Every Canadian has a story about how the health-care system has failed them, whether it’s being turned away from every walk-in clinic they visit, searching for a family doctor or waiting months or even years for surgery to improve their quality of life.
There is something fundamentally wrong when the country with the fourth highest health-care spending as a share of GDP ranks second last on the Consumer Choice Center’s Healthcare Time Saved Index. The index relies on OECD standards for the average number of doctor visits a year, meta-analyses of waiting times in multiple countries, individual academic studies, official reports, other indices, general survey data and newspaper articles. It ranks 20 of the most advanced health-care systems according to a comprehensive set of 13 factors, ranging from potential time saved on an average telemedicine appointment to the availability of over-the-counter birth control.
No country got the maximum possible score of 75 points, showing there is always room for improvement. Denmark and the Netherlands share the top position, at 60 points, with Switzerland close behind at 55. Not all the Canadian news is bad. We offer easily accessible emergency contraception at the federal level and convenient access to pharmacy services, with 60 per cent of Canadians living not more than a kilometre from one. Overall, however, Canada registered the second-lowest score at 20 points, beating out only Ireland’s 15 points.
That isn’t surprising. Canada registers an average of 68 minutes for in-clinic waits, the highest in the rankings. We are also worst in terms of average wait times for an elective surgery appointment and third worst in time wasted on average appointments for non-chronic patients (those who have been sick for fewer than three months). In a ranking focused on efficient use of patients’ and medical staff’s time, a country where patients wait a median of 210 days for elective surgery and spend approximately 218 minutes a year on regular checkups isn’t going to do well. And, of course, the longer patients wait to be seen, the higher the chance their ailment worsens, further burdening an already broken system.
The good news is that Canadians don’t seem to be apathetic about this problem: 73 per cent want major reform, while 69 per cent are open to having private choices alongside the public system. Two countries Canadians often look up to in terms of quality of life, Switzerland and the Netherlands, are near the top of the index, in large part because of their decision to open up health care to private care. It is often feared that as private alternatives increase, low-income people will lose access, undermining equality. But that has not been the case in those two countries, nor in Quebec, which has successfully contracted private clinics to help clear out health-care backlogs.
OECD data show that 88 per cent of Swiss patients see their primary care doctor the day they request an appointment, with only 12 per cent waiting longer. In contrast, 68 per cent of Canadians wait more than two weeks to see their family physician. Just 25 per cent of Swiss patients wait more than a month for a specialist appointment, compared to 60 per cent of Canadians.
The secret of Switzerland’s success lies in mixing decentralized and private health-care provision with compulsory health insurance. Canadian hospitals rank low in the OECD in doctors, hospital beds and machinery per capita, but competition among Swiss services improves the quality of care provided. At the same time, no Swiss patient has to worry about being unable to afford health care, as the state has established an insurance floor.
The legal precedent for a similar approach is already set in Canada. Ever since the 2005 Chaoulli Supreme Court case, which argued that Jacques Chaouilli’s year-long wait for a hip replacement violated his rights under both the Canadian and Quebec charters, the Quebec government has sought to clear surgical backlogs by contracting private clinics, with one in six publicly-funded day surgeries in Quebec taking place in private clinics in 2023. Rather than destroy the public system, Chaoulli released the health-care pressure valve in a way that benefited long-suffering patients.
The Time Saved Index should act as yet another wake-up call to policy-makers. Most Canadians crave change and want more choices in their health-care system. All that’s lacking is the political will to turn things around.
Originally published here
