Published:December 20, 2021
The COVID-19 pandemic has once again revealed that Canadians pay among the highest costs in the developed world for health care, in return for mediocre results judged by international standards.
Clearly, we need meaningful and sensible reforms, not more political nostrums that Canadian health care is “free” and “the best in the world”.
It isn’t free, and it hasn’t been the best in the world — if it ever was — for a long time.
As the Fraser Institute recently reported, adjusted for the age of our population, we spent a higher proportion of our Gross Domestic Product on health care (11.3%) in 2019 than 27 other comparable countries that are members of the Organization for Economic Co-operation and Development.
Only Switzerland spent more at 11.4%.
The U.S. was excluded because it does not have universal health care.
Through taxes, Canadians spent $174 billion on health care in 2019 — this year it’s expected to be $191 billion — costing families anywhere from $726 to $41,916 annually in taxes, based on their incomes, with a family earning $75,300 paying an estimated $6,521 annually.
Since 1997, the cost of health care for the average Canadian family has increased 177.6%, compared to increases in average incomes of 109.9%.
The cost of health care Canadians pay through taxes has increased 3.4 times faster than clothing, 2.2 times faster than food, 1.7 times faster than shelter, and 1.6 times faster than income growth.
That doesn’t include the cost Canadians pay privately for medical insurance to cover uninsured services, nor the billions of dollars Canadians lose in wages and productivity every year because of long medical wait times for medically necessary surgeries, treatments, and diagnostic procedures.
Last year, in the first year of the pandemic, the median wait time in Canada was 22.6 weeks. This year, it’s estimated at 25.6 weeks — the longest ever.
Despite the high expenditures paid by Canadians for health care, Canada ranks 25th out of 26 comparable OECD countries in acute care beds per 1,000 population (2.0); 26th out of 28 in doctors (2.8); 14th out of 28 in nurses (10.4); 24th out of 28 in psychiatric beds (0.37); 21st out of 24 per million population in MRIs (10.5) and 22nd out of 26 in CT scanners (15.2).
Of 10 OECD countries with universal health care that track medical wait times, Canada finished last with the lowest percentage of patients waiting four weeks or less to see a specialist (38%), and the lowest percentage waiting four months or less for elective surgery (62%).
Canada finished in ninth place out of the 10 countries in patients being able to make an appointment with a doctor on the same day they’re sick, and eighth place in finding medical care after hours.
In August, the U.S. Commonwealth Fund compared Canada’s health care system to 10 comparable, developed countries — Australia, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the U.K., and the U.S.
It examined 71 performance measures in five categories: access to care, care process, administrative efficiency, equity, and health care outcomes.
Canada finished 10th, the U.S. last. Norway, the Netherlands and Australia were the top three.
This isn’t meant as a criticism of Canada’s medical professionals. To their credit, Canada has fared relatively well in the pandemic.
What it does show is that our template for funding health care is broken.
The question is what are other countries doing right, and what are we doing wrong?