Fraser Forum

Ontarians wait longer for health care than citizens of other universal health-care countries

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When the bar is low, it’s easy to present the picture of success. And in Canada, when it comes to wait times for health care, the bar is six feet under.

Last week, Premier Wynne’s government issued a news release extolling the benefits of their new health-care funding promises, while citing Fraser Institute research showing that Ontario has the shortest wait times for health care in Canada.

It’s true that, on average, Ontarians wait a shorter time (15.6 weeks) for health care than residents of other Canadian provinces according to our survey. However, Ontario’s record on wait times is nothing to brag about. Worse, the reality is that residents of all Canadian provinces—including Ontario—face much longer wait times for health care than citizens of other economically developed countries with universal health-care systems.

For example, a recent survey by the U.S.-based Commonwealth Fund examined Canada’s performance compared with 10 other affluent countries including Australia, the Netherlands and Switzerland. The comparison isn’t flattering for Canada.

The study finds that Canada tied for last place in terms of ability to get a same or next-day appointment when sick. Canada also finished dead last when in wait times for treatment in emergency rooms, waits to see specialists, and overall waits for elective surgery. Unsurprisingly, the same survey also reported that Ontario’s performance on most of those indicators was equally abysmal.

Of course, despite the upbeat tone of last week’s news release, Queen’s Park is likely well aware that wait times are a serious concern in the province—or at least that’s a premise for the additional funding promised in their budget. Unfortunately, while this funding may improve the situation at the margin, it fails to address the core issue, which is Canada’s unique approach to health care.

Consider that, unlike Canada, almost every other country that performed better than Canada in wait times in the Commonwealth Fund survey embraces the private sector for the financing and delivery of core medical services. For example, in the Netherlands, individuals must purchase insurance in a regulated market from a mix of public, private not for profit and for profit insurers. In Germany, about 40 per cent of hospitals are for-profit institutions—almost all of which are part of the country’s universal health-care framework.

Most of the countries also usually expect patients to share in the cost of treatment, helping temper demand. Furthermore, most of the higher-performing jurisdictions fund hospitals on the basis of activity, a strategy that rewards productivity, rather than through the global budgets routinely found Canada.

Unfortunately, rather than analysing and considering the introduction of such policies, Ontario’s government has chosen to simply throw money at the problem in the hope it will disappear. But that approach has been tried before. During much of the 2000s the provincial government increased health-care spending at an unsustainable rate that outpaced spending on other programs and the province’s economy. But as we have seen, all this extra money didn’t solve the problems, and Ontarians continue to wait months on end for medically necessary treatments while the province’s overall performance on wait times continues to lag behind other developed countries.

Ontario’s wait times for health care are the shortest in Canada, but they are still unacceptably long. Real policy reform is needed to fix this problem, not just self-congratulatory press releases and more money thrown at an underperforming system.


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