Despite high spending, Canada’s health-care system is failing badly: op-ed In the pandemic’s wake, with mounting surgical backlogs, and nurses, Canada’s health-care system is teetering. While some hope we can spend our way out of this problem, a new report finds that Canada is already the most expensive health-care system in the world but has little to show for it.
Using data from 2020, the latest year of available comparable data, the (published by the Fraser Institiute) compares the spending and performance of 30 universal health-care countries in key areas of availability, utilization, access and clinical performance. In a departure from frequent (and ) comparisons with health care south of the 49th parallel, the analysis does not include the United States because according to the OECD the U.S.
did not have universal insurance coverage in 2020. Of the 30 countries with universal insurance coverage, Canada ranked as the highest spender on health care as a share of its economy (13.3 per cent) and 8th highest on a per-person basis (after adjusting for age).
- However, despite this spending, Canada’s performance was middling to poor.
- Our health-care dollars simply weren’t translating into resources and timely care.
- For example, Canada ranked 23rd out of 28 countries for the number of somatic care beds (i.e.
- Beds dedicated to physical care) on an age-adjusted basis.
Japan, the highest-ranking country, reported nearly 3.5 times more somatic care beds per 1,000 population. Canada also had far fewer physicians available (ranking 28th out of 30 ), MRI machines (26th out of 29) and CT Scanners (ranked 27th out of 30) than most other countries.
And although Canada’s nursing density was on par with the OECD average, this has likely now changed due to from the work force.) Obviously, a relative dearth of resources can contribute to long health-care wait times for Canadians. In 2020, according to from the Commonwealth Fund, Canada ranked dead last (10 out of 10) among universal health-care countries for both specialist appointment waits and receipt of elective surgery.
Only 38 per cent of Canadians reported waiting less than four weeks for a specialist appointment compared to 69 per cent of patients in the Netherlands. And 62 per cent of Canadians reported waiting less than four months for elective surgery compared to 99 per cent of Germans and 94 per cent of Swiss.
- Of course, many in Canada, including many politicians, want to blame COVID for our health-care woes over the last two years.
- But in reality, Canada’s wait times were already longer than its international peers before the pandemic.
- Notably, the previous Commonwealth Fund survey (in ) similarly ranked Canada dead last on waits for specialist appointments and elective treatment among 10 countries with universal health care.
Fortunately, it’s not all bad news. Canada fared better than the average universal country on survival rates for heart attacks (9th of 28), breast cancer (5th of 28) and rectal cancer (6th of 28). Unfortunately, Canada also reported the highest rate of obstetric trauma (during child birth) among 20 countries where data available, and statistically no different than the average for mortality after ischemic and hemorrhagic strokes.
- Clearly, these few bright spots for survival rates notwithstanding, our health-care system was struggling before the pandemic—despite a comparatively high price tag.
- If anything, COVID and the ensuing surgical postponements have pushed a faltering system over the brink.
- While other countries have faced similar challenges during the pandemic, many have built systems that deliver better performance at a similar (or lower) cost.
Canadian policymakers must learn from these countries to avoid a further erosion of our health-care system, with patients paying the price. : Despite high spending, Canada’s health-care system is failing badly: op-ed
Is Canada good for health care?
TORONTO, ON- OCTOBER 29 – American Senator Bernie Sanders talks at Convocation Hall to talk about, Canadian healthcare at the University of Toronto in Toronto. October 29, 2017. (Steve Russell/Toronto Star via Getty Images) Toronto Star via Getty Images Next week, the U.S.
Senate will return to work in Washington. Several key committees will welcome new leaders, including the Health, Education, Labor, and Pensions Committee, which will be led by Vermont socialist Sen. Bernie Sanders. Sen. Sanders has promised to make “universal health care” a focus of his tenure atop the HELP Committee.
He’s long been a fan of Canada’s single-payer system, wherein the government has a monopoly on paying for medically necessary care. But that system is crumbling. Canadian patients face record waits for both routine and emergency care. And they pay dearly for the privilege.
- Canada’s healthcare system, called Medicare, was once the country’s pride and joy.
- But as the program enters its seventh decade, public opinion is starting to turn.
- Just over half of Canadians said they were satisfied with their healthcare system in 2022, down from nearly 70% in 2020.
- It’s easy to see why.
Waits are interminable. In 2022, Canadian patients waited a median 27.4 weeks between referral from a general practitioner and receipt of treatment from a specialist, according to the Fraser Institute, a Vancouver think tank. That’s nearly two weeks longer than the median wait time in 2021—and almost triple the 9.3 weeks Canadians waited on average in 1993.
- And since private health insurance is illegal for care the government deems medically necessary, patients can’t pay a premium to escape the queue.
- Nor, for that matter, can doctors.
- They have one customer—the government.
- And that customer is committed to keeping a lid on costs.
- Canada spends 12.2% of GDP on health care; health care accounts for 18.3% of U.S.
GDP, by comparison. So Canadian doctors have to do more with less. And that’s pushing many to the brink. More than half of Canadian doctors reported burnout in 2021, up from just 30% in 2017, according to a recent Canadian Medical Association survey. Another survey found that over 75% of Canadian nurses “qualified as burnt-out in 2021.” And while doctors work an average of 52 hours a week, they spend just 36 hours treating patients, devoting a total of 16 hours to paperwork and other bureaucratic tasks.
Facing these onerous conditions, Canadian doctors are quitting the business. Nearly 20% of family doctors in Toronto are planning to shut their doors in the next five years, according to a study published in the journal Canadian Family Physician, Many are citing burnout as their reason for doing so. The Canadian Medical Association estimates some 5 million Canadians did not have a primary care provider in 2021.
The Children’s Hospital of Recent Ontario was so short-staffed this winter that the Canadian Red Cross needed to send reinforcement doctors. To add insult to injury, this shoddy “free” care actually costs Canadians a pretty penny. A typical family of four paid a whopping $15,847 in taxes just to cover the cost of public health insurance, according to research from the Fraser Institute.
- The Canadian health tax burden has surged in recent years.
- A childless couple who paid $8,225 in taxes for public coverage in 1997 pays around $15,229 today — an 85% increase.
- Not even these hefty taxes can keep Medicare running smoothly.
- Provincial leaders are asking the Canadian government to cover 35% of healthcare costs, up from the 22% they currently cover.
But 57% of Canadians say the current spending rate is already unsustainable, and experts agree. As Steven Staples, national director of policy and advocacy for the Canadian Health Coalition, put it, increasing funding to Medicare at this point is like “pouring hot water into a leaky bathtub.” Rather than doubling down on failed and expensive socialized medicine, Canadian leaders need to consider lifting the ban on private health coverage and allowing market forces to repair some of the nation’s broken healthcare system.
Why is healthcare better in Canada than us?
21 Ways the Canadian Health Care System is Better than Obamacare By – Dear America: Costly complexity is baked into Obamacare. No health insurance system is without problems but Canadian style single-payer full Medicare for all is simple, affordable, comprehensive and universal.
- Below please find 21 Ways the Canadian Health Care System is Better than Obamacare.
- Repeal Obamacare and replace it with the much more efficient single-payer, everybody in, nobody out, free choice of doctor and hospital.
- Love, Canada
- Number 21: In Canada, everyone is covered automatically at birth – everybody in, nobody out.
- In the United States, under Obamacare, 31 million Americans will still be uninsured by 2023 and millions more will remain underinsured.
- Number 20: In Canada, the health system is designed to put people, not profits, first.
- In the United States, Obamacare will do little to curb insurance industry profits and will actually enhance insurance industry profits.
- Number 19: In Canada, coverage is not tied to a job or dependent on your income – rich and poor are in the same system, the best guaranty of quality.
In the United States, under Obamacare, much still depends on your job or income. Lose your job or lose your income, and you might lose your existing health insurance or have to settle for lesser coverage. Number 18: In Canada, health care coverage stays with you for your entire life.
- In the United States, under Obamacare, for tens of millions of Americans, health care coverage stays with you for as long as you can afford your share.
- Number 17: In Canada, you can freely choose your doctors and hospitals and keep them.
- There are no lists of “in-network” vendors and no extra hidden charges for going “out of network.” In the United States, under Obamacare, the in-network list of places where you can get treated is shrinking – thus restricting freedom of choice – and if you want to go out of network, you pay for it.
Number 16: In Canada, the health care system is funded by income, sales and corporate taxes that, combined, are much lower than what Americans pay in premiums. In the United States, under Obamacare, for thousands of Americans, it’s pay or die – if you can’t pay, you die.
That’s why many thousands will still die every year under Obamacare from lack of health insurance to get diagnosed and treated in time. Number 15: In Canada, there are no complex hospital or doctor bills. In fact, usually you don’t even see a bill. In the United States, under Obamacare, hospital and doctor bills will still be terribly complex, making it impossible to discover the many costly overcharges.
Number 14: In Canada, costs are controlled. Canada pays 10 percent of its GDP for its health care system, covering everyone. In the United States, under Obamacare, costs continue to skyrocket. The U.S. currently pays 18 percent of its GDP and still doesn’t cover tens of millions of people.
- Number 13: In Canada, it is unheard of for anyone to go bankrupt due to health care costs.
- In the United States, under Obamacare, health care driven bankruptcy will continue to plague Americans.
- Number 12: In Canada, simplicity leads to major savings in administrative costs and overhead.
- In the United States, under Obamacare, complexity will lead to ratcheting up administrative costs and overhead.
- Number 11: In Canada, when you go to a doctor or hospital the first thing they ask you is: “What’s wrong?”
- In the United States, the first thing they ask you is: “What kind of insurance do you have?”
- Number 10: In Canada, the government negotiates drug prices so they are more affordable.
- In the United States, under Obamacare, Congress made it specifically illegal for the government to negotiate drug prices for volume purchases, so they remain unaffordable.
- Number 9: In Canada, the government health care funds are not profitably diverted to the top one percent.
In the United States, under Obamacare, health care funds will continue to flow to the top. In 2012, CEOs at six of the largest insurance companies in the U.S. received a total of $83.3 million in pay, plus benefits.
- Number 8: In Canada, there are no necessary co-pays or deductibles.
- In the United States, under Obamacare, the deductibles and co-pays will continue to be unaffordable for many millions of Americans.
- Number 7: In Canada, the health care system contributes to social solidarity and national pride.
- In the United States, Obamacare is divisive, with rich and poor in different systems and tens of millions left out or with sorely limited benefits.
- Number 6: In Canada, delays in health care are not due to the cost of insurance.
- In the United States, under Obamacare, patients without health insurance or who are underinsured will continue to delay or forgo care and put their lives at risk.
- Number 5: In Canada, nobody dies due to lack of health insurance.
- In the United States, under Obamacare, many thousands will continue to die every year due to lack of health insurance.
Number 4: In Canada, an increasing majority supports their health care system, which costs half as much, per person, as in the United States. And in Canada, everyone is covered.
- In the United States, a majority – many for different reasons – oppose Obamacare.
- Number 3: In Canada, the tax payments to fund the health care system are progressive – the lowest 20 percent pays 6 percent of income into the system while the highest 20 percent pays 8 percent.
- In the United States, under Obamacare, the poor pay a larger share of their income for health care than the affluent.
Number 2: In Canada, the administration of the system is simple. You get a health care card when you are born. And you swipe it when you go to a doctor or hospital. End of story.
- In the United States, Obamacare’s 2,500 pages plus regulations (the Canadian Medicare Bill was 13 pages) is so complex that then Speaker of the House Nancy Pelosi said before passage “we have to pass the bill so that you can find out what is in it.”
- Number 1: In Canada, the majority of citizens love their health care system.
- In the United States, the majority of citizens, physicians, and nurses prefer the Canadian type system – single-payer, free choice of doctor and hospital, everybody in, nobody out.
: 21 Ways the Canadian Health Care System is Better than Obamacare
What is Canada’s healthcare like?
How Much Do You Know About Healthcare in Canada? – Are you thinking about relocating to Canada? Whether you envision making Canada a stop in your travels abroad as a digital nomad, or you’re hoping to establish a permanent home in that country, you owe it to yourself to learn about healthcare in Canada before booking an itinerary.
- The Canadian public healthcare system, known as Medicare, is funded by taxes,
- It covers all care deemed “medically necessary,” including hospital and doctor visits, but generally does not provide prescription, dental, or vision coverage.
- This program is only available to citizens, permanent residents, some people with Canadian work permits, and some refugees,
Canadian provinces and territories each manage their own separate healthcare systems. Private insurance options make medical care accessible for those who don’t qualify for Canada’s public system. Therefore concerns about the availability of healthcare need not stand in your way if you are visiting or making a home in Canada.
Is healthcare better in Canada or us?
The Canadian Healthcare System – There is more shared in the US healthcare system vs Canada healthcare system than there are differences. Both countries are ranked relatively high in international surveys of healthcare quality according to the World Health Organization (WHO).
- Both countries are relatively wealthy compared to much of the world, with long life expectancy.
- But Canadian life expectancy is slightly higher.
- In Canada, the national government funds health insurance.
- Most of the services patients would receive from a hospital or general practitioner (GP) office are covered by government insurance.
According to the National Center for Biotechnology Information (NCBI) it is actually illegal in Canada for private insurance to cover services covered by government insurance. Thus, Canadian healthcare is a “single-payer” system according to Harvard Health Publishing,
The Canadian healthcare system was established by the Canada Health Act of 1984, The government provides insurance for Canada healthcare, but it generally doesn’t own hospitals or employ doctors directly. In the United Kingdom, the government directly employs providers, but in Canada they are privately employed according to the (NCBI),
Doctors practice independently, though they meet insurance requirements for reimbursement. Under the Canadian healthcare system, citizens can and do buy private health insurance for some services. For example, dentistry and cosmetic services are not covered by government insurance.
- There are also some minor differences in coverage between Canadian provinces, which are equivalent to US states.
- One of the major differences between healthcare in Canada vs US is in how much the patient pays at the time of care.
- Also, while Canadians generally pay for healthcare through taxes, higher earners are taxed at a higher rate according to the Government of Canada website.
In practical terms, this means that high earners pay more for healthcare than low earners do. Costs per person are lower in Canada in part because the government has a better negotiating position. For example, the Canadian government has more negotiating leverage than any private insurer could in negotiating pricing agreements with drug companies.
Which nation has the best healthcare?
South Korea – South Korea tops the list of best healthcare systems in the world. It’s been praised for being modern and efficient, with quality, well-equipped medical facilities and highly trained medical professionals. Generally, treatment in South Korea is affordable and readily available.
The number of beds per 1000 people is 10, which is well above the OECD countries’ average of 5. South Korea provides universal healthcare but much healthcare is privately funded. Not all treatment is covered by South Korea’s universal healthcare scheme. Some procedures, such as those related to chronic illnesses such as cancer, won’t be covered and can be more expensive.
This is where expats should ensure they’re covered with comprehensive private healthcare insurance.
Is health care actually free in Canada?
How is Public Healthcare in Canada Paid For? – Public healthcare is free because patients are not required to pay any fees to receive medical attention at a healthcare facility. However, public healthcare in Canada is funded by a tax paid by Canadian citizens and permanent residents.
Why are wait times so long in Canada?
COVID-19 has compounded longstanding access problems but may compel change. This article is the first in a special series on access to care. Read the next article on neglected wait times here, About one in three Canadians who need joint replacements or cataract surgery don’t get those procedures within recommended times.
Wait times for prostate cancer and lung cancer surgeries are increasing. And those are just the delays we know about – for most health services, beyond a handful of priority procedures, there is scant information about how long patients are waiting to access care. Year after year, it’s been the same story – that is, until the COVID-19 shutdown compounded Canada’s access issues.
As thousands of patients across the country face additional delays in care, “I’m not sure we’re ever going to catch up,” says cardiologist and wait time expert Dr. Chris Simpson. Together with family physician Dr. Kamila Premji and Robin McGee, a cancer patient whose care was delayed due to the COVID-19 slowdown, Simpson spoke to CMAJ about how Canada can avert an access crisis in the months and years ahead.
Their comments have been edited for clarity and length. CMAJ: Why are wait times so bad in Canada? Simpson: There are bottlenecks everywhere. A lot of delays are driven by the fact that hospitals operate at very high capacity because there are large numbers of patients requiring alternate levels of care,
The interconnectedness of all the sectors in healthcare has been underappreciated, and siloed funding has inhibited the kinds of cross-sector discussions which could improve patient flow. A lot of people still manage waitlists as a stack of paper on the side of their desks, which leads to inefficiency.
- And we know that a significant amount of care that’s provided is low value – we haven’t really made any serious effort to address that.
- Premji: There’s a limited number of specialists, limited operating room time allocated to surgeons, limited machines for advanced imaging, and that keeps patients on waitlists for long periods.
The waits for specialist care and diagnostic imaging in turn increase the number of contacts patients need to have with primary care while they’re waiting for the next step in addressing their problems. We also have poorly integrated health information technology that creates a lot of administrative burdens and decreases the number of patients we can take on.
- The amount of time I spend on administrative work has increased over the years to the point that I’m now doing close to one hour for every hour I spend doing direct patient care.
- McGee: Often there are profound failures of understanding and communication.
- A third of referrals may not make it to specialists.
Error is rife – errors in process, in communication, and in practice. My access to care was delayed all three times I’ve been diagnosed with cancer. The third time, I found out my cancer was worsening on March 17, the very day of the COVID-19 lockdown.
- It took weeks of effort to communicate with my cancer doctors.
- There was no getting through.
- I waited three months for treatment of any kind, when normally chemotherapy should be initiated within weeks, and five months to even speak to a surgeon.
- CMAJ: Is part of the problem that Canadians accept these waits as the price of publicly funded health care? Premji: The fact that the United States, our closest neighbour, has such a problematic health care system creates a bit of complacency at every level, from the patients to the physicians to the policymakers and administrators.
I also think some people don’t realize how long the queues are until they’re in one – it’s an abstract concept until you hear, like one of my patients did recently, it’s going to take two years to get cataract surgery. Simpson: Canadians have accepted that some delay is reasonable in order to have an equitable health care system, and that’s not necessarily a bad thing.
- But one of the things we’re doing in Kingston now is a major project to guarantee that every patient who is referred to a specialist waits no more than three months.
- In my view, this is what organizations need to take on – a sense that we have a responsibility to the patients we serve and if we can’t provide a three-month guarantee, then we’re not doing it right.
We just haven’t put our feet to the fire on this stuff as much as we could. McGee: In the United Kingdom, urgent cancer cases must receive treatment in two weeks. Not to say there aren’t people who fall through the cracks, but they have a system in place which recognizes the need for timely care.
- Here, it just doesn’t seem to have priority, and with COVID-19 thrown in the mix, there’s an attitude like, “People can wait.” CMAJ: What are some obvious fixes to the access challenges Canadians are facing? Simpson: One of the things that have been underutilized has been single entry models,
- If we distributed patients to the first available provider, rather than having individual lineups for different providers, we could gain 20-30% efficiency.
That’s why Walmart does it that way – it’s far more efficient to have a single queue for all the cashiers. Premji: Lots of time is spent trying to organize tests and referrals only to hear back, “My wait is too long. Send it somewhere else.” Especially during the pandemic, we’re having to redirect referrals multiple times.
- Being able to see the estimated wait time for each specialist or having a centralized queue would be fantastic.
- Support for team-based care with allied health providers like nurse practitioners and social workers and psychologists could also help share some of the work – has been frozen for years in Ontario.
McGee: We need to empower patients with information. The silence of the system is painful. It is destructive to patient care. And to me, it seems you don’t have to be silent. Every patient who was awaiting a heart transplant or something serious should have gotten a phone call saying, “This is what’s going to happen with your case with the cancellations.
You’re going to have to wait this long, but I hear you, I see you and I haven’t forgotten.” CMAJ: What have been the barriers to meaningful reform? Simpson: We haven’t really embraced the notion that we need to measure and publicly report wait times beyond a few politically advantaged procedures, like hip and knee and cataract surgery.
If you’re not willing to report and publicly make it very clear where the problems are, then clearly there’s not going to be any momentum to make change. Premji: Part of it is money. there’s a distribution problem and a shortage of physicians, not in total numbers, but in the number providing comprehensive primary care.
- Especially in Ontario, where there has been a freeze on funding for team-based models, new graduates don’t want to go into solo practice so they are going into more focused practices or doing walk-in care or locum work, so they’re not necessarily adding a comprehensive family doctor to the system.
- CMAJ: We know COVID-19 has created new challenges in access to care, but what opportunities do you see it creating? Premji: We’ve learned that we can do more by virtual care than we previously had been doing.
If we look at U.S. data, virtual care actually created new health care utilization, far more than it replaced face-to-face care. It’s unclear whether that reflects previously unmet needs or new demand. McGee: I like to think telemedicine will expedite access because people can be assured of communication.
- A wise nurse once told me, “Communication is medicine.
- When we fail to communicate with the patient, we’re depriving them of important reassurance, guidance and care.” Simpson: There’s nothing like a crisis to make things happen.
- A lot of people have said we can’t move patients requiring alternative levels of care out of hospitals.
Well, guess what? We did it in about four weeks. The crisis created the political will to make it happen. We’re not going to be able to do that for wave two because long-term care capacity has been decreased so this is a perfect time for us to double down on appropriateness.
Does Europe have better healthcare than Canada?
Canada v. Europe on Health Care: Europe Wins : Canada suffers from low healthcare system performance, despite high levels of spending. With a combination of high spending and mediocre performance, Canadians get less ‘bang for the buck’ in healthcare than citizens of most European countries.
Is it hard to see a doctor in Canada?
You’ll have to wait: Only 43 per cent of Canadians are able to snag same- or next-day appointments at their regular place of care, such as their doctor’s office. About 20 per cent of Canadians end up waiting about seven days.
Which is better Canada or Germany?
2. Is Germany better than Canada for living? – Germany offers high level education at a low cost, great weather, good healthcare and a minimum cost of living. On the other hand, Canada provides a quality healthcare system, effortless PR applications and an excellent public health system. As per Human Development Index (HDI) 2022, Germany is in 9th and Canada is in 15th position.
What are the flaws of Canadian health care?
Endless Cycles – “We expressed disappointment because we had a moment to rise to the crisis and make the choice to be collaborative in a way that we’ve never been before,” Lafontaine said. CMA had worked with the Canadian Nurses Association and HealthCareCAN to produce a ‘prescription of hope ‘ from providers to Canadian governments.
“There haven’t been many times in Canadian healthcare that you get patients, doctors, nurses, and other allied providers all on the same page — that things have to change.” That the talks fell through because of disagreements about how much money the provinces were receiving and the federal government’s focus on how the money is spent “is classically the way things have been — it’s a cycle of returning to the same way we’ve always done things,” Lafontaine said, “and people are breaking under these cyclical crises.” In an opinion piece in the Vancouver Sun published following the meeting, journalist Vaughan Palmer bluntly stated, “Patients and their families might have chosen something stronger than ‘disappointing’ to describe the outcome of this week’s meeting.
Lengthy waiting lists for cancer diagnosis, radiation treatment, and surgery. Overcrowded emergency wards. Millions of Canadians without a family doctor. Shortages of nurses, therapists, and pretty much every other category of healthcare worker. Flu season upon us when COVID-19 has never left.
60% of respondents indicated that their mental health is worse now than before the pandemic 48% screened positive for depression, up significantly since the CMA’s 2017 survey (33%). 57% reported increased workload and lack of work-life integration since the onset of the pandemic as contributing to worsening mental health 25% of physicians and residents experience severe (10%) or moderate (15%) anxiety 79% of physicians and medical learners scored low on professional fulfillment; fewer than 60% said they were satisfied with their career in medicine
Is Canada nice to live in?
6. Very Multicultural and Immigrant-Friendly – Canada is very welcoming to immigrants and a wonderfully tolerant country. In fact, most Canadians believe that diversity makes a country stronger, and they’ve been encouraging people from other countries to make it their home for a long time.
Is Toronto healthcare good?
Healthcare is often one of the most important considerations for those emigrating abroad to Canada. Our guide provides information about the healthcare services in Toronto. Toronto is home to excellent free public health services, with locations throughout the city for your peace of mind.
If you are moving to Toronto, healthcare in the city may of course be a prime area of interest. Luckily, the system is straightforward and comprehensive, and once you have applied for and received your OHIP card, it is easy to access a wide range of services throughout the city. To connect newcomers with healthcare in Toronto, the Health Care Connect service is available.
This will help you find the nearest family doctor (GP) that is accepting new patients. It is important to note that there may be health clearances required to move abroad to Toronto, Canada.
Is healthcare better in France or Canada?
Conclusion – Overall, it looks like France’s healthcare system offers more consistent advantage’s than Canada’s. While the costs appear to be somewhat similar, and Canada does better in primary care, France’s excellent results across the board make it an excellent country to get sick in. : Comparing France and Canada’s healthcare system: which is better?
Who has better doctors Canada or the US?
Abstract – OBJECTIVES. The aim of this study was to examine the US and Canadian systems from the unique perspective of physicians who have practiced in both Canada and the United States. METHODS. Questionnaires were sent to 355 Canadian physicians who graduated from US medical schools and 347 US physicians who graduated from Canadian medical schools.
- RESULTS. The overall response rate was 59% (65% of US-graduated Canadian physicians and 54% of Canadian-graduated US physicians).
- Thirty-six percent of the respondents were “dual experience” physicians; that is, they had practiced medicine in both countries after completing their medical training.
- Physicians who left Canada were more likely than those who left the United States to indicate dissatisfaction with the health care system as a reason for leaving.
Respondents expressed greater professional satisfaction with their current country of practice, but overall, dual-experience physicians in the United States favored that system only slightly more than the Canadian system, whereas those in Canada rated the Canadian system significantly better than the US system.
Who has best medical care in the world?
Best Healthcare in the World 2023
|Country||LPI 2020 Ranking||LPI 2019 Ranking|
Why is Canadian health care so slow?
2. Canada’s lack of medical equipment and staff – One of the other main causes for long wait times is that Canada underinvests in equipment and staff. Canada has 35% fewer acute care beds and per capita than the United States. If we’re talking about MRIs per capita, Canada is doing worse than Turkey, Chile or even Latvia.
- In Canada, MRIs have waits that average over nine weeks.
- Even ultrasound, which is a routine procedure, have almost four-week waiting lists in Canada.
- According to the OECD, Canada ranks 29th out of 33 high-income countries in terms of doctors per 1,000 population,
- In terms of specialist doctors per capita, Canada has only half as many as the United States.
Another nuance of Canada’s healthcare system is that it’s not a single organism: it is broken up into pieces, with a different health plan, coverages and access to resources for every province and territory. There is no federal healthcare system in place, and so the same treatment, consultation, surgery or test may take longer, depending on the province.
Why is healthcare not free in Canada?
How is Public Healthcare in Canada Paid For? – Public healthcare is free because patients are not required to pay any fees to receive medical attention at a healthcare facility. However, public healthcare in Canada is funded by a tax paid by Canadian citizens and permanent residents.
What is the problem with primary care in Canada?
Primary care is facing a capacity crisis — can pandemic lessons help chart a path forward?
- Primary care is facing an accelerating capacity crisis driven by worker shortages, a patchwork of delivery models, and inadequate data systems, according to Ontario’s disbanded COVID-19 science table.
- In a final series of briefs, the science table shared lessons learned during the pandemic and called for urgent action to strengthen the sector.
- More than two years of ongoing COVID-19 response has challenged primary care capacity in Ontario for better and worse, said the advisory group.
- Primary care clinicians have taken on new roles, including administering COVID-19 vaccines, educating patients and the public, and collaborating with hospitals and community groups to address health equity gaps while rapidly expanding virtual care.
- However, “these new roles resulted in trade-offs, with non-COVID-19 care being deprioritized at times, and some care gaps have emerged as a result,” the science table said.
In Ontario alone, more than 170 000 people lost access to their family doctors in the first six months of the pandemic due to practitioner retirement, burnout, and other practice changes. As of September, roughly six million people across Canada lacked a primary care physician, a third of whom have been searching for one for more than a year.
- “Investments are needed to increase the number of Ontarians formally attached to a primary care clinician supported by a primary care team,” the science table said.
- Patients connected to primary care providers had better outcomes during the pandemic, and team-based practices were better able to respond to patient needs and work with other parts of the health system than solo practitioners.
- Given ongoing shortages of family doctors and nurses, the advisory group said, “it will be necessary to maximize the use of a much wider potential range of health workers in primary care,” including physician assistants and nonclinical staff.
The pandemic has already driven a substantial reorganization of primary care across the country. In Quebec and Nova Scotia, for example, the emergency accelerated innovations in centralized booking systems and access centres, interim clinics for patients without a family doctor, and dedicated COVID services including hotlines.
- However, as the burden of COVID increasingly shifts from hospitals to primary care, the science table warned that it is unrealistic to expect the sector to do more with the same resources.
- “Trade-offs happen when demands rise but resources stay the same,” they said, citing recent declines in childhood vaccinations, cancer screening, and diabetes monitoring, to name a few.
- The science table recommends better integrating primary care into the health system, including setting up more direct lines of communication between health leaders and clinicians to make the most of their role as trusted sources of information for patients.
- The advisory group also found that the absence of an integrated and inclusive data system compromised the pandemic response.
“A complete picture of primary care does not exist in Ontario’s data sets,” the table explained. Information on the care provided by nonphysicians is often lacking, as are demographic details on patients, especially underserved groups. “This makes it difficult to identify gaps in care or disparities in health outcomes.” Ontario dissolved the COVID-19 science table in early September.
Posted on on October 6, 2022
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