The Canadian healthcare system is often spoken of in a controversial manner, even among Canadians. There are arguments about whether the cost of care, quality of resources and care options, as well as accessibility are up-to-par with other developed countries. Since the Affordable Care Act was signed into law by President Obama in 2010, healthcare comparisons between Canada and the U.S. have become more prominent. One of the biggest challenges to both healthcare systems is wait times. Waiting for medical care has become a defining characteristic of the Canadian system, and it’s only getting worse through mismanagement of funds, physician shortages, and slow technology adoption. But telehealth is a promising solution to this problem.
Let’s quickly set the landscape. How does the Canadian healthcare system function? In 1984, the Canada Health Act (CHA) was passed, establishing criteria on portability, accessibility, universality, comprehensiveness, and public administration. The goal of Canadian Medicare is to offer “universal coverage for medically necessary healthcare services provided on the basis of need, rather than the ability to pay.” Medical services are funded through federal, provincial and territorial taxation, such as personal, corporate and sales taxes. The CHA’s criteria for health insurance plans must be followed by provinces and territories, and the federal government serves as a gatekeeper for financial support. As of 2010, the private sector accounted for 30% of total health expenditures.
Regardless of this value based care model, nearly every Canadian has a wait time-related story. Long wait times are so common that, in 2018, more than one million Canadians incurred a conservative estimate of $2.1 billion in private medical costs, or $1,924 per patient, due to lost wages and reduced work productivity. As the demand for medical treatment grows and the supply of medical professionals drops, those numbers will increase exponentially in the coming decades.
Despite this reality, Canadians seem to be split on whether these excessive wait times are reasonable for a universal health system. The Commonwealth Fund’s 2016 Health Policy Survey reports that supporters of the current system believe wait times are “a small price to pay for universal healthcare.” However, when we compare Canada with other countries in the Commonwealth Fund’s survey, it’s clear that wait times are not characteristic of universal healthcare. In fact, the survey revealed that 18% of Canadians waited four months or longer for elective surgery, compared to 4% in the Netherlands, 2% in France and 0% in Germany.
The Fraser Institute reports that the average wait time, from your general practitioner’s referral to specific treatment, is 19.8 weeks. So, why are wait times so high in Canada? There are many reasons worth looking at. A few of them include: