Here’s a commentary by the good Fraser Institute’s Nadeem Esmail.
Date Published: November 6, 2009
News reports from across the country this week highlighted the plight of thousands of Canadians lining up and waiting for H1N1vaccinations while politicians of all stripes cast about for someone to take the blame.
Meanwhile, wait times for medically necessary health services across Canada continue to remain unnecessarily high, but you’ll find few politicians willing to discuss this issue in a realistic manner.
The Fraser Institute’s annual survey of hospital waiting lists released last week showed that total wait time in 2009 is still 73 per cent longer than it was back in 1993, despite the fact that health spending per person has increased by 41 per cent since then. Simply put, the public health care system is still failing Canadians.
That Canadians are required to endure a median wait time of 16.1 weeks from GP referral to treatment by a specialist in the developed world’s second most expensive universal access health care program should be considered unacceptable. So should the fact that wait times remain historically high in spite of substantial increases in health spending across Canada over time.
This second point is critical in understanding why the small reduction in wait times in 2009 compared to 2008 is not something to celebrate. Looked at another way, the 113 day total median wait time from GP to treatment in 2009 is the same as it was back in 2000-01, despite the fact that provincial health expenditures per Canadian have increased 29 per cent over that period, after adjusting for inflation. Canadians, through their tax dollars, are spending more than ever on health care and yet are experiencing wait times that are just as long as they were at the start of the decade, an outcome that is hardly a sign of success.
Despite a minor improvement in wait times and despite the many excuses offered by defenders of the status quo, Canada’s health care system is not delivering good value for taxpayer investments. Canada maintains a relatively expensive health care system yet leaves Canadians to endure relatively poor access to physicians and medical technologies, cares for them using far too many old and outdated pieces of medical equipment, and requires Canadians to suffer some of the longest queues for treatment in the developed world.
Importantly, there are seven developed nations who spend the same as or less than Canada on health care but manage to deliver universal access to health care services without queues for treatment. Patients in Austria, Belgium, France, Germany, Japan, Luxembourg, and Switzerland all receive wait-list free access to health care services regardless of their ability to pay.
These nations all share a common approach to health care policy based on private competition and appropriate financial incentives for patients and providers. That is, patients are free to choose for themselves whether their care provider will be a public or private hospital, all within the universal health insurance system. Patients in these nations are also free to purchase the care they desire privately if they wish to do so. Finally, patients must share in the cost of the care they consume, which encourages them to make more informed decisions about when and where it is best to access the health care system.
By pursuing an approach to health care policy that has often been falsely labelled as the “Americanization” of health care in Canada, these nations are able to deliver what many Canadians might consider the impossible dream: a wait-list free universal health care system for the same or less cost than Canada’s health care system.
This reality exposes the failure of Canada’s health care system when it comes to dealing with queues for medical treatment. The fact that wait times have fallen to the level experienced nearly a decade ago following sizable real increases in health spending is not a sign of sensible investments. Rather it is a clear indication that Canada’s health care system continues to fail Canadians.
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