The contrast is startling. According to Newsweek magazine’s global survey of World’s Best Hospitals (2024): Toronto General-University (TGH) Health Network * is rated third best, just behind fabled institutions Mayo Clinic and the Cleveland Clinic in the United States, and ahead of Johns Hopkins and Massachusetts General. Also highly rated (in the top 100 globally) were Sunnybrook Health Sciences Centre, Mount Sinai Hospital and North York General in Greater Toronto, and Centre hospitalier de l’Université de Montréal, all in the top range of 2,400 hospitals rated worldwide. *TGH was especially recognized for its research in applying artificial intelligence to advance organ transplant procedures. Clearly, these ratings elicit a national pride, as do the names of fabled Canadian medical pioneers Drs. Banting, Best, Osler and Penfield, all emblematic of the tradition of high quality and training which Canadians expect of their physicians and nursing partners. But tradition isn’t always enough, as more and more Canadians experience increasing impediments to even basic medical care, and growing numbers see their healthcare system as being “in crisis.” According to the Institute for Research on Public Policy, 28 per cent of Canadians surveyed in 2023 believed that their health-care system was in a ‘state of crisis” – three times more than in 2016. According to the Fraser Institute’s 2024 Comparing Performance of Universal Health Care Countries report, Canada might do well to learn from some of its 38-member nation-cohorts in the Organization for Economic Co-ordination and Development about getting greater value out of dollars spent. Co-authors of the report, senior policy analyst Mackenzie Moir and director of health policy studies Bacchus Barrua conclude that “Canada ranks among the most expensive universal health-care systems in the OECD (on an age-adjusted basis). However, its performance for availability and access to resources is generally below that of the average OECD country, while its use of resources and quality and clinical performance are mixed. Clearly, there is an imbalance between the value which Canadians receive, and the relatively high amount of money they spend on their health-care system.” They add that “Medical resources are of little use if their services are not being consumed by those with health-care demands” and data from their report show that Canada is performing well below the average OECD countries on most broad indicators such as doctor availability, access to care beds, access to MRI units and CT scanners, and surgical wait times. And, while Canada performed higher than the average OECD country on just over half of the specialty indicators examined (for example, coronary artery bypass grafts and knee replacement), it scored average to lower rates on the rest.” In addition, Moir and Barrua also noted that Canada has “substantially fewer human and capital medical resources than many peer jurisdictions that spend comparable amounts of money on health care” and, after adjustment for age, “it has significantly fewer physicians, somatic (physical care) beds and psychiatry beds per capita, compared to the average OECD countries included in the group of countries studied.” What are the numbers? In 2022, the most recent year for which the data were compiled, Canadians spent 11.5 per cent of their Gross Domestic Product on health care – the fourth highest of the 31 OECD countries tallied. The average spending among them all was 9.4 per cent of GDP. The most expensive was Germany at 12.6 per cent; the least expensive – Luxembourg at 6.5 per cent GDP. Only New Zealand, Switzerland and Germany topped Canada’s spending per GDP – 12.5, 11.9 and 11.7 respectively. Of 38 countries in the OECD, several – the United States among them – do not have universal health care in that they don’t require or offer system-wide access to health insurance. Thus, the 17.7 per cent of GDP that the U.S. spends on health care is not directly comparable. As a bottom line, study analysts concluded that though Canada ranks among the top spenders, Canadians receive only “average to poor” value. Examples: of 30 countries tallied, Canada ranked only 28 for availability of doctors at 2.8 per 1000 population, compared to 4.6 for Germany; 6.6 for Greece; and 4.1 for Australia. Availability of somatic (physical care) hospital beds also ranked poorly at 26 out of 29, while psychiatric beds ranked 23. And though availability of nursing ranked a more respectable 16 out of 30, the ranking of 27 (out of 31) for availability of MRI machines, 28 for CT scanners, 22 for PET scanners (positron emission tomography to detect early signs of cancer, heart disease, brain conditions) were less so. However, Canada’s availability and use of Gamma cameras (nuclear imaging devices) earned a high rank of 4... Canada Rates “Modest to Poor” in value for Health-care spending: Fraser Institute Study Health 32 | www.snowbirds.org
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