Reducing imaging costs in Manitoba, Canada

Manitoba, Canada, has serious debt and deficit problems and spends one-third of its revenue on health care. Manitoba Health, the single government carrier, has requested a 5-year management plan from the Provincial Imaging Advisory Committee to maintain and improve the present services within reduced funding [1]. The committee members are radiologists, nuclear medicine specialists, physicists, physicians, hospital officials, and senior government staff. In 1993, each Manitoba hospital prepared a 5-year plan for imaging equipment purchases based on projected patient and attending staff needs. The requests for services and new imaging technology exceed planned resource allocations. I was asked by Manitoba Health in July 1993 to prepare a cost restraint position paper with a target of 10% savings to help with government restraint and to allow some transfer of resources for continuing growth in imaging. The approach was to consult widely and to seek methods of significant cost savings that Canadian society might accept (Table 1). Areas of potential savings now are being considered by ad hoc committees appointed by hospitals and Manitoba Health. Several are being implemented on a trial basis.