Sweden, Switzerland, Korea, Japan, Taiwan - and Saskatchewan - all present options for breaking through the stagnant debate about medicare
OTTAWA, March 31, 2016 – A new Macdonald-Laurier Institute video is making the case for exploring internationally tried and tested ideas for improving Canada’s expensive and underperforming health-care system.
Brian Lee Crowley, MLI’s Managing Director, points to examples from Sweden, Switzerland, Korea, Japan and Taiwan of how Canada can adopt policies that help deliver better care to patients at a lower cost for taxpayers. But there are good ideas here at home as well, including the introduction of private clinics in Saskatchewan.
Learning from these ideas will, however, mean slaying some misconceptions about what is meant by “reform”.
“Combine private provision with a funding model based on services provided, and you’re really onto something"
Many Canadians equate changing Canada’s publicly-funded health-care system with adopting the United States’ poorly-performing free-market plan.
To watch the full video, entitled "Medicare's Midlife Crisis video three: Good ideas for health care reform", click here.
This is a false polarity, says Crowley.
Many countries have transformed their health-care systems into top-performing examples for the rest of the world by introducing private services. For example, Switzerland and Sweden, among others, fund their hospitals differently from Canada and get better results.
“Combine private provision with a funding model based on services provided, and you’re really onto something, because suddenly patients have the ability to reward the providers who meet their needs and penalize those who don’t”, says Crowley.
Some of this reform has already taken place in Canada, the video shows.
Janice Mackinnon, former Minister of Finance with the Saskatchewan NDP, has long been warning that the publicly-funded status quo can’t continue indefinitely.
In a paper for MLI, she studied reforms at the provincial level, such as the introduction of private-sector clinics in Saskatchewan. This helped reduce costs while continuing to respect the principles of publicly-funded health care.
“I would say a lot of people in Saskatchewan who really would have wondered about private clinics have been to them now and they kind of say ‘I’m not sure what the issue is here’”, says Mackinnon.
She says that Tommy Douglas – the godfather of Canada’s publicly-funded health care system – would today be in favour of introducing more private care. It would be the only way, she says, to modernize a system first invented nearly three-quarters of a century ago.
“I would say a lot of people in Saskatchewan who really would have wondered about private clinics have been to them now and they kind of say ‘I’m not sure what the issue is here’”
Even Sweden, famous for its “socialist” programs, is leading the way on reforming publicly-funded health care.
The Swedish government started looking for answers to problems with its centrally-planned system in the mid-2000s.
“The answer has been over time to introduce, within this publicly-funded system, a larger proportion of private suppliers of these services”, Sven Otto Littorin, the Swedish Minister for Employment from 2006-2010, says in the video.
James Tiessen, an MLI author and Ryerson University professor, says the services Canadians receive in exchange for their tax dollars are underwhelming. A more efficient system like those in many Asian countries would provide coverage for items like dental work and pharmaceuticals, items currently not covered under medicare, but they would require patients to pay for a portion of the care provided.
This is the third video in MLI’s series, titled Medicare’s Midlife Crisis, on reforming Canada’s health care system.
The first video explains why Canada’s health care system does not live up to the world-class reputation many Canadians assign to it. The second video looks at barriers, both real and imagined, to health care reform in Canada.
MLI has also produced several reports, commentaries and Q&As designed to break the stasis on Canada’s expensive and underperforming health care system. This includes a paper by Mackinnon, a paper co-authored by Tiessen and a Q&A with Littorin.
Brian Lee Crowley is the Managing Director of the Macdonald-Laurier Institute.
The Macdonald-Laurier Institute is the only non-partisan, independent national public policy think tank in Ottawa focusing on the full range of issues that fall under the jurisdiction of the federal government.
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