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Canada’s Expensive Health-Care System Ranks Poorly Compared to Most Developed Countries: Study

By Andrew Chen - November 9, 2021

Despite spending more on health care than most other high-income countries with universal coverage, Canada’s health system ranks poorly in comparison, having the longest wait times, with fewer doctors and hospital beds, and lagging behind on medical technologies, a new Fraser Institute study has found.

The study uses a “value for money” approach to compare the cost and performance of the universal health-care systems in 28 high-income countries, selected from the member states of the Organisation for Economic Co-operation and Development (OECD).

“There is a clear imbalance between the high cost of Canada’s health-care system and the value Canadians receive in terms of availability of resources and timely access to care,” said report co-author Bacchus Barua, director of health policy studies at the Fraser Institute, in a Nov. 4 news release.

The authors analyzed cost by using two indicators to measure the level of health-care expenditures in those 28 countries. Performance of those countries’ health systems was examined using 40 indicators representing the four broad categories of availability of resources, use of resources, access to resources, and clinical performance and quality.

According to the OECD’s latest data from 2019, Canada’s spending on health care as a share of its GDP (11.3 percent) is the second-highest among the 28 countries (after making adjustments for the percentage of the population over age 65), coming behind only Switzerland (11.4 percent).

Despite its high expenditures, Canada is seeing “generally worse” availability and access to medical resources compared to the other countries, the authors found.

Out of the 28 countries, Canada ranks 26th in terms of the number of doctors, 14th in the number of nurses, 25th in the number of acute beds, and 24th in the number of psychiatric beds.

Canada is also behind on medical technologies and equipment, ranking 21st out of 24 countries in the number of magnetic resonance imaging (MRI) machines, with 10.5 MRI units per million people. It ranks 22nd out of 26 countries in terms of CT scanners, with 15.2 scanners per million people, the study found.

As for patient wait times, the study ranked Canada last among 10 comparable universal health-care countries, with only 38 percent of patients waiting four weeks or less to see a specialist, and 62 percent waiting four months or less for elective surgery.

“Canada’s relative lack of critical resources and struggle with long wait times for treatment precede the COVID-19 pandemic,” said co-author Mackenzie Moir, a policy analyst at the Fraser Institute.

“To improve Canada’s health-care system in the post-pandemic world, policy-makers should learn from other successful universal health-care countries, for the benefit of Canadians and their families.”

Another report, published in September by the U.S.-based Commonwealth Fund, reached a similar conclusion.

The report compared the performance of the health-care systems of 11 high-income countries by analyzing 71 performance indicators across five key domains: access to care, care process, administrative efficiency, equity, and health-care outcomes.

It showed that, compared to the other countries, Canada’s health-care system has the second-lowest performance score overall as well as in terms of equity and health-care outcomes, ahead only of the United States for all three of those rankings. Canada, Switzerland, and France rank 10th, 9th, and 8th respectively in their overall scores.

The top three countries in terms of overall ranking are Norway, the Netherlands, and Australia.

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