Canadians have long felt a sense of pride in our health-care system — often comparing a free hospital visit here to the stifling bills our southern neighbours sometimes receive for the same treatment. However, when we use a wider lens that captures health-care systems available to many of our global peers, particularly in Europe, it becomes clear we don’t have much to be proud of.
TORONTO SUN COLUMN: Looking at global options to improve Canadian health care
In fact, nearly every other developed country that offers universal health care performs better than Canada.
Sure, many of us have had positive encounters with Canada’s health-care system, but there is a growing list of Canadians who are falling through the cracks, who are waiting months or years for appointments with specialists and who don’t have family doctors. It’s a problem poised to get even worse.
Canada has a growing population and we are faced with a significant aging population, both of which are already putting additional pressure on existing health-care providers.
And yet, politicians right across the country seem unable or unwilling to confront these challenges with any meaningful reforms.
That’s why SecondStreet.org launched a new documentary: Health Reform Now. It gives a voice to Canadians who have been let down by the health-care system and it speaks to experts and health-care providers to point to meaningful reforms — ones that are widely used in Europe to provide better care to patients.
One such reform would be implementing activity-based funding, a policy the Montreal Economic Institute and Fraser Institute have recommended for years.
Right now, hospitals in Canada are funded in large block grants, with one large lump sum providing the entire year’s operating budget. What that means, in practice, is that every patient a hospital treats is a drain on that budget. So the incentive is entirely backwards in terms of getting more people through the doors and into treatment.
What activity-based funding does is reverse that incentive structure. Instead, funding would follow the patient, meaning if a patient is treated, the health-care facility would be given a set fee to pay for that treatment. In practice, this means the more patients a hospital helps, the more dollars the hospital receives from the government.
This isn’t a new concept either. Rather, most countries that operate universal health-care systems follow a similar funding formula, tying tax dollars to treatment and results. Canada is a holdout here and there don’t seem to be any coherent arguments as to why.
We have seen the difference a simple reform like this can make in delivering health care to folks who need it. For instance, the Quebec government has used this funding policy to increase MRI scans by 22% while the cost per procedure decreased by 4%. This is the type of meaningful but simple reform that could be introduced across Canada to reduce wait times and encourage hospitals to be more efficient and patient-centred.
To be sure, there are many other proven reform measures discussed in the documentary that could reduce wait times for patients. Governments owe it to patients to pursue them and provide Canadians with the best health-care system in the world, not one where people get sicker or even die while they are stuck on a waiting list.
It’s time for health reform – now.
Harrison Fleming is the legislative and policy director with SecondStreet.org, a Canadian think tank.
This column was originally published on August 15, 2024.
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