Canadians know more money won’t fix our health-care problems

The majority of Canadians believe the health-care system has deteriorated over the past 10 to 15 years, and are “not convinced that money is enough to solve the crisis,” according to a new poll recently released by the Angus Reid Institute. Indeed, 66 per cent of respondents believe “there are bigger challenges that money can’t fix.”

Clearly, Canadians know that money is not the problem. And it’s time governments focus on bold reforms to address the structural issues that plague our system.

In 2020 (the latest year of comparable data), Canada was the number one spender on health care (as a share of the economy) among 30 high-income universal care countries.

And yet, despite that high spending, Canada had some of the lowest availability of basic medical resources including physicians (ranked 28th out of 30 countries) and care beds (23rd out of 28). And we rank dead last (10th of 10) on timely access to specialists and surgical care.

Last year, the median wait for a patient from the time they met a family physician to the actual treatment was 27.4 weeks—6.5 weeks longer than the wait Canadians endured in 2019 and 195 per cent longer than the 9.3 week experienced in 1993. In other words, wait times in Canada have been worsening for decades.

The results from the Angus Reid survey reinforce the wait times data. For instance, the majority of respondents (60 per cent) indicated that getting an appointment with a specialist was either difficult or impossible, while 47 per cent reported the same for accessing surgery. Overall, only 16 per cent of Canadians reported having comfortable access to care.

So, if money alone is not enough to tackle this crisis, what’s to be done?

One potential solution is to embrace the private sector as a partner or alternative for the delivery of universal care. Doing so could help expand the supply of medical services and potentially reduce the burden on the government-run system.

The survey also suggests a great deal of misunderstanding about the potential role (and impact) the private sector could play in Canada, which is likely impeding reforms. Consider that private-sector involvement in the universal health-care system is the norm in countries such as Australia, Germany, the Netherlands, Switzerland, France and Sweden. And critically, all these countries have shorter wait times than Canada and spend less than Canada on health care (as a share of their economies).

Encouragingly, a majority of Canadians (56 per cent) are open to allowing for the private delivery of surgical care so long as government pays for the care, not out-of-pocket payments by individual Canadians.

This approach has already proven successful in Saskatchewan where in 2010 the provincial government introduced the Saskatchewan Surgical Initiative (SSI), a wait time strategy. One of the major initiatives of the SSI, which ran until 2014, was the delivery of publicly-funded surgeries through private surgical centres. Wait times decreased from 26.5 weeks in 2010 (the longest outside of Atlantic Canada that year) to 14.2 in 2014, second-lowest only to Ontario. And per-procedure costs in the private clinics was 26 per cent lower than in their government-sector counterparts.

Canadians agree; the health-care system has deteriorated and suffers from challenges that outstrip the ability of additional money to solve. Instead of spending more, politicians should examine a broader range of reform options and learn from the example of more successful universal health-care countries.