Sudden crises, such as hurricanes or the Greek debt crisis, produce fast reactions. Slowly worsening problems, however, are often left to fester until they become a crisis, by which time remedial action is painful and sometimes too late.

For some years now, we’ve had a slowly worsening problem of financing health care. Many people, including university health-care “experts” who dominated a lot of public debate about the issue, denied the existence of a problem. The Romanow Commission of 2002 ignored the challenge entirely. Politicians knew a problem was emerging, but were scared to talk about it, fearing public reaction. A few lonely voices tried to alert readers or listeners to the looming problem, but they were derided. The public was blissfully ignorant that health-care budgets were growing at an unsustainable pace.

Unsustainable, that is, provided we didn’t want governments to pay for health care’s higher costs with more borrowing. We could easily pay these higher bills with more taxes, but they would be politically explosive, as premiers who imposed health-care premiums discovered. Or, we could pay by curtailing other programs, which is what’s been happening by stealth to every provincial budget in Canada. Warning signs that this was occurring have been around for a long time, but they were ignored.

For example, 10 years ago, in 2000, the Conference Board of Canada did a report about health care in British Columbia. It said “expenditures on other programs, which include social services, education, police and economic development will need to be reduced” if the rhythm of health-care spending continued.

The board warned that the health budget, then about $8-billion in 2000, would hit $16-billion by 2020. The Conference Board got it wrong. B.C.’s health-care budget will be $16-billion in 2012-2013, eight years early.

Almost all of B.C. Premier Gordon Campbell’s budgets have touted the need to make the province the best-educated place in Canada. A very laudable and important objective, to be sure. Except that from 2000 to 2010, the province’s higher education budget grew by 36 per cent and the health-care budget by 84 per cent.

In this year’s budget, health care is going up $447-million, the last instalment of a three-year rise of $2-billion. To pay for this, the government is diverting all kinds of revenue into the system: all the extra money from the controversial harmonized sales tax, the tobacco tax, health-care premiums and $167-million from the provincial lottery, plus of course general tax revenues and $3.6-billion in health transfers from Ottawa.

While B.C.’s health-care budget jumps by $2-billion over three years, what about other spending? Adjusted for inflation, the following departmental budgets are falling: universities, children and family development, citizens’ services, K-12 education, forests, housing and social development, public safety, justice, tourism and culture. This profile of one budget rising while all others shrink is precisely what the Conference Board told British Columbians in 2000 they could expect.

Every area of B.C. public spending, except transportation, is falling while the health-care budget soars. The same pattern is reproduced in every province of Canada, and no provincial government has had the courage to try to change it.

This week, TD Economics produced a report about health-care in Ontario, recommending 10 steps to slow down the rate of increase. Quite aptly, the report observed, “it is quite likely that Ontarians have not come to grips with the potential risk to their future quality of life from the health-care Pac-Man.” For “Ontarians” substitute “British Columbians” and people in every province.

The Ontario government is floating a complete myth, presumably to comfort people and sugarcoat the raw numbers of what really lies ahead for the province. It promises to reduce health-care spending to 3 per cent increases within three years. This has never been done and, as TD Economics showed, cannot be done, given population growth, aging and the increasing use of the system.

Instead, health-care spending is likely to stay on the track of 6- to 7-per-cent yearly increases, compared to 4-per-cent increases in government revenues. Under that very hopeful scenario (Ontario will be lucky to see a 4 per cent increase in revenues), TD Economics says that in 2030, 80 per cent of the province’s budget will be devoted to health care. That prediction jibes with the one made by Ontario Finance Minister Dwight Duncan that if nothing changes, 70 per cent of the budget will go to health care by 2022.

What to do? The first and indispensable step is for politicians of every stripe to recognize publicly that the problem is becoming a crisis of public finance. If they don’t talk about the problem, citizens won’t pay attention.

The trouble is that politicians are scared of us and the powerful interest groups that will rally against change. Even the TD Economics recommendations, which don’t go far enough to solve the problem but are nonetheless useful starting points for discussion, would scare the wits out of most politicians.

We remain, alas, far from the “adult conversation” about health care that former Bank of Canada governor David Dodge correctly said Canada needs.