Another study has been released to the media to confirm what Canadians have known for some time: our health-care system sucks.
Ours isn’t the worst in the world, only the worst among many nations. When compared with 30 countries in the same developmental ballpark as our home and native land, Canada comes 30th. Yes, 30th. That’s how we finish in the “value-for-money” category of the medical sweepstakes. Dead last.
We do a little better in other categories, according to the Frontier Centre for Public Policy, the Canadian think-tank that released a joint report with the Stockholm/Brussels-based Health Consumer Powerhouse (HCP). Their current rating, the latest in a series that started in 2005, has the Canadian system 23rd in the area of “consumer sensitivity.”
There are, apparently, seven countries on the Euro-Canada Health Consumer Index whose health-care systems are even less user-friendly than Canada’s. That’s the good news. The bad news is most countries on the list, 22 to be exact, have systems that are more user-friendly.
Nothing to write home about, you say? Well, it’s good to know that in total points we’re ahead of Slovakia, Hungary, Romania, Lithuania, Poland, Bulgaria and Latvia. It means Canada beat most former Soviet bloc countries — all, really, except Estonia and the Czech Republic — in offering people medicine with a human face.
It’s all those pesky waiting times that drag us down, because in strictly medical terms Canada is doing OK. In the sub-categories of “outcome” Canada’s system is at least average — our five-year cancer survival rates put it in the middle of the pack — and when it comes to surviving heart attacks, we do better than most. In other words, our problem in Canada isn’t the quality of health care; the problem is getting to it. Our dilemma is access.
But then, as a poor man explained it once, that’s the problem with money, too: access. Money solves everything (well, most things, anyway) but how do you get your hands on it? Yes, there’s plenty in the bank, but they won’t let you have any.
There are plenty of specialists in the phone book, too — the problem is getting one to see you. The next problem is getting him or her to do something about what’s ailing you.
Last December, the venerable Fraser Institute released its latest study and found the magic distance between this country’s afflicted and healers was 18.3 — no, not yards, nor days, but weeks. That was the nationwide average. Canada’s queues have been steadily lengthening since the conservative think-tank began surveying them 17 years ago. The 2006 figure, a nationwide average of 18.3 weeks between referral to a specialist and climbing on the operating table, gave new meaning to the word “patient.”
It’s not simply private versus public health care. All 30 countries in the Euro-Canada Health Consumer Index have public health-care systems, based on what the authors of the report describe as either the Bismarck or the Beveridge model. The system named after the earliest exponent of social insurance, the Prussian aristocrat Prince Otto von Bismarck (1815-1898), splits funding and provision of services between independent organizations. In contrast, the system named after the British limousine socialist, Henry William, Lord Beveridge (1879-1963), unites them into one government-funded-and-delivered service.
“It is hard to avoid noticing,” write Johan Hertquist of Brussels and Peter Holle of Winnipeg, “that the Top 5 countries, which fall within 36 points of each other on a 1,000-point scale, have dedicated Bismarckian health-care systems.” Yes: it is hard not to notice. The best Beveridge-type system, Sweden’s, comes sixth overall. Canada’s Beveridge-type system, far from being the best, comes 23rd.
Why is Canada, one of the wealthiest and most resolutely humane countries on earth, in the bottom 10 when it comes to providing health care for its people? Maybe it’s because “our system is oriented towards providers rather than the system’s users,” as one of the report’s researchers, Rebecca Walberg of the Frontier Centre, puts it.
She points out that “in successful European health-care systems there are strong patient rights laws.” Hmm. I think the state wouldn’t have to empower people if it didn’t enfeeble them first. We wouldn’t need new “patient’s rights” if our ancient rights to freely choose and contract with each other were restored. We miss only the rights we had in Canada before the state decided to “protect” us.
What patients and providers need protection from in this country is the state.