Newspaper article The Canadian Press

How Healthy Is the Canadian Health-Care System?

Newspaper article The Canadian Press

How Healthy Is the Canadian Health-Care System?

Article excerpt

How healthy is the Canadian health-care system?

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This article was originally published on The Conversation, an independent and nonprofit source of news, analysis and commentary from academic experts. Disclosure information is available on the original site.

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Authors: Chris Simpson, Professor of Medicine and Vice-Dean (Clinical), School of Medicine, Queen's University, Ontario; David Walker, Professor of Emergency Medicine, Queen's University, Ontario; Don Drummond, Stauffer-Dunning Fellow in Global Public Policy and Adjunct Professor at the School of Policy Studies, Queen's University, Ontario; Duncan Sinclair, Professor of Health Services and Policy Research, Queen's University, Ontario, and Ruth Wilson, Professor of Family Medicine, Queen's University, Ontario

This article is part of our global series about health systems, examining different health care systems all over the world. Read the other articles in the series here.

Canada's health-care system is a point of Canadian pride. We hold it up as a defining national characteristic and an example of what makes us different from Americans. The system has been supported in its current form, more or less, by parties of all political stripes -- for nearly 50 years.

Our team at the Queen's University School of Policy Studies Health Policy Council is a team of seasoned and accomplished health-care leaders in health economics, clinical practice, education, research and health policy. We study, teach and comment on health policy and the health-care system from multiple perspectives.

While highly regarded, Canada's health-care system is expensive and faces several challenges. These challenges will only be exacerbated by the changing health landscape in an aging society. Strong leadership is needed to propel the system forward into a sustainable health future.

A national health insurance model

The roots of Canada's system lie in Saskatchewan, when then-premier Tommy Douglas's left-leaning Co-operative Commonwealth Federation (CCF) government first established a provincial health insurance program. This covered universal hospital (in 1947) and then doctors' costs (in 1962). The costs were shared 50/50 with the federal government for hospitals beginning in 1957 and for doctors in 1968.

This new model inspired fierce opposition from physicians and insurance groups but proved extremely popular with the people of Saskatchewan and elsewhere. Throughout the 1960s, successive provincial and territorial governments adopted the "Saskatchewan model" and in 1972 the Yukon Territory was the last sub-national jurisdiction to adopt it.

Read this article in French: Système de sante canadien : un bilan en demi-teinte

In 1968, the National Medical Care Insurance Act was implemented, in which the federal government agreed to contribute 50 per cent toward the cost of provincial insurance plans. In 1984 the Canada Health Act outlawed the direct billing of patients supplementary to insurance payments to physicians.

The five core principles of the Canadian system were now established: universality (all citizens are covered), comprehensiveness (all medically essential hospital and doctors' services), portability (among all provinces and territories), public administration (of publicly funded insurance) and accessibility.

For the last 50 years, Canada's health-care system has remained essentially unchanged despite numerous pressures.

Long wait times

The quality of the Canadian health-care system has been called into question, however, for several consecutive years now by the U.S.-based Commonwealth Fund. This is a highly respected, non-partisan organization that annually ranks the health-care systems of 11 nations. Canada has finished either ninth or 10th now for several years running.

One challenge for Canadian health care is access. Most Canadians have timely access to world-class care for urgent and emergent problems like heart attacks, strokes and cancer care. …

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