There is no doubt, Canadians are proud of their universal healthcare system. Perhaps this pride comes from a strong sense of community- concern for one’s neighbor, or perhaps from piece of mind knowing a trip to the emergency room won’t break the bank. How long this pride can persist amid increasing problems is not clear. Idealistic as it may seem, the limitations of universal healthcare are coming to full fruition in Canada as the aging population steadily increases demand on the system.
This year will see the front edge of the baby boomers reaching the age of 65. By 2031 one third of Canada’s population will be between the ages of 65 and 85, an age range associated with high healthcare utilization (1) . Considering this trend, the sustainability of the Canadian healthcare system enters muddied waters. Health spending absorbs a large percentage of provincial and territorial budgets already and this is only expected to increase (2). To make matters worse, Canada Health Transfer, a policy which significantly increased federal funding to provincial and territorial budgets targeted at improving the standard of care, will expire in 2013 (3) . Without tax increases, which Canadians are all too familiar with, or healthcare reform, the standard of care will surely deteriorate.
Although Canada ranks above its southern neighbor in overall health system performance by the WHO, problems associated with access to care and wait times threaten this ranking (4). A recent Maclean’s article pointed out that although Canadians pay the fifth highest-per capita costs among 32 OECD countries, Canada has fewer doctors, fewer hospital beds and fewer high-tech diagnostics (CT scanners, and MRI units) than the OECD average. Therefore, “Canadians are paying for a world-class healthcare system but for a variety of reasons they are not getting one” (5). Without a shift in the way healthcare is managed, increased demand will multiply the negative effects that limited access and long wait times are having on the population. The question is how deteriorated does the health system need to be before serious policy initiatives towards reform are implemented. Moreover are Canadians willing to budge on a system that they take pride in?
Canadians vote for and see parties win elections time after time based on their healthcare platforms, but aside from band aid solutions, i.e. increased federal funding for health spending, no fundamental changes have been made to combat the inherent limitations of the current system. As we have seen with “Obama Care” in the US, fundamental changes are not easy to implement but the initiative that the US government has taken is commendable. The current conservative Prime Minister, Stephen Harper is not ignorant about the unsustainability of the current health system, and has expressed the need for reform. Specifically he has recommended a revision to the Canada Health Act in order to allow private integration in the public system via provincial and territorial mandates. This idea has not caught on; perhaps winning a majority government in the most recent election will give the conservatives the teeth it needs to implement reform, only time will tell.
Although an appropriate and acceptable plan for reform is not yet known, population trends do tell us that the time for change is now. Canadians are aging, and healthcare demand will continue to increase. The intent of healthcare reform must not only be to avert economic disaster, it must seek to sustain Canadian pride in the system.
1. Wister, A.V. 2005. ‘Baby Boomer Health Dynamics: How Are We Aging?’. Toronto: University of Toronto Press.
2. Sepehri, A., Chernomas, R. 2004. Is the Canadian Health Care System Fiscally Sustainable? International Journal of Health Services; 34(2): 229–243.
3. Health Council of Canada. Progress Report: 2011. Retrieved from: http://www.healthcouncilcanada.ca/docs/rpts/2011/progress/2011Progress_ENG.pdf
4. Tandon, A., Murray, C., Lauer, J., Evans, D. Measuring Overall Health System Performance for 191 Countries. Retreived from: http://www.who.int/healthinfo/paper30.pdf
5. MacQueen, K. Our Health Care Delusion. Macleans Magazine: January 25, 2011. Retrieved from: http://www2.macleans.ca/2011/01/25/our-health-care-delusion/3/