes as part of the problem in recruiting and retaining doctors.

“Taxation is a concern,” he told CBC News. “It certainly doesn’t help our case when we’re trying to attract physicians to New Brunswick.”

Taxes matter for competitiveness. Lower taxes help attract those with mobile professions to the province. More working professionals means more people paying taxes, which means more revenue for governments. More revenue for governments means better services. Increased economic activity overall makes New Brunswick a more attractive place to newcomers and further increases the potential for job and revenue growth.  

Doctors and nurses face many of the same challenges as other professionals in New Brunswick. The taxes are higher than other places they can live and work, making life less affordable and the province less attractive. The high taxes contribute to fewer people in their profession settling there, which makes their day-to-day work significantly more challenging, juggling larger, more complicated patient loads. 

The high taxes and lack of opportunity drive too many young, gainfully employed people out of the province. The number of births fell by 17 per cent to a new low in 2018. New Brunswick trails most provinces in population growth. Deaths in New Brunswick well outpace births.

Without that growing tax base of employed people to pay taxes which fund the province’s taxpayer-funded health-care system, the system is becoming even more stressed.

Solving New Brunswick’s health-care challenges will be complex. The government shouldn’t forget that focusing on pro-growth policies and lowering taxes can help. The last budget delivered no broad-based tax relief, but there’s no time for boldness like the present.

Lowering taxes and increasing competitiveness will make the province a more attractive place for all job creators and professionals – including health-care professionals. More people and more economic activity will generate more revenue to pay for health services.

The health-care system has many problems, but here’s a major piece of the puzzle: It’s the economy, stupid.

Paige MacPherson is Atlantic Director of the Canadian Taxpayers Federation.