In The Line, Harrison Ruess points out how far down the international “league table” Canadian healthcare ranks, despite our fervent beliefs that it’s our healthcare system that somehow “defines” what it is to be Canadian (I’ve honestly never understood that particular belief):
Toronto General Hospital in 2005.
Photo via Wikimedia Commons.
Millions of Canadians are extremely proud of our health-care system. They defend it and are utterly convinced of its greatness. They react with hostility to any hint of change.
But on what basis could Canada make a claim to health-care greatness?
According to OECD data, on life expectancy Canada ranks 16th. On morality rates from avoidable causes, we’re 23rd. On cancer survival rates we range from 13th down to 18th, depending on the cancer type. On the number of one-year-olds vaccinated for diphtheria, tetanus and pertussis, we rank an abysmal 37th (even the U.S. is higher here at 27th. Gulp.). One area where we do rank closer to the top is spending as a proportion of GDP, where we sit at seventh.
In modern parlance of TL;DR, what the OECD data says is that Canada spends a disproportionately large amount of money to get strongly mediocre health outcomes.
For an overall picture we can look at the World Health Organization’s ranking system, which measures, “responsiveness (both level and distribution), fair financing, and health inequality, in addition to the more traditional goal of population health.” Here, Canada ranks 30th overall.
“But …” I’m sure you’re about to say … “Canada has universal health care!”
Yes. And that’s good. But the shortfall of that argument is that dozens of other countries have universal health care and many also have far better overall outcomes. In short, universal health care access is not a unique feature in Canada. For instance, a few notable countries from the WHO’s top 10 include France, Italy, Singapore, Spain, Austria, and Japan. These are hardly countries that let citizens go bankrupt or die in the streets when they need health care.
So why are we so darned committed to defending the Canadian status quo?
I genuinely can’t make sense of it. Canadians are smart, sensible people. We want the best for ourselves and our children. But at the same time, we have a very long history of refusing to change and improve our health care despite every piece of evidence that says we desperately must do better. The COVID pandemic has made this especially clear over the last couple years, but none of this is new.
As Robyn Urback recently asked in the Globe & Mail, “When do we admit Canada’s health-care system just isn’t working?” and as Matt Gurney pondered on TVO, “When can we start trying to make it [better]?”
