NCPA - National Center for Policy Analysis


September 16, 2005

The Canadian health care model is inferior to health care models in other countries of the Organization for Economic Cooperation and Development (OECD), say Nadeem Esmail and Michael Walker, authors of the Fraser Institute's 2005 report, "How Good is Canadian Health Care? An International Comparison of Health Care Systems."

In their study, Esmail and Walker examine the way health services are delivered in other nations, whether their policy choices differ from those in Canada and what the optimal policy choice is, based on various measures of access and health outcomes. They believe taking this empirical approach to health care provides clear direction for health care reform in Canada.


  • Estimates indicate Canada spends more on health care than all OECD nations with universal health care systems, except Iceland and Switzerland.
  • Canada does not rank first in any of the seven health care outcome categories or in any of the comparisons of access to care, supply of technologies or supply of physicians.
  • No country in the industrialized world other than Canada outlaws a parallel private health care system for their citizens.
  • All three countries that out-performed Canada on the cumulative rank for mortality amenable to health care, potential of life lost, mortality from breast cancer and mortality from colorectal cancer have private health care alternatives and some form of user fees at the point of access; none spend more than Canada after age adjustment.

The models that produce superior results and cost less than Canada's monopoly-insurer, monopoly-provider system have: user fees; alternative, comprehensive, private insurance; and private hospitals competing for demand. Esmail and Walker found overwhelming evidence that Canada's system of health care underperforms and needs to emulate the more successful models available elsewhere in countries offering their citizens universal access to health care.

Source: Nadeem Esmail and Michael Walker, "How Good is Canadian Health Care? 2005 Report: An International Comparison of Health Care Systems," Fraser Institute, Critical Issues Bulletin, July 2005.


Browse more articles on Health Issues