Ontario needs health-care reform not more billions from taxpayers

Last week, Ontario became the latest province to sign on to yet another multi-billion dollar health-care deal with the federal government. Media reports were full of the usual governmental claims this will improve access to health care for Ontarians—some commentators even suggested more money was needed to solve Ontario’s health-care problems.

But money is not the problem. Poor policy is the problem. Without meaningful reform, this agreement only increases the burden on taxpayers, both present and future given the sizable deficits being foisted on them by Queen’s Park and Ottawa, with limited benefit for patients.

In reality, Canadians already commit a larger share of their economy to health care than most other developed countries with universal access (after adjusting for population age, which affects health-care spending). Yet, for all this spending, Canadians get surprisingly little in return. Our health-care system ranks near the bottom internationally for the availability of doctors, hospital beds and advanced technologies such as MRI machines and CT scanners. Canadians also wait longer than their counterparts in other developed countries for specialist consultations and non-emergency surgery, with wait times reaching all-time highs year after year.

In other words, Canadians spend more, wait more, and get less. Again, splashy announcements of yet more money won’t solve that problem.

If spending (and borrowing) more money is not the solution to the problem, what is?

Consider the universal health-care experiences of Switzerland, Germany, the Netherlands and Australia, which all spend the same or less on health care than we do (as a share of the economy) and provide faster access to care than Canadians receive. Notably, all of them have chosen a different policy path than Canada.

These countries all have private competition in the delivery of universally accessible hospital and surgical care, rather than monopolistic government-operated hospitals. Hospitals are also paid for services delivered rather than through government-provided budgets, which are unconnected to ongoing patient care and actually discourage expansions in service. In all these countries, patients are free to seek care privately if they wish and are not shackled to the government system. And patients share the cost of their care, with reasonable limits and exemptions for certain populations such as lower-income families and patients with pre-existing health conditions.

In the narrow confines of the Canadian debate, defenders of the failed status quo denounce these polices as anathema to the ideals of universal health care. And the federal Canada Health Act, which regulates provincial health policy in exchange for cash transfers, disallows some of these policies including cost-sharing. Yet all these policies exist to varying degrees in every country that actually delivers on the promise of universal access to high-quality health care in a timelier manner.

The fact is, these policies work. And while they’ve worked for decades elsewhere, Canadians have been enduring ever-expanding wait times and ever-higher health-care spending.

Last week’s announcement by the Ford government is yet another example of governments doubling down on our expensive but failing health-care system with more taxpayer dollars. We already spend enough money on health care. To improve the system for patients in Ontario, the Ford government must push for reforms that would unlock the value of all that spending, not simply promise to spend more.