Despite high health spending, Canada near bottom on doctors and wait times

by Leo Almazora25 Sep 2017
A new study from the Fraser Institute suggests that despite being a point of pride for Canadians, the country’s public health system isn’t delivering the level of care they’re paying for.

The newly released report, titled Comparing Performance of Universal Health Care Countries, 2017, compared 29 universal healthcare systems in developed countries. The areas studied include cost, availability and use of resources, access to care and treatment, clinical performance and quality, and patients’ health condition. The researchers studied data from 2015, the most recent year for which there is complete comparable data.

The researchers found that in 2015, Canada spent 10.6% of its GDP on healthcare, after adjusting for age. Only two countries outspent Canada in this regard: Switzerland (11.9%) and France (10.7%). The OECD (Organisation for Economic Co-operation and Development) average for age-adjusted healthcare spending as a share of GDP, according to the proponents of the study, is 9.1%.

Despite the high spending, the Canadian healthcare system ranked poorly on several indicators of resource availability. In terms of number of physicians, Canada placed 25th out of 29 with only 2.7 per 1,000 people; the OECD average was 3.4. As for the number of acute-care beds, the country was at the bottom with 2.1 per 1,000 people, compared to the OECD average of 3.8. In terms of availability of MRI scanners, the country ranked 20 out of 27 with 9.8 per million people.

The researchers had to work with limited wait-time information, as only 10 countries had data available. Among those countries, Canada did worst as it had the highest percentage of patients (30%) who waited two months or longer for a specialist appointment. It also got the highest percentage of patients (18%) who waited at least four months for elective surgery.  In terms of both measures, Germany did best; no German patients reported having had to wait more than four months for elective surgery.

In terms of quality and clinical performance, Canada did well on some indicators including rates of survival for breast and colorectal cancer, but was average or worse in seven other areas. For example, the country had 7.4 lower-extremity amputations related to diabetes, compared to the OECD average of 6.4%. The percentage of obstetric trauma for vaginal delivery among females 15 years old and above in Canada, meanwhile, was 17.1% for cases where instruments were used, compared to the OECD average of 6%; for cases without instruments, Canada got 3.1% compared to the average 1.7% found among OECD countries.

“Although Canada ranks among the most expensive universal-access health-care systems in the OECD, its performance for availability and access to resources is generally below that of the average OECD country, while its performance for use of resources and quality and clinical performance is mixed,” the institute said.


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