By Mackenzie Moir
In light of regular reports of hallway health care, regular closures of emergency rooms, and the longest wait times for care on record, it’s understandable that Canadians want dramatic improvements to their health-care system. For governments, particularly during budget season, improvement often means an increase in spending.
However, Canada already ranks among the most expensive universal health-care systems in the world. In 2022 (the latest year of comparable data), and after adjusting for population age in each country, Canada ranked fourth-highest for health-care spending as a share of the economy (11.5 per cent). For per-person spending, Canada ranked ninth. In other words, whichever way you look at it, Canada ranked among the top-third of spenders among 31 universal health-care countries.
That’s a lot of money. But what do Canadians get in return?
Canada ranked near the bottom (28th of 30) on the availability of physicians. Canada also had some of the fewest hospital beds and diagnostic equipment (including CT scanners and MRI units) per person.
Moreover, among nine universal health-care countries surveyed by the Commonwealth Fund, a health-care research organization, 65.2 per cent of Canadian patients reported waiting more than one month for a specialist appointment (8th worst out of 9 countries) compared to 35.7 per cent in top-ranked the Netherlands.
We see the same thing for patients trying to access timely non-emergency surgical care. In Canada, 58.3 per cent of patients reported waiting more than two months (9th worst of 9 countries), far more than in the Netherlands (20.3 per cent), Germany (20.4 per cent) and Switzerland (21.1 per cent).
While Canada clearly struggles on measures of availability and timely access to medical resources, it reported mixed results in other areas. For example, Canada performed well on measures of heart attack survival (ranked 8th of 26). And while Canada had average performance for stroke survivability, it remained a bottom of the barrel performer on safety measures such as obstetric trauma during birth (23rd of 23).
With relatively fewer key medical resources and long waits for non-emergency surgery, patients in Canada face major challenges. And this budget season, while governments may be keen to simply spend more, in reality Canadians do not currently receive commensurate value for their health-care dollars. Without fundamental reform, based on the experiences of other more successful universal health-care systems, it’s unlikely we’ll see improvement.
Mackenzie Moir
Senior Policy Analyst, Fraser Institute
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