Fresh Takes

Structural Weaknesses in Canada’s Health Care Surge Capacity

According to a 2020 MEI study, during the pandemic Canada raised hospital capacity 30%-40% over six months, while Singapore doubled capacity in four months and Sweden raised capacity four-fold. In a matter of months, Singapore (population 6 million) went from 11,000 to 29,000 beds. While Quebec (population 8 million) went from 19,000 to between 24,000 and 26,000—much of that from reopening a recently mothballed Montreal Hospital.

Our research found that key elements in surge capacity were flexible funding, decentralization, flexible decision-making from “front-line” administrators, and the use of entrepreneurial providers who can better understand and serve patients. In both Sweden and Singapore, authority for deploying resources and making decisions was decentralized to individual hospital administrators.

Flexibility was given to managers who are closest to the problem and have the most information about trade-offs. To illustrate, in Singapore even housekeepers and security guards could be repurposed for whatever a particular hospital needs—very difficult to imagine under Canada’s union-dominated health care system. Finally, both Sweden and Singapore use activity-based funding, where the money follows the patient, rather than the clumsy and remote annual political negotiations that happen in Canada.

Our health professionals are doing their best, but Canada’s capacity problems are structural, and need structural solutions. To read more, click here.

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