Canadian healthcare: another lost year
In 2008 the Health Consumer Powerhouse (HCP) and the Frontier Centre for Public Policy
presented the first Euro-Canada Health Consumer Index. This marked the induction
of Canada into a comprehensive benchmarking exercise that analyzes the consumer
responsiveness among 29 national European healthcare systems.
The Euro-Canada Health Consumer Index (ECHCI) was an alarm bell, as it showed that
Canada was placed in the bottom quarter of the Index – though it spent more money to
achieve worse results than a large number of European competitors. In specific:
• Canadians suffer from a healthcare system officially based on equity and solidarity –
but in reality it is a sub-standard one that denies Canadian healthcare consumers many
of the services taken for granted in Europe;
• Patient rights, access to information, and choice and services without delay are
underdeveloped in Canada and deliver low value for the money spent;
• The positive part of the comparison is that the quality of treatment – when delivered
– puts Canada on par with most European countries.
The authors believe in the power of benchmarks. The lesson from the HCP’s five years
of healthcare benchmarking is that comparisons count. Weak or excellent performances
among the national healthcare systems are highlighted as good examples. But to serve
the intended purpose, stakeholders must take action when the alarm bell rings.
The 2008 Index caused a stir within Canada. But that is far from enough. Governments,
patients and consumers now have a better foundation for taking action. This year’s Index
will provide additional fuel for that fire as it confirms the poor cross-Atlantic position of
Canada; 2008 evidently was no isolated poor score on Canada’s part.
Canada can ill-afford another lost year without closing the gap and the question remains:
why should Canadians be satisfied with a level of (poor) care that is becoming outdated
In this second annual Euro-Canada Health Consumer Index (ECHCI), Canada ends up in
23rd place. This year’s winner, the Netherlands, scores 824 points out of 1,000 edging
out runner-up and last year’s winner, Austria, by a margin of eleven points. Luxembourg
and Denmark take third and fourth place with 795 and 794 points, respectively.
In terms of medical outcomes, Canada compares reasonably well with the best
performing healthcare systems and on the generosity scale Canada collects an average
score. With respect to patient rights, waiting times and availability of pharmaceuticals
Canada places at the absolute bottom in the rankings.
Estonia prevails in the value-for-money-adjusted Bang-for-the-Buck index, while placing
11th overall in the ECHCI Index and competing very well with countries spending vastly
more per capita on healthcare. Taken together – Canada’s poor overall performance in
the Index along with a high expenditure on healthcare services – leads to Canada’s lastplace
ranking in the Bang-for-the-Buck index.