For many Canadians, our universal health care system is a source of national pride. But the head of a government-funded health care improvement organization says Canadaâs system barely ranks above that of the U.S. and lags far behind systems in Europe, where taxpayers get more care for their money.
Maureen OâNeil is the president of the Canadian Foundation for Health Improvement, a not-for-profit organization funded by Health Canada to evaluate ways to improve our countryâs health system.
She notes that experts weighing in on a global âhealth care tournamentâ voted to eliminate Canada in the first round. The tournament rankings, published found that, while the U.S. health system is âa bit of a mess,â expensive and non-universal, that country excels in medical technology innovation, has few delays, and good outcomes for patients.
Canada, on the other hand, was found to have profound âaccess problems,â so that nearly one in five Canadian patients wait four months or more for elective surgery.
Sharing her take on CTVâs Your Morning, OâNeil is not sure she can agree that the U.S. health system is better than the Canadian system.
âWe actually arenât inferior to the Americans,â she said Friday. âIn fact, if you look at all the comparisons that get made â by the Commonwealth Fund, by the OECD â Canada always does almost as badly as the U.S., but usually one or two (rankings) up.â
For example, by the Canadian Institute for Health Information (CIHI) using survey results compiled by the Commonwealth Fund found that Canadians experienced some of the longest delays to see specialists.
OâNeil agrees with the New York Timesâ assessment that Canadians wait far too long to see specialists. But she says the other reason countries in Europe typically outperform Canada is because their systems are more integrated, offering many kinds of health services for free.
The NYT tournament noted that Canada and Britain, for example, both spend slightly more than 10 per cent of their GDP on health care, but the British system is able to offer more health care services to its citizens. Brits donât need to buy supplementary health insurance the way many Canadians do if they donât have health coverage at work.
âWe donât cover dentistry, we donât cover physiotherapists, we donât cover psychologists⌠We donât have a broad enough range of things that we cover,â OâNeil said.
She says Canada has failed to create an actual, integrated health system; instead, we created a payment system. Our medicare system covers the costs of doctorsâ visits and hospital care, but other things like medications and home nurses get left out.
Lots of possible solutions have been proposed over the years, and âjust about everythingâ has been tried somewhere in Canada, OâNeil says.
She suggests one possible solution would be to make better use of home care and house calls, to keep more people out of hospitals and free up beds and resources for the most complicated cases.
âFor example, if youâve got lung disease, you can be helped at home much more effectively than at the hospital,â she said. âThat reduces the likelihood of you racing to the hospital, breathless. And if youâre not in the hospital, weâre spending less money on you and can spend more on appropriate care for someone else.â
When it comes to reducing wait times, OâNeil says one solution could be in finding ways of eliminating the need for patients and specialists to meet face-to-face.
âWe could have a system with a bank of specialists on call. A GP (family doctor) could call them and get advice within a day,â she said.
A review of a system in B.C. and Yukon called RACE () found family physicians reported that made to the hotline avoided face-to-face consultation and emergency department visits.
âSo there are solutions out there that can be spread,â she said.