Our Health Care Report Card

Media Appearances, Healthcare & Welfare, Frontier Centre


First the good news: An international survey of health outcomes finds some improvement in Canada, and the quality of our care is — once you get in to see a doctor — pretty good. But I rarely focus on good news — I’m a newspaper columnist, after all — so I’ve got some bad news as well. 
It’s that a survey of 34 countries shows Canada near the top of the pack for per-capita spending, but near the bottom for results. 
In other words, we pay for a world-leading health care system, but we don’t get it. 
The survey, done for the third year running by the Frontier Centre for Public Policy, spurns the usual measures of health care — money spent and resources available.
"Counting resource inputs such as hospital beds and doctors per capita does not tell us very much about the care that consumers actually receive," write the authors, Ben Eisen and Arne Bjornberg. "The amount of time the average person has to wait for an MRI is a much better indicator of health care quality than the number of MRI machines in a particular country."
So they looked at five measures that impact patients. They are:
– Waiting times, where Canada trails almost all of the 33 European countries in the survey.
– Patient outcomes, where Canada is closest to the other end of the spectrum — either "fair" or "good" for each subcategory measured.
– Range and reach of services where, despite the fourth-highest per capita spending, Canada is in the middle of the pack.
– Pharmaceuticals, where Canada tied with Lithuania for the lowest level of subsidizing needed drugs — a mere 45 per cent, compared with up to 90 per cent in most of Europe.
– Patient rights and information, where Canada’s performance is getting better, but is still well below most of Europe.
Add it up and Canada finished 25th out of 34 countries, essentially unchanged from last year, when we were 23rd of 32.
The nine countries we beat did not include France or Sweden or any of the wealthy ones with the pricey social safety nets. We can brag only that we finished better than, in order, Slovakia, Macedonia, Malta, Albania, Poland, Lithuania, Latvia, Romania and Bulgaria.
The Frontier Centre is often accused of having an agenda, and there’s no question it does favour market solutions.
This study, for example, makes a point of noting a correlation between high scores for delivering cost-effective health care and a competitive mixture of public and private providers of insurance and care.
And it states point-blank, "Canada’s health care problems do not stem from a lack of money, and it is therefore unlikely they can be solved by throwing money at (them)."
But the fact the authors manifest a point of view is no reason to dismiss their work lightly.
The things it focuses on aren’t the only health care measures that matter, but they are important.
And worrisome.
My own view of health care is that we should cherish and protect the universal accessibility we have in Canada, but we shouldn’t fixate on who delivers care.
It doesn’t matter if my life is saved or my hip is replaced by a public hospital or a private one. As long as it’s high quality and reasonably priced, may the best facility win.
But I suspect the lessons we could and should learn from the more cost-effective Europeans go well beyond our public-private debate.
And it will be a pity if they get lost in the ideological spats that dominate our health care discussions.