Everyone in Canada has heard alarming stories of people in the United States being presented with five- or six-figure bills for hospital care, and any hint that one of our provincial healthcare systems might move in that direction scares the pants off almost everyone. Politicians know this well, and salivate at the chance of deploying charges that their opponents favour “American-style” changes to our system because it’s a guaranteed vote-winner. None of it has to be true — very few Canadians know much about US systems aside from the horror stories — but it’s always effective.
In The Line, Harrison Ruess makes the sensible point that there are more healthcare systems in the western world than those of Canadian provinces and our closest neighbour:
Toronto General Hospital in 2005.
Photo via Wikimedia Commons.
First, to be emphatic on this point, we need to be realistic about where our system ranks globally.
It is truly bewildering to me the lengths that otherwise smart and empathetic Canadians will go to to defend the status-quo approach to health care in Canada. The results we get, versus the money we spend, is simply not brag-worthy. The argument that our system works great, if only we threw more money at it, doesn’t stand up to scrutiny.
Is our health care okay? Sure. Decent? Probably. Is it great? Hardly. Could we do better? Yes, much. Do we need to spend more? Maybe a tad, but not likely much, if any. To wit:
According to OECD data, on life expectancy Canada ranks 16th. On mortality 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 seventh.
World Health Organization (WHO) data wasn’t any more flattering, where Canada’s health care ranked 30th in overall performance despite being 10th in spending. The Commonwealth Fund ranks Canada 10th out of 11 in performance and 6th out of 11 in spending. In report after report Canadians aren’t getting the outcomes we need or want based on the money we’re spending on our current system.
Besides for reasons of nostalgia, why would anyone spend their energy defending these sorts of results? “We’re 16th! We’re 16th!” is hardly a chant you’d hear at a rally. It’s time to do better. And I get the feeling most people recognize this – certainly when you get onto Main Street.
Ipsos polling from December 2021 reported that 55 per cent of Canadians are “somewhat satisfied” with their health care, alongside 22 per cent that are “somewhat dissatisfied.” I.e. three quarters of Canadians find themselves in the middle of the road on the quality of our health care. This seems about right — mediocre support for mediocre health care. (The strongly satisfied and strongly dissatisfied were about even, at 12 per cent and 10 per cent respectively.)
But today Canadians are also, rightly, very worried. Leger polling in January 2023 showed that 86 per cent of Canadians are worried about the state of our health care.
