By Mackenzie Moir
Whether it’s hospital overcrowding, physician resignations and shortages or the millions without a regular primary care provider, Canadians are caught in an endless struggle to obtain medical care. Stories like these are now so frequent that many Canadians have come to accept them—and the long delays for care they create—as a natural consequence of universal health care.
But it doesn’t need to be this way. As a recent study has found, other countries do universal health care better than Canada.
In fact, compared to these other countries, Canada has some of the fewest hospital beds, doctors, MRI machines and CT scanners in the developed world. Canada also reports some of the longest delays for physician appointments, specialist consultations and non-emergency surgery.
In 2023, the most recent year of comparable data, some 65 per cent of Canadians reported waiting one month or longer for a specialist appointment compared to 52 per cent of Australians and 44 per cent of Germans. And 58 per cent of Canadians reported waiting more than two months for a non-emergency surgery compared to 33 per cent of Australians and 20 per cent of Germans.
And despite claims to the contrary, we can’t simply spend our way out of these problems, because we’ve already tried that. In 2023, Canada was the third-highest spender on health care among industrialized countries with universal coverage. Germany ranked 8th and Australia ranked 10th.
Clearly, we can learn many lessons from Germany and Australia given that these countries spend less than Canada but perform better. But the main lessons are about how both countries finance and deliver universal health care.
In Germany, for instance, nearly half of all hospitals are operated on a private for-profit basis and around 99 per cent of hospital beds in the country (both government and private) were accessible to those with universal insurance. The government also allows Germans to opt out of the public system and purchase private coverage for medical care. Yet despite the arguments often heard in the Canadian media about the harms of private providers and financing, the German system remains one of the best performing and most accessible in the developed world.
In Australia, patients are not only able to purchase private health insurance, they receive subsidies to do so. On the delivery side, private hospitals regularly contract with Australian governments to provide publicly-funded surgical care.
Here at home, not only did Canadians wait longer than ever for non-emergency surgery last year, but because there’s no alternative, they were forced to either wait or travel out-of-province and pay out-of-pocket for care.
Despite spending more than most developed countries with universal health care, Canadians remain stuck with some of the lowest levels of access to care. And while we remain caught in an endless struggle to access medical services, while weathering whichever new crises that arises within our system, evidence from other countries with universal coverage clearly demonstrates there’s a better way.
Policymakers should follow the example of these better-performing countries and allow a larger role for the private sector in Canada’s health-care system.
Mackenzie Moir is a policy analyst at the Fraser Institute.
