As is often the case in U.S. politics—though normally on the Democratic side of the aisle—Canada’s health care system was raised as a functioning alternative to the American model. Specifically, GOP front-runner Donald Trump described Canada’s health care system as working just fine.
The facts are markedly different from Mr. Trump’s description. Canada suffers from a high-cost health care system that delivers only modest performance across most measures of health care. Put simply, Canada’s model of health care delivery and financing is not something to be emulated but rather avoided.
In terms of cost, Canada’s system is among the most expensive among the OECD countries that provide universal access to health care, after adjusting for age. This latter point is essential since demographics are a key driver of health care costs. Data for 2011, the most recent year currently available, shows that Canada’s health care system was the second most expensive (measured as a share of the economy) among 27 OECD countries with universal access.
The cost of Canada’s health care system would be less worrying if it was deemed to be high-performing. On measure after measure, however, Canada’s performance is middling at best. A central problem in Canada’s health care system and a driving force for reform are wait times for medical procedures. The latest data for waiting lists indicates that in 2014, Canadians could expect to wait 18.2 weeks for treatment after seeing a general practitioner, which is 96 per cent longer than they had to wait in 1993. Such wait times are three weeks longer than what physicians consider clinically reasonable.
In a comparative sense, Canada’s wait lists are among the worst in developed countries. According to the Commonwealth Fund, Canada ranked dead-last on most measures of timeliness of care (behind 10 other countries, including the U.S.). Only 41 percent of Canadians were able to get an appointment the same day (or next) when sick compared to 76 per cent in Germany. Further, 29 per cent of Canadians waited two months or more for a specialist appointment while only three percent reported such waits in Switzerland and the Netherlands.
There are also worrying statistics regarding Canadians’ access to medical doctors and technology. For instance, among OECD countries with universal access, Canada ranked close to the bottom of the pack for availability of practicing doctors per thousand population (25 of 27), and below the OECD average for availability of MRI scanners per million population (16 of 24).
Health care reform is a central policy consideration for most industrialized countries both because of its cost to government and citizens and perhaps more importantly because it is a highly-valued, personal service that citizens care deeply about. Successful reforms are premised on accurate information. Contrary to statements made by Trump, Canada’s health care system is neither high-functioning nor reasonably cost and should not be considered a model for reform except for what to avoid.
Jason Clemens is executive vice-president and Bacchus Barua is senior health economist at the Canadian-based Fraser Institute.