This report provides insights into the challenges the province faces in trying to rebalance its budget. Three scenarios are considered:

• Maintain the spending plan.
• Adjust for the aging population.
• Maintain recent spending growth.

These scenarios highlight the challenge of controlling health care spending growth, transforming the health care system in Ontario, and/or increasing available government revenues. And they show that if Ontario residents want continued strong funding growth for their public health care system, they will have to pay for it through higher taxes or accept big changes in the way publicly funded health care is delivered in Ontario.

Executive Summary

Chapter 1—Introduction

Chapter 2—Ontario’s Economic Outlook Over the Longer Term

• Demographic Assumptions
• Calculating Ontario’s Potential Output

Chapter 3—Methodology Used to Estimate Health Care and Education Spending Over the Long Term

• The Health Care Model
• The Education Model
• Forecasting Inflation
• Public Accounts Projections

Chapter 4—The Spending Scenarios and Results

• Introduction
• Scenario 1: Maintain the Spending Plan
• Scenario 2: Adjust for Aging Population
• Scenario 3: Maintain Recent Spending Growth
• Summary

Chapter 5—Conclusion

Appendix A—Ontario’s Potential Output

Appendix B—Methodology Used to Develop Wage Deflators

Appendix C—The Public Accounts Model

Appendix D—Methodology for the Second and Third Scenarios

Appendix E—Statistical Results