So we're better than The United States, but should we really aim so low?
Those who suggest changes to the health care system are generally met with cries of "treason" and are invited to move south of the border. The superiority of our model to that of the U.S. has become such a part of our national identity that we've grown reticent to experiment with new ideas. Calls for reform invariably spark fears of a plot to put an end to the free system and make us more like the Americans.
Meanwhile, other nations in the advanced world are providing much better care than Canada. A study released Monday by the respected health care think tank The Commonwealth Fund ranked Canada's system 10th out of 11 wealthy nations, ahead of only the U.S.
The U.K., which spends roughly $1,000 less per person than Canada, ranked first.
The study notes a tendency to believe that there is an inevitable trade-off between a universal system and timely access to care. As such, Canadians often think that the long wait times and bureaucratic roadblocks we experience are simply the price we pay to have a system that is fair and free.
This was the debate that took place earlier this year when Canadian Dr. Danielle Martin testified in Washington D.C. about our health care system. Martin became an instant hero to Canadians for standing up to Republican Senator Richard Burr, but their exchange revealed some of the stale thinking around our health care model.
Burr: "On average how many Canadian patients on a waiting list die each year? Do you know?"
Martin: "I don't, sir, but I know that there are 45,000 in America who die waiting because they don't have insurance at all."
There it is. Those with private care in the U.S. think public care equals long wait times. Those with public care in Canada think private care equals an inequitable system.
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But the world tells us otherwise. The study points out that countries such as the Netherlands, the U.K. and Germany all provide universal access at a comparatively low per-capita cost while also keeping wait times short. And all three systems use a hybrid of private and public models to achieve the results.
But Canadians are unlikely to consider ideas from these countries because of the dreaded "private" element. Introducing any hint of private care into the system has become synonymous with "going American" and has thus become politically taboo. Worse, the private vs. public debate has become a barrier to change of any kind, preventing Canada from adopting best practices from around the world that have nothing to do with who pays for them.
The survey points out a number of key areas where Canada is lagging behind. Sick adults in Canada are "most likely to experience delays in being notified about abnormal [test] results." In fact, the study notes that "Canada ranks last or near-to-last on most measures of timeliness of care."
The state of affairs on health care has not been improving in Canada. In four previous Commonwealth Fund surveys over the past decade, Canada has always ranked second from last, ahead of only the U.S.
It doesn't have to be this way. Many of the nations that rank higher spend less money per capita than Canada. In short: their systems are just run more intelligently.
And yet since the Romanow Report in 2002 and the subsequent deal to increase health transfers to the provinces in 2004, Canada has not taken a serious look at reforming the system. The rankings should give us reason to reconsider our complacency.
Yes, the U.S. spends the most money on care to get the worst health outcomes in the advanced world, but America's failures are not our victory. Do we really want to settle for second worst?
It's time Canada looked at the rest of the world, free from the constraints of our "public vs. private" fixation, and adopted some ideas that actually work.
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