Thursday, September 14, 2023

Canada ranks low in health-care outcomes

Canada ranks near last place among OECD countries for health-care outcomes, well below those countries with hybrid public-private health systems.

Canada ranks near last place in OECD healthcare rankings | The Suburban | Charles S. Shaver, MD:

August 17, 2022: "Ontario Health Minister Sylvia Jones stated that she was 'looking at all options,' but was strongly criticized because this might lead to increased privatization. Of note is that health care is already 30% privately-funded in Canada. Meanwhile, Quebec is short 8,000 health workers compared to last summer. As a result, it is partially closing six emergency departments and will reduce services in some neonatal units.

"Yet consider countries ranked highest for health outcomes and wait times such as Denmark, Austria, France, Germany, and Belgium. They all have in common universal healthcare that covers everyone, but also a hybrid public-private system..... [W]e need to look at Europe — not the United States — to see what these countries are doing right. [As] Vancouver orthopedic surgeon Dr. Brian Day stated, 'Canada is the only country in the world where accessing private health care is outlawed, and where you’re forced onto a state wait-list of harm'....

"from 1997 [through] 2021, the cost of our public health insurance has increased by 210.2%. We spend over 11% of our GDP on health care — more than 27 comparable [OECD] countries. Yet among OECD countries, we are 25th of 26 in acute care beds/1000 population, 26th of 28 in MDs, 14th of 24 in nurses and 21st of 24 in MRI scanners....

"Residents of Nova Scotia face long waits in the emergency department and last year 43,000 left without being seen. At least 15 ERs have closed in British Columbia, 20 in Ontario, six in Quebec, three in New Brunswick, one in PEI, and a dozen in rural Newfoundland and Labrador. Most of this is due to a severe staffing shortage, especially of nurses. Last September, nearly half of Nova Scotia nurses worked overtime — the highest of any province. Many across Canada are burning out from poor working conditions and lack of financial incentives, and are leaving for Alberta or the United States.

"The Ontario College of Nursing processed only 2,000 applications last year and 4,300 to date this year; 26,000 are still waiting. Ironically, a nurse from Windsor recently applied for a licence in Michigan and was approved in only four days. Foreign-trained MDs are likewise limited. An advocacy group represents over 1,200 international medical graduates who have not yet been able to obtain a licence to practice in Canada. Of note is that last October, the Labour Mobility Act now requires Alberta regulatory bodies to review and accept or reject credentials within 20 business days; Quebec and all provinces should follow this example.

"Our Canadian health system is in crisis due to lack of adequate federal funding, a severe shortage of nurses and other health professionals, and the need to revamp the system to look for efficiencies. Germany has twice the population of Canada, yet we have 10 times as many health administrators. Money could be saved by pruning the bloated number of paper-pushers in hospitals and ministries of health, and redirecting savings into hiring more nurses and other health workers.... 

"[I]n Ontario, nurses’ salary increases have been limited to 1% annually by Bill 124, which should be repealed. Many orthopedic and other surgeons are underemployed and the increased money could provide increased OR time (possibly in privately-funded free-standing facilities) to shorten wait times for knee and hip replacements and cataract extractions.... One obvious fear of increased privatization is that nurses, MDs, etc. will leave the public system for the private one, leaving the former even more short-staffed. Hence ... adequate sick benefits and other financial incentives must be provided in the public system immediately so as to encourage nurses and other to return to the workforce....  

"If federal transfer payments do not increase and various creative means are not found to alleviate the staffing shortage, the status quo will continue. Most Canadians will continue to wait, many will suffer, and a few will die unnecessarily.... We must be open-minded, not fear change, and should learn from Europe how to successfully blend public and private systems so as to be more efficient and yet fair to all patients and health professionals."

Read more: https://www.thesuburban.com/opinion/op_ed/canada-ranks-near-last-place-in-oecd-healthcare-rankings/article_50a29114-868a-5436-a367-5094701fc325.html

Canada's health-care system is a laggard. Here's how the top-ranked countries do it | The Hub Canada | November 21, 2022:

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