By Dr. Keith Martin MD, The Windsor Star - April 27, 2009
Contrary to public opinion, Canada does not have "the best health care system in the world." We actually rank 26th, and yet have the fifth highest expenditures for health care.
So, which countries fare better than us, and why? The Canadian Medical Association just examined this question and came up with some fascinating
findings.
Of the world's top 20 national health care systems, 17 are European.
These word leaders share some common traits: They all have mixed systems that combine both public and private providers; everyone is covered; no one is hurt financially when they fall ill, and there is the widespread use of information technology, which improves efficiency and reduces errors and cost.
In some European countries, prescriptions are no longer written -- rather, all prescribed courses of treatment are entered into a computerized database
which ensures less drug abuse, fewer administrative errors and greater oversight and transparency. Also, the efficient integration of public and private services has actually drawn on the strengths of both systems to ensure that patients get the care they need without being hurt financially. This has enabled countries to even expand coverage to include global prescription drug coverage.
The CMA found that, in Europe, patients are placed at the centre of the health care system. European hospitals are not paid solely by block funding -- i.e., a lump sum of money that does not take into account the demands made of them. Instead, hospitals receive monies for services rendered.
The medical system treats patients as an asset because resources are provided for treating each person. These efficiencies free up monies for
prevention, health promotion and other initiatives that reduce the demand on our health care system.
When Europeans hear that Canadians tolerate atrocious waiting lists of nine to 12 months or more for care, and endure the pain, suffering and loss of
function that accompanies these wait times, they are shocked.
If they were confronted with these delays in Europe, people would be storming government offices.
Unfortunately, since the debate around health care reform remains mired in the false assumption that changes to our current system would result in a
"U.S.-style system," policy makers stick their heads in the sand hoping no one will notice.
Sadly, this inaction is contributing to the continued decline in access to care and the avoidable suffering that is the price the ill pay.
Canadians must fully grasp the following truths:
- Demographic pressures brought on by an aging population, and more expensive technologies, are outstripping the supply of money that governments have to pay for health care. This structural shortfall
will certainly be exacerbated by the current global economic downturn.
- The Canada Health Act, and its five principles which govern health care in Canada (public administration, comprehensiveness, universality, portability and accessibility), is broken in every province, every day.
- We actually have a mixed system, but it is not integrated in a way that supports our public system.
- The status quo is actually contributing to the creeping privatization of our public system and a decline in the services that are covered.
The lesson we should learn from the Europeans is that the absence of competition leads to inefficiencies in our health system, a dearth of innovation and compromised care.
If we fail to modernize our health care system and live with the illusion that we have the "best" system, more and more people will fail to receive the care they need.
This would be a national disgrace and an entirely avoidable one.
We can have the best health care system in the world but we must adopt those solutions that will allow us to achieve this noble goal. We must have courage and we must not fear change.
It's Essential MT @carnegiecouncil @carnegiePI: For Future Innovators: Can You Teach Policy & Empathy at the Same Time? 