Connect with us

Fraser Institute

Australia’s universal health-care system outperforms Canada on key measures including wait times, costs less and includes large role for private hospitals

Published

5 minute read

The Role of Private Hospitals in Australia’s Universal Health Care System

From the Fraser Institute

by Mackenzie Moir and Bacchus Barua

In the wake of the COVID-19 pandemic, provincial governments across Canada relied on private
clinics in order to deliver a limited number of publicly funded surgeries in a bid to clear unprecedented
surgical backlogs. Subsequently, surveys indicated that 78% of Canadians support allowing more
surgeries and tests performed in private clinics while 40% only support this policy to clear the
surgical backlog. While a majority of Canadians are either supportive (or at the very least curious)
about these arrangements, the use of private clinics continues to be controversial and raise questions
around their compatibility with the provision of universal care.

The reality is that private hospitals play a key role in delivering care to patients in other countries with universal health care. Canada is only one of 30 high-income countries with universal care and many of these countries involve the private-sector in their health-care systems to a wide extent while performing better than Canada.

Australia is one of these countries and routinely outperforms Canada on key indicators of health-care performance while spending at a similar or lower level. Like Canada, Australia ranked
in the top ten for health-care spending (as a percentage of GDP and per capita) in 2020. However, after adjusting for the age of the population, it outperforms Canada on 33 (of 36) measures of performance.

Importantly, Australia outperformed Canada on a number of key measures such as the availability of physicians, nurses, hospital beds, CT scanners, and MRI machines. Australia also outperformed
Canada on every indicator of timely access to care, including ease of access to after-hours care, same-day primary care appointments, and, crucially, timely access to elective surgical care and specialist appointments.

Australia’s universal system is also characterized by a deep integration between the public and private sectors in the financing and delivery of care. Universal health-insurance coverage is provided through its public system known as Medicare. However, Australia also has a large private health-care sector that also finances and delivers medical services. Around half of the Australian population (55.2% in 2021/22) benefit from private health-insurance coverage provided by 33 registered not-for-profit and for-profit private insurance companies.

Private hospitals (for profit and not for profit) made up nearly half (48.5%) of all Australian hospitals in 2016 and contain a third of all care beds. These hospitals are a major partner in the delivery of care in Australia. For example, in 2021/22 41% of all recorded episodes of hospital care occurred in private hospitals. While delivering a small minority of emergency care (8.2%), private hospitals delivered the majority of recorded elective care (58.6%) and 70.3% of elective admissions involving surgery.

Private hospitals primarily deliver care to fully funded public patients in two ways. The first is contracted
care, either through ad hoc inter-hospital contracts or formal programs. Fully publicly funded episodes of care occurring in private hospitals made up 6.4% of all care in private hospitals, while representing 2.6% of all recorded care. The second way is privately delivered care paid for through the Department of Veterans’ Affairs. A full 73.5% of care paid for by the Department of Veterans’ Affairs occurred in private hospitals.

It would be easy, however, to underestimate the significance of this public-private partnership by examining only the delivery of care that is fully publicly funded. Privately insured care is also partially subsidized by the government, at a rate of 75% of the public fee. Therefore, in order to understand the full extent of publicly funded or subsidized care in private hospitals, it is helpful to examine private hospital expenditures by the source of funds. In 2019/20, 32.8% of private hospital expenditures came from government sources, 18.2% of which came from private health-insurance rebates. This means that a full
third of private hospital expenditure comes from a range of public sources, including the federal government.

Overall, private hospitals are important partners in the delivery of care within the Australian universal healthcare system. The Australian system outranks Canada’s on a range of performance indicators, while spending less as a percentage of GDP. Further, the integration of private hospitals into the delivery of care, including public care, occurs while maintaining universal access for residents.


More from this study

Todayville is a digital media and technology company. We profile unique stories and events in our community. Register and promote your community event for free.

Follow Author

Business

Ottawa should end war on plastics for sake of the environment

Published on

From the Fraser Institute

By Kenneth P. Green

Here’s the shocker: Meng shows that for 15 out of the 16 uses, plastic products incur fewer GHG emissions than their alternatives…

For example, when you swap plastic grocery bags for paper, you get 80 per cent higher GHG emissions. Substituting plastic furniture for wood—50 per cent higher GHG emissions. Substitute plastic-based carpeting with wool—80 per cent higher GHG emissions.

It’s been known for years that efforts to ban plastic products—and encourage people to use alternatives such as paper, metal or glass—can backfire. By banning plastic waste and plastic products, governments lead consumers to switch to substitutes, but those substitutes, mainly bulkier and heavier paper-based products, mean more waste to manage.

Now a new study by Fanran Meng of the University of Sheffield drives the point home—plastic substitutes are not inherently better for the environment. Meng uses comprehensive life-cycle analysis to understand how plastic substitutes increase or decrease greenhouse gas (GHG) emissions by assessing the GHG emissions of 16 uses of plastics in five major plastic-using sectors: packaging, building and construction, automotive, textiles and consumer durables. These plastics, according to Meng, account for about 90 per cent of global plastic volume.

Here’s the shocker: Meng shows that for 15 out of the 16 uses, plastic products incur fewer GHG emissions than their alternatives. Read that again. When considering 90 per cent of global plastic use, alternatives to plastic lead to greater GHG emissions than the plastic products they displace. For example, when you swap plastic grocery bags for paper, you get 80 per cent higher GHG emissions. Substituting plastic furniture for wood—50 per cent higher GHG emissions. Substitute plastic-based carpeting with wool—80 per cent higher GHG emissions.

A few substitutions were GHG neutral, such as swapping plastic drinking cups and milk containers with paper alternatives. But overall, in the 13 uses where a plastic product has lower emissions than its non-plastic alternatives, the GHG emission impact is between 10 per cent and 90 per cent lower than the next-best alternatives.

Meng concludes that “Across most applications, simply switching from plastics to currently available non-plastic alternatives is not a viable solution for reducing GHG emissions. Therefore, care should be taken when formulating policies or interventions to reduce plastic demand that they result in the removal of the plastics from use rather than a switch to an alternative material” adding that “applying material substitution strategies to plastics never really makes sense.” Instead, Meng suggests that policies encouraging re-use of plastic products would more effectively reduce GHG emissions associated with plastics, which, globally, are responsible for 4.5 per cent of global emissions.

The Meng study should drive the last nail into the coffin of the war on plastics. This study shows that encouraging substitutes for plastic—a key element of the Trudeau government’s climate plan—will lead to higher GHG emissions than sticking with plastics, making it more difficult to achieve the government’s goal of making Canada a “net-zero” emitter of GHG by 2050.

Clearly, the Trudeau government should end its misguided campaign against plastic products, “single use” or otherwise. According to the evidence, plastic bans and substitution policies not only deprive Canadians of products they value (and in many cases, products that protect human health), they are bad for the environment and bad for the climate. The government should encourage Canadians to reuse their plastic products rather than replace them.

Continue Reading

Automotive

Governments in Canada accelerate EV ‘investments’ as automakers reverse course

Published on

From the Fraser Institute

By Kenneth P. Green

Evidence continues to accrue that many of these “investments,” which are ultimately of course taxpayer funded, are risky ventures indeed.

Even as the much-vaunted electric vehicle (EV) transition slams into stiff headwinds, the Trudeau government and Ontario’s Ford government will pour another $5 billion in subsidies into Honda, which plans to build an EV battery plant and manufacture EVs in Ontario.

This comes on top of a long list of other such “investments” including $15 billion for Stellantis and LG Energy Solution, $13 billion for Volkswagen (with a real cost to Ottawa of $16.3 billion, per the Parliamentary Budget Officer), a combined $4.24 billion (federal/Quebec split) to Northvolt, a Swedish battery maker, and a combined $644 million (federal/Quebec split) to Ford Motor Company to build a cathode manufacturing plant in Quebec.

All this government subsidizing is of course meant to help remake the automobile, with the Trudeau government mandating that 100 per cent of new passenger vehicles and light trucks sold in Canada be zero-emission by 2035. But evidence continues to accrue that many of these “investments,” which are ultimately of course taxpayer funded, are risky ventures indeed.

As the Wall Street Journal notes, Tesla, the biggest EV maker in the United States, has seen its share prices plummet (down 41 per cent this year) as the company struggles to sell its vehicles at the pace of previous years when first-adopters jumped into the EV market. Some would-be EV makers or users are postponing their own EV investments. Ford has killed it’s electric F-150 pickup truck, Hertz is dumping one-third of its fleet of EV rental vehicles, and Swedish EV company Polestar dropped 15 per cent of its global work force while Tesla is cutting 10 per cent of its global staff.

And in the U.S., a much larger potential market for EVs, a recent Gallup poll shows a market turning frosty. The percentage of Americans polled by Gallup who said they’re seriously considering buying an EV has been declining from 12 per cent in 2023 to 9 per cent in 2024. Even more troubling for would-be EV sellers is that only 35 per cent of poll respondents in 2024 said they “might consider” buying an EV in the future. That number is down from 43 per cent in 2023.

Overall, according to Gallup, “less than half of adults, 44 per cent, now say they are either seriously considering or might consider buying an EV in the future, down from 55 per cent in 2023, while the proportion not intending to buy one has increased from 41 per cent to 48 per cent.” In other words, in a future where government wants sellers to only sell EVs, almost half the U.S. public doesn’t want to buy one.

And yet, Canada’s governments are hitting the gas pedal on EVs, putting the hard-earned capital of Canadian taxpayers at significant risk. A smart government would have its finger in the wind and would slow down when faced with road bumps. It might even reset its GPS and change the course of its 2035 EV mandate for vehicles few motorists want to buy.

Continue Reading

Trending

X