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using far too many old and outdated pieces of medical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.