NCPA - National Center for Policy Analysis


December 5, 2008

Canada's refusal to consider increased private sector involvement and competition in health care has left the country struggling with a health care system burdened with lengthy wait lists and aging medical technology despite being one of the most expensive systems among industrialized nations, concludes a new study by the Fraser Institute.

The peer-reviewed study, "How Good is Canadian Health Care?" compares Canada to other Organization for Economic Co-operation and Development (OECD) countries that guarantee access to health care insurance regardless of ability to pay.  Twelve indicators of access to health care and outcomes from the health care process are examined including access to physicians, access to high-tech medical equipment, and key health outcomes.  The United States and Mexico are not included in the study because they do not have universal-access systems.

According to Nadeem Esmail, one of the co-authors of the study:

  • Canada spends more on health care on an age-adjusted basis than any other industrialized nation with a universal access system except Iceland and Switzerland, yet Canada ranks near the bottom in terms of access to physicians and new medical technology.
  • Canada is the only OECD country that outlaws privately-funded purchases of core health care services.
  • In addition, nearly 85 per cent of the other OECD countries also charge user fees for access to health care services such as doctor visits and hospital care.

According to Esmail:

  • Health care costs can be significantly reduced if consumers of care have to participate in paying for the care they demand through some form of user fees.
  • More than three quarters of the universal-access countries in the OECD (including Canada) charge user fees for access to hospitals, general practitioners, or specialists-in many cases, to all three.
  • Low income citizens are often exempted from these fees.
  • And while many OECD countries rely principally on public hospitals to provide publicly insured services, more than half of the countries also permit private providers to deliver publicly funded care.

Every top performing OECD nation has some form of user pay, private provision health care. The evidence clearly shows these systems are delivering better results for their citizens. So why are Canadians so reluctant to consider these models?

Source:  New Release, "Canada needs to follow European example and increase private-sector involvement in health care," Fraser Forum, December 1, 2008; based upon: Michael Walker and Nadeem Esmail, "How Good Is Canadian Health Care? 2008 Report," Fraser Institute, December 1, 2008.


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