Lorne Gunter: Canada needs to look to public-private models to fix health care

Canada spends the second-highest percentage of its GDP on health care of any of the 32 industrialized countries with universal health-care systems.

Second highest.

So every time a politician or a health-care union, a provincial medical association or a friends of medicare group complains about the level of public funding in the Canadian system, you know they’ve identified the wrong cause for the deterioration in Canadian health care.

If public money was the measure of success, Canada would be near the top of the developed world. Instead, despite the vast sums of tax dollars we pump into care, Canada is near the bottom.

According to a new study by Vancouver’s Fraser Institute, Canada is 30th of 32 countries in number of doctors per capita. Can’t find a family doctor? The problem lies elsewhere than public funding.

We are 28th in medical imaging, such as MRI and CT scans, and 26th of 32 in acute-care beds.

France, Germany, Sweden and most other western countries have far better outcomes than we do.

The United States was not included in the Fraser study because it does not have a universal system, in which everyone gets treated regardless of his or her ability to pay. I am not comparing Canada to the U.S., which is what medicare advocates do to scare away the public any time someone says Canada’s system is dysfunctional.

This spring I spent 12 hours in a major hospital’s emergency room waiting to see a doctor. After I’d seen one, I spent three days on a gurney in a hallway waiting to be moved to an active-care ward. (At least I had a plug-in for my phone.)

I recount this tale of woe not to illicit your sympathy, but to recount how commonplace such care is.

Our ER waiting rooms are full of people who have waited half a day or more to be assessed. And stays of a day or more on a “hallway bed,” which is euphemistic name for a gurney, are too frequent, too.

On Wednesday, the Calgary-based think-tank SecondStreet.org published a report that says, “Canadian patients are waiting for at least 3.6 million surgical appointments, diagnostic scans, or appointments with specialists.”

That means at any one time nearly one per cent of the Canadian population — men, women and children — are waiting for critical care.

In Sweden, which spends roughly the same percentage of its national income on health care as Canada does, surgical wait times for joint replacements are only two-thirds of what they are here — 80 days versus 125. There are nearly twice as many doctors per capita and double the number of advanced medical scanning devices (which can speed treatment and make diagnoses more accurate).

So how come other universal-care nations do not have our expensive but teetering system?

Lately a lot of blame has been placed on the flood of immigrants the Liberals welcomed to Canada after the pandemic. And that’s part of it. No government can increase the population by nearly 10 per cent in a short time without severely straining social services such as health care.

The simplest reason, though, that Canadian health care is at the breaking point is the fact our universal health-care system remains a government monopoly. Not only do we insist government pay for everyone’s care (which isn’t a bad thing), we also insist a massive government bureaucracy deliver all the care, too.

In the other western countries that have universal care, many services are now provided by private clinics and providers, while still being paid for by government. Since the private-sector is more efficient at delivering most services, this makes sense.

For instance, few health services in the Swedish capital of Stockholm are delivered at government-run facilities anymore.

Until Canada allows a similar blend of public-private care, things will only get worse.

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