Hey there, time traveller!
This article was published 20/5/2013 (1135 days ago), so information in it may no longer be current.
For many Canadians, the Victoria Day long weekend marks the beginning of summertime holiday planning, if not a late-May escape after a long winter. For those who travel outside the country in the coming months, we have a modest proposal: Find a pub, sit down with locals and ask about their nation's health-care system.
We would wager citizens of every country think health care could be improved. However, we would also bet a plane ticket to someone's favourite summer getaway that Canadians will find countries with universal health care, such as Australia, Japan or favourite tourist destinations in Europe have far better health care than we do.
That's because their citizens and their governments have no hang-ups about the three bogymen of upfront fees, "private" insurance and private delivery. In developed countries around the world that cover every citizen (so exclude the United States at present), competition, user fees and the private sector help get citizens the health care they need, and importantly, when they need it.
For example, consider Australia, where Australians have a choice of public-hospital care or private-hospital care, the former fully funded with tax dollars and the latter partially funded with tax dollars. Not to mention taxpayer financing for private parallel health insurance.
Australia's goal is to ensure fair and affordable choice with vibrant, competitive public and private systems. The benefit is better cost management. And, it must be mentioned, Australians don't wait anywhere near as long as we do for health care; they also receive excellent care for fewer dollars.
Or ponder Japan. There, private hospitals and clinics compete with one another to supply patient care. Patients in Japan are responsible for a big part of the final bill, however, with insurance picking up only part (but more than half) of the tab until a monthly cap on user fees is reached. The result of competition and upfront user fees is prompt, high-quality health care, delivered very cost-effectively.
Like Europe? So do we, and not only for its great architecture, fine food and pleasant cities. In Europe, a variety of countries best Canada's record on health care. They do so with approaches that would have status-quo health-care types set their hair on fire.
Consider Sweden. There, you might hear how patients were treated under the universal insurance scheme in a private for-profit hospital with a reputation as one of Sweden's most efficient. You'll likely also hear that going to the doctor is not "free" in Sweden, and generally costs patients $15 or more per visit. Then again, the Swedes get world-class health care delivered much more efficiently than ours.
While you're in Europe, chat with someone from Switzerland: Swiss patients not only get to choose who provides their health care, they can also pick their private, universal insurance company. You might also hear interesting stories of how people select different deductible levels or self-limit their choice of providers to reduce their insurance premiums. What you won't hear are complaints about health-care waiting times. Instead, they have some of the best health care in the developed world.
Finally, let's not forget the Netherlands. In the past decade, this is the only developed nation with universal health care to have eliminated concerns about waiting. How? As with Switzerland, talk to a local, and you'll likely hear about insurance deductibles and choices about insurers. You may also hear about insurance programs that aim to speed up care for patients. Some even guarantee treatment within days. In addition, you'll discover that private hospitals in the Netherlands compete for patients under the universal scheme, one key policy that helped eliminate lineups for health care.
The above are but a selection of some favourite tourist destinations. They are also nations with progressive, sensible health-care practices that could help improve Canada's health care system. Travel can be enlightening.
Nadeem Esmail is the director of health policy at the Fraser Institute. Mark Milke is a senior fellow with the Institute.
A better way
See analysis of why the traditional lump-sum approach to funding hospitals provides little motivation to improve either their quality of care or their efficiency. Ontario is trying to change that.