Health
Opening independent non-profit hospitals would improve access to care and efficiency in Canada’s healthcare system
From the Montreal Economic Institute
Autonomous non-profit hospitals tend to perform better than government-run hospitals, shows a study published this morning by the Montreal Economic Institute.
“Interminable waits in Canadian hospitals show that our healthcare systems are struggling to deliver basic services to the population,” says Emmanuelle B. Faubert, economist at MEI and author of the study. “By allowing independent non-profit hospitals to open, our governments would help increase treatment capacity, to the benefit of patients.”
In 2023, the median wait time in Quebec ERs was 5 hours and 13 minutes, up 42 minutes from five years earlier.
It is estimated that as a result of chronic overcrowding in Canadian ERs, there are between 8,000 and 15,000 avoidable deaths each year.
The Canadian health care system ranks 10th out of 11 comparable industrialized countries, just ahead of the United States, in the Commonwealth Fund’s ranking of healthcare systems. The French, German, and Dutch systems are 8th, 5th, and 2nd respectively in the same ranking.
While the Canadian system has no independent non-profit hospitals according to the OECD’s definition, such facilities account for 14 per cent of French hospital beds, 28 per cent of German hospital beds, and 100 per cent of Dutch hospital beds.
The researcher attributes a portion of the success of these facilities to their greater managerial autonomy and to a funding method that encourages the treatment of more patients.
“One of the strengths of these hospitals is how quickly they can adapt, contrary to facilities micromanaged by government ministries, as is the case in Canada,” explains Ms. Faubert. “Since their financing depends on the type and the quantity of ailments treated, administrators see the sustainability of their facilities as being directly linked to their capacity to treat patients.”
Although Canadian hospitals generally have their own boards of directors, the management of their daily activities and their funding are subject to strict government control.
Aside from certain limited experiments, notably in Quebec, Canadian hospitals still depend largely on a global budgeting model, in which funding depends entirely on the level of activity in the previous year.
Since the annual budgetary envelope is fixed, each additional patient is seen as a cost, says the researcher.
In Europe, in contrast, hospitals are largely financed according to an activity-based funding model, whereby a hospital receives a set amount of money for each treatment carried out within its walls. With this system, each additional patient treated represents an immediate source of revenue for the facility, says the researcher.
“It’s clear that our healthcare system can and must do better, and that means changing the incentives of those who manage it,” says Ms. Faubert. “By introducing non-profit hospitals, with a better funding model, and by granting health professionals more flexibility, we will be able to provide better care to more patients, as they do in Europe.”
The MEI study is available here.
* * *
The MEI is an independent public policy think tank with offices in Montreal and Calgary. Through its publications, media appearances, and advisory services to policymakers, the MEI stimulates public policy debate and reforms based on sound economics and entrepreneurship.
From the Fraser Institute
Canadians continue to endure long wait times for health care. And while waiting for care can obviously be detrimental to your health and wellbeing, it can also hurt your pocketbook.
In 2024, the latest year of available data, the median wait—from referral by a family doctor to treatment by a specialist—was 30 weeks (including 15 weeks waiting for treatment after seeing a specialist). And last year, an estimated 1.5 million Canadians were waiting for care.
It’s no wonder Canadians are frustrated with the current state of health care.
Again, long waits for care adversely impact patients in many different ways including physical pain, psychological distress and worsened treatment outcomes as lengthy waits can make the treatment of some problems more difficult. There’s also a less-talked about consequence—the impact of health-care waits on the ability of patients to participate in day-to-day life, work and earn a living.
According to a recent study published by the Fraser Institute, wait times for non-emergency surgery cost Canadian patients $5.2 billion in lost wages in 2024. That’s about $3,300 for each of the 1.5 million patients waiting for care. Crucially, this estimate only considers time at work. After also accounting for free time outside of work, the cost increases to $15.9 billion or more than $10,200 per person.
Of course, some advocates of the health-care status quo argue that long waits for care remain a necessary trade-off to ensure all Canadians receive universal health-care coverage. But the experience of many high-income countries with universal health care shows the opposite.
Despite Canada ranking among the highest spenders (4th of 31 countries) on health care (as a percentage of its economy) among other developed countries with universal health care, we consistently rank among the bottom for the number of doctors, hospital beds, MRIs and CT scanners. Canada also has one of the worst records on access to timely health care.
So what do these other countries do differently than Canada? In short, they embrace the private sector as a partner in providing universal care.
Australia, for instance, spends less on health care (again, as a percentage of its economy) than Canada, yet the percentage of patients in Australia (33.1 per cent) who report waiting more than two months for non-emergency surgery was much higher in Canada (58.3 per cent). Unlike in Canada, Australian patients can choose to receive non-emergency surgery in either a private or public hospital. In 2021/22, 58.6 per cent of non-emergency surgeries in Australia were performed in private hospitals.
But we don’t need to look abroad for evidence that the private sector can help reduce wait times by delivering publicly-funded care. From 2010 to 2014, the Saskatchewan government, among other policies, contracted out publicly-funded surgeries to private clinics and lowered the province’s median wait time from one of the longest in the country (26.5 weeks in 2010) to one of the shortest (14.2 weeks in 2014). The initiative also reduced the average cost of procedures by 26 per cent.
Canadians are waiting longer than ever for health care, and the economic costs of these waits have never been higher. Until policymakers have the courage to enact genuine reform, based in part on more successful universal health-care systems, this status quo will continue to cost Canadian patients.
Mackenzie Moir
Senior Policy Analyst, Fraser Institute
|
|
|
|
|
New RCMP program steering opioid addicted towards treatment and recovery
LA Mayor Karen Bass Makes New Demands Of Trump At Monday Night Press Conference
Natural gas pipeline ownership spreads across 36 First Nations in B.C.
We need an immigration policy that will serve all Canadians
RFK Jr. purges CDC vaccine panel, citing decades of ‘skewed science’
Letter Shows Biden Administration Privately Warned B.C. on Fentanyl Threat Years Before Patel’s Public Bombshells
Leftists devastate Los Angeles with fiery riots against Trump immigration policy
-
conflict2 days agoOne dead, over 60 injured after Iranian missiles pierce Iron Dome
-
Crime18 hours agoManhunt on for suspect in shooting deaths of Minnesota House speaker, husband
-
Business7 hours agoCarney’s European pivot could quietly reshape Canada’s sovereignty
-
Alberta7 hours agoAlberta’s grand bargain with Canada includes a new pipeline to Prince Rupert