Our health-care sys­tem can do bet­ter


The Hamilton Spectator - - OPINION - John Roe

As proud as most Cana­di­ans are of their pub­lic health­care sys­tem many of us re­al­ize it could, with some ef­fort, be even bet­ter.

Alarm­ingly, a com­pre­hen­sive new re­port from south of the bor­der in­di­cates the room for im­prove­ment and the need for it to hap­pen are both enor­mous. Af­ter a study of 11 wealthy coun­tries, Canada was awarded the dis­mal rank­ing of ninth place by the Com­mon­wealth Fund, an Amer­i­can re­search foun­da­tion.

Only France and, per­haps pre­dictably, the United States fin­ished lower than us. And when it came to peo­ple’s ac­cess to health care, Canada was judged the sec­ond worst in the de­vel­oped world be­cause of its lengthy waits for ev­ery­thing from pri­mary care to emer­gency treat­ment, elec­tive surgery and long-term care.

Ab­sorb those words: Sec­ond worst in the de­vel­oped world. Maybe we have less to be proud of than our politi­cians tell us.

The Com­mon­wealth Fund re­port wasn’t dashed off on the back of an en­ve­lope af­ter a morn­ing meet­ing. It is an ex­haus­tive com­pi­la­tion of in­for­ma­tion that comes from Com­mon­wealth Fund sur­veys and groups such as the World Health Or­ga­ni­za­tion and Or­ga­ni­za­tion for Eco­nomic Co-op­er­a­tion and De­vel­op­ment. The 11 coun­tries were graded ac­cord­ing to 72 mea­sure­ments that were grouped into five cat­e­gories: care process, ac­cess, ad­min­is­tra­tive ef­fi­ciency, eq­uity and health-care out­comes.

When it came to care process and ad­min­is­tra­tive ef­fi­ciency, Canada fin­ished in sixth place or the mid­dle of the pack. And there is com­fort in know­ing Cana­di­ans re­ceive very good med­i­cal care — once they can fi­nally get it. But in the cat­e­gory of health-care out­comes, we were ninth. Canada’s in­fant-mor­tal­ity rate was 4.8 deaths for ev­ery 1,000 live births, the worst show­ing next to the U.S. Mean­while, 16 per cent of Canadian adults re­ported hav­ing two of five com­mon chronic con­di­tions. Once again, only Amer­ica was ranked lower.

This study leaves many tough ques­tions to be an­swered. One of the hard­est is: Why don’t we get a big­ger bang for our health-care bucks?

While Canada spent the equiv­a­lent of 10 per cent of its gross do­mes­tic prod­uct on health care in 2014, it was dra­mat­i­cally out­per­formed by Bri­tain, Aus­tralia, Nor­way and New Zealand, which all spent less. Th­ese coun­tries were re­spec­tively ranked first, sec­ond and tied for fourth. How do they do it?

For too long, Cana­di­ans have been con­tent to favourably com­pare them­selves with the Amer­i­cans who grap­ple with an ul­tra­ex­pen­sive, but prob­lem-plagued, health-care sys­tem.

It’s time to look at and learn from other coun­tries such as Bri­tain and Aus­tralia. It’s not nec­es­sar­ily how much you spend or how peo­ple pay that mat­ters, it’s how you de­liver that counts. Canada has a long way to go in what it de­liv­ers — a de­fi­ciency our fed­eral and pro­vin­cial lead­ers must fix.

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