Textes d'opinion

Time to cure what ails Canada’s health-care systems

The need to reform Canada’s health-care systems has long been a hot topic of debate. After all, Canada is an easy target: It has one of the highest price tags among countries with universal health systems in the Organization for Economic Co-operation and Development, but its performance has lagged behind for years.

The effect of the poor performance of Canada’s health-care systems on the lives of patients is bad enough, but now the lack of capacity is interfering with the daily lives of all Canadians. Indeed, the (re-)re-introduction of strict public health measures that have been put in place in several provinces in response to the Omicron wave has been repeatedly justified by our health systems’ lack of capacity.

So how do we fix them? On one side of the debate, there are those who believe throwing more money at the problem would be a miraculous cure. Unfortunately, several provincial premiers seem to be of this opinion, with their plea to substantially increase the Canadian health transfer.

And yet, health-care spending in Canada has increased at an average yearly pace of over 7% since 1975, without delivering better results for patients. In fact, 55% of Canadians believe the additional amounts of money injected over the past decade have either had no effect at all or actually worsened their health-care system. At this point, spending even more taxpayer dollars would simply be placing our health systems on an artificial respirator.

On the flip side, there are those who want to give the country’s health systems room to breathe by expanding the role of entrepreneurs in the delivery of care. Such a structural reform could involve encouraging provinces to form more partnerships between public and private institutions, or even letting entrepreneurs run publicly funded hospitals.

Now, adopting a greater mix of public and private care would not equate to an Americanization of our health care. Allowing and even encouraging entrepreneurs to pick up the slack is no danger to the universality of Canada’s health-care systems. Rather, as many European countries know well, such a change would increase the accessibility of services that families already pay for through their taxes and offer greater choice within the public system. As an added bonus, expanding the role of entrepreneurs would enable health authorities to make better use of the billions of dollars spent on health care every year.

Involving entrepreneurs in the delivery of health services is the next step toward more efficient systems that Canadians can truly be proud of — ones that encourage innovation and prioritize public-private partnerships rather than always resorting to the mechanisms of a single-payer system. Taking this step will require political courage and co-operation from all levels of governance, including unions, professional orders, and colleges.

In fact, the management of a health-care system should not revolve around politics at all. It’s a matter of doing everything possible to guarantee the high quality of care that Canadians are right to expect, given that 33% of federal and provincial government budgets are directly funnelled into their health systems.

Health reform has been talked about enough; it’s time to take action and catch up to the other universal health systems in the world that have already embraced the role of entrepreneurs in the delivery of care. Otherwise, the next generation is doomed to experience the same heartaches we’re suffering through today. As we head into the umpteenth wave of COVID-19, the pandemic must be the spur that finally gets us to have the conversation we need to have on fundamentally reforming Canada’s health-care systems. Anything less would be irresponsible.

Maria Lily Shaw est économiste à l’IEDM. Elle signe ce texte à titre personnel.

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