Taking a Second Look at the Health Index

Commentary, Frontier Centre, Healthcare, Media Appearances

About a year ago the Frontier Centre for Public Policy released the first annual Euro Canada Health Index.

I wrote a column on it. The index compared the user-friendliness of Canada’s health care system with those of 29 European countries. The results were startling to many of my readers. Canada placed 23rd out of 30 countries. Given our high level of health care spending, when adjusted for “bang for the buck,” Canada ranked last. The column has generated such a passionate response that a second look at the index is warranted.

Let’s be clear about what is being measured here. The index did not measure clinical outcomes in the health care systems in Canada or Europe. This index ranks health care from the consumers’ perspective.

Here is how it works: a country is awarded points for health care quality indicators like wait times, access to medical records, patient rights and information, etc. Add up the points and you can determine which countries have the most user-friendly health care systems.

In this study, Austria was declared the winner followed by the Netherlands, France, Switzerland and Germany. The study said Austria has a generous health care system that provides good access for patients and very good medical results. On the other hand, from the consumers’ perspective, Canada’s health care system was found to be “sclerotic, inefficient and remarkably stingy.”

Most of my readers think that is nonsense and they have chastised me for not being more critical of this study. Well, maybe, but look at the data. When it comes to patient rights and information, Canada tied with Poland, ahead of only Latvia. And, Canada shared last place with Ireland and Sweden for wait times which the report called the “weak spot” in Canadian health care.

Given that there are currently more than 800,000 people on wait lists in this country, and that it’s not unusual for these waits to cumulatively exceed a year, the assessment on wait times in Canada seems to me to be bang on. This study isn’t an anomaly.

There have been other studies, by other groups and the results are always the same: when it comes to user-friendly health care, Canada lags far behind that which is commonplace in Western Europe.

The United States and Mexico were not included in the index because neither country has a publicly insured health care system. The Canadian health care system is publicly financed and governed. When looking at the rankings one can’t help but notice that the top five countries in the index have a mix of public and private health care providers. So, should privately operated health care facilities have a place within Canada’s publicly funded health system? Why not? We have that now.

The Canadian Health Coalition estimates that 30 per cent of what Canadians spend on health care is private expenditure. If you’re using a Care Card, as opposed to a credit card, to access health services it really doesn’t matter if those services are publicly or privately owned. As long as the provider of the service is reimbursed by the government and not by the patient, I don’t have a problem with private health care. I don’t have a problem accepting the results of the Euro Canada Health Index either. I’m neither shocked nor surprised by Canada’s ranking in the index. But I am disappointed.

Tom Carney is the co-ordinator of the Lionsview Seniors’ Planning Society. Ideas for future columns are welcome. Contact him at 604-985-3852 or send an e-mail to lions_view@telus.net.