Health-care costs not justified by results: Fraser Institute
By Derek Abma, Postmedia NewsMarch 21, 2012
OTTAWA — The Canadian health-care system has proven to be a black hole for federal tax dollars over the past decade or so, a report released Wednesday contends.
Despite hikes in federal transfers to provinces for health care that were $97.6 billion beyond what was needed to account for inflation and population growth in the last 13 years, there has been little improvement in access to care for Canadians, says this Fraser Institute study.
A highlighted point was the time it takes to get treatment from a specialist after a referral from a general physician. The report says the median time was 19 weeks last year, up almost 60 per cent from 1997.
"Canadians should have expected the health-care system to improve, and it's troubling that there has not been an improvement in spite of this very large increase in health-care expenditures since 1997-98," said Nadeem Esmail, a senior fellow at the Fraser Institute and co-author of the study.
The report also found that since 1997 wait times have increased for getting an appointment with a specialist after a general referral, getting treatment from a specialist after the initial consultation, getting a CT scan and getting an ultrasound. It also found fewer nurses in proportion to the population, as well less availability of lithotripters (machines that break up kidney stones so they can be more easily passed).
The study found improvements in four of the 11 factors it compared between 2011 and 1997; there were more physicians, MRI machines and CT scanners per capita, as well as shorter wait times to get an MRI.
However, Esmail said it's an sign of the system's general inefficiency that waiting times increased for getting a CT scan despite greater availability of the equipment. He also noted that the number of available MRI machines increased 353.8 per cent in proportion to the population, but waiting times to use them fell by just 4.2 per cent.
"The core problem here is that the Canadian health-care system is relying on an inefficient model for health-care policy, that is we have a preponderance of government in the health-care system," Esmail said. "Government is delivering health care and government is regulating health care."
He said provinces are constrained by the Canada Health Act from improving the efficiency of their systems. Allowing people to pay for quicker access to care, and more private-sector involvement in health insurance and delivery, while still ensuring universal access for all, are among the measures Esmail recommends.
Esmail said he is not suggesting a move toward U.S.-style health care. He said Canada should strive for something closer to what is seen in countries such as Switzerland, France and Japan, where allowing more private-sector involvement in universally accessible health-care systems has produced better results than what's seen in Canada.
"We find health-care systems that are performing better than Canada's that remain universal but do a much better job than Canada's health-care system at delivering on the promise of universal access to high-quality care in a time frame that provides peace of mind," he said.
The Fraser Institute's study did not specifically look at health-care outcomes, and Esmail acknowledged at least some of the increased funding seen in Canada in recent years has improved the quality of patients' health after treatment.
"The reality is that it would be very difficult to spend $97.6 billion without buying something," he said.
On how much of the money went toward serving an aging population, Esmail said this accounts for just one percentage point of the 6.9 per cent average increase in annual health-care costs since 1997
