Canadian policymakers should learn from Australia’s health-care system
Faced with record high wait times, a majority of Canadians support partnerships between the government and private sector to deliver publicly-funded health care. And yet, advocates for the status quo—including the Trudeau government and several high-profile politicians—continue to criticize such arrangements. Public/private partnerships are the norm in many successful universal health-care systems worldwide.
Why look abroad for lessons? Put simply, when compared to other industrialized countries with universal health care, Canada underperforms, meaning there are opportunities for reform from simply observing how other countries provide universal health care.
In 2020, for instance, Canada’s health-care system was one of the most expensive in the world (when measured as a share of the economy) but achieved poor-to-moderate results on access to doctors and medical technologies such as MRIs, and ranked last when it came to of the share of the population receiving timely medical care.
One high-performing country that has many lessons for Canada is Australia. Of all the industrialized countries in the world, Australia is perhaps the most similar to Canada with respect to its culture, economy and even geography.
Although Australians generally spend less on health care (as a share of the economy), they outperform Canada on a number of key metrics. After adjusting for age (which is important when comparing countries because differences in ages can drive differences in overall health spending), Australia’s health-care system outperformed Canada’s on 33 (of 36) performance measures including the availability of physicians, nurses, hospital beds, CT scanners and MRI machines. Australia also outperformed Canada on the timeliness of non-emergency care and access to specialists.
In light of wait times in Canada, it’s worth reviewing some of the recent results for Australia. Data for 2020 (the most recent available) indicates that 66 per cent of patients in Australia were able to make a same-day appointment when they were sick compared to 41 per cent in Canada, indicating issues with access to family physicians here at home. Fifty-four (54) per cent of patients in Australia reported waiting less than four weeks for an appointment with a specialist compared to 38 per cent in Canada. And 72 per cent of patients in Australia reported waiting less than four months for non-emergency surgery compared to 62 per cent in Canada.
In other words, Australia outperforms Canada both in terms of access to health-care services and timely delivery of care. And yet, many Canadians continue to resist meaningful reform. But what does Australia do differently?
Unlike in Canada, Australia’s private sector plays a major role in the delivery of hospital care in their publicly-funded universal health-care system. Of Australia’s 1,355 hospitals in 2016 (the latest year of available data) almost half (48.5 per cent) were private. More importantly, in 2021/22 (the latest year of available data), 41 per cent of all care provided in a hospital took place in a private facility. And 70.3 per cent of non-emergency care that involved surgery occurred in a private hospital. Clearly, private hospitals play a large and important role in delivering non-emergency care in Australia.
The Canadian public has expressed a clear appetite for change that breaks with the status quo of simply increasing spending and avoiding fundamental reform. If policymakers in Canada want to emulate other high-performing universal health-care systems, they should look to countries such as Australia where patients benefit from more timely access to high-quality care and private hospitals play an important role in delivering publicly-funded care.
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