Canada at the bottom in 30 country health-care survey

Commentary, Frontier Centre, Healthcare

In terms of value for money, Canada ranks at the absolute bottom in a health-care comparison of 30 countries, according to a new report from the Stockholm/Brussels-based Health Consumer Powerhouse (HCP) and the Frontier Centre for Public Policy, released today.

The detailed comparison of healthcare in Europe and Canada ranks Canada 23rd for consumer sensitivity in healthcare. The Euro-Canada Health Consumer Index marks the first time that Canada is included in the comprehensive benchmarking exercise that analyzes consumer responsiveness among 29 national European healthcare systems.

“The news about medical outcomes is somewhat better, however,” Rebecca Walberg, one of the report’s researchers and the Social Policy Analyst at the Frontier Centre, said. “The 30 day mortality rate for Canadian patients who suffered a heart attack is a very low 11.1%, which indicates excellent hospital treatment. For infant mortality and cancer five-year survival rates, we are in the middle of the European pack.”

Health Consumer Powerhouse President Johan Hjertqvist said that the Index, which HFC first started producing in 2005, has led to significant changes in some EU countries. “Following the release of our 2006 European Health Consumer Index, the Danish government added more money to improve Danish healthcare. In Ireland, its poor ranking caused a media outcry and intense political debate that resulted in pressure for reform. In Sweden, significant steps toward public ranking of healthcare were also taken.”

The Index is based on the simple question: “How well are the needs of consumers met?”

In the area of patient rights and information, Canada lags far behind most of Europe, the report concludes. “Because our system is oriented towards providers,” Walberg said, “rather than the system’s users, consumers do not receive meaningful guarantees of timely and effective treatment. In successful European healthcare systems there are strong patient rights laws. Because Canadians lacks such rights, Canadians are treated as passive patients, rather than empowered consumers.”

Nowhere is this more apparent than with regard to waiting times, she said. “It’s certainly not news to Canadians that diagnosis and treatment waits in Canada are long. But it is a surprise to see that we finish at the very bottom of the Index in this area.”

One indicator of the generosity of a healthcare system, she added, is cataract surgery. “Canada received the highest score possible here. Unfortunately, as a whole, Canada provides much less to its residents than most European states.”

Pharmaceuticals is one area, she added, in which Canada performs poorly. While the top ranked healthcare states in Europe provide public funding for over 90% of all spending on drugs, in Canada just 38% of prescription costs are publicly paid. “This level of commitment,” she said, “gives us a failing grade in this area.”

“Furthermore, most provinces lack a publicly available formulary that explains in layman’s terms what drugs are covered, and under what circumstances. Compared to Europe, new drugs in general are available in Canada for over a year before they are eligible for public funding. Lowering the ceiling for drug subsidies, and promptly including effective new drugs in the formulary, would improve access and also outcomes.”

According to the Index, Canada’s performance is consistently between poor and adequate. The only countries doing worse, it points out, are rehabilitated former Iron Curtain states.

The Index includes a “Bang for the Buck” metric, which assesses each state’s performance in the context of how much is spent on healthcare per capita. From this perspective, Walberg said, Canada falls to the very bottom, getting the least value for money of all 30 of the countries analyzed.

“The Euro Canada Health Consumer Index shows that we do a mediocre job of fulfilling our commitment to excellent and accessible healthcare,” she said. “The Austrians, the French, and the Dutch enjoy better and more accessible healthcare than we do, and at a lower per capita cost. There is no reason why Canada cannot improve and reach a similar level, and the release of the Index marks an important new tool to use to this end.”

To download a copy of the Health Consumer Index, click here.

About Health Consumer Powerhouse

Health Consumer Powerhouse is the leading European provider of consumer information on health care. The Powerhouse is dedicating ideas and resources to the development of consumer empowerment action. We analyse health care and compare the outcomes, designing consumer information tools like health care system and Illnesses indexes, consumer press and education. We are a registered Swedish entity working from Stockholm and Brussels and soon also in Canada.

About the Frontier Centre for Public Policy

The Frontier Centre for Public Policy is an independent think tank with offices in Winnipeg and Regina. Its mission is to explore options for the future by undertaking research and education that supports economic growth and opportunity.