Canadians losing faith in our health-care system

According to a new Leger poll, two-thirds of Canadians worry they’ll be unable to access quality medical care when they need it. This is unfortunate but unsurprising news. Data have consistently documented a steady deterioration in timely access to care, with Canadians now facing the longest wait times in recorded history.

At 27.7 weeks, the median wait between referral to treatment is now almost three times as long as it was in 1993 when the Fraser Institute began publishing national estimates. And while the pandemic and ensuing backlogs have certainly made things worse, patients still faced a 20.9 week wait in 2019 before COVID.

It’s no wonder the Leger survey also found that “long waits” were the top phrase that came to mind for the majority of respondents (66 per cent).

To be clear, the current situation is not for a lack of funding. In 2021, the latest year of available data, among 30 high-income countries with universal health care, Canada ranked highest for health-care spending (as a share of the economy, after adjusting for population age) and ninth-highest on a per-person basis.

However, unlike our international peers with comparable spending, Canada had little to show for it. Canada ranked 28th (out of 30) for the relative availability of physicians and 23rd (out of 29) for beds. We also had fewer MRI and CT scanners—important diagnostic tools—per person than the average high-income universal health-care country, ranking 25th and 26th, respectively. In other words, we have relatively fewer resources to diagnose patients and prioritize care.

And again, for timely access to specialists and for non-emergency surgery, we ranked at the bottom (10th out of 10 countries with available data). Only 38 per cent of Canadians were able to see a specialist in four weeks, far less than in Switzerland (68 per cent) and the Netherlands (69 per cent). And only 62 per cent of patients in Canada received non-emergency surgery within four months compared to 99 per cent in Germany.

The difference? Countries that tend to outperform us—Switzerland, the Netherlands, Germany and Australia—take a remarkably different approach to universal health care.

First, these other countries have a different attitude towards the role of the private sector for the financing and delivery of universal care, including the private sector as a partner in the universal health-care framework or using it as a pressure valve to alleviate the burden on the public system.

Second, these countries incentivize the responsible use of resources by requiring patients to share the cost of treatment, but with generous exemptions for vulnerable populations.

And third, they fund hospitals based on activity to incentive treatment. This approach ensures that money follows the patient to where they’re treated, and contrasts with the outdated “global budget” model employed by Canada’s bureaucracy.

There’s no way for defenders of the status-quo to hide it anymore—Canada’s health-care system is a shambles and Canadians are losing faith in its ability to deliver care when they need it most. Instead of pumping more money into the system, we must look towards reform that prioritizes the welfare of the patient. Let’s use the best tools at our disposal, whether public or private, to actually deliver on the promise of universal care that we cherish so deeply.