a recent damning report revealed that “hallway medicine” is now the norm in ontario. almost 50% of hospitals in the province regularly operate beyond capacity, with patients accommodated in unconventional spaces including corridors, meeting rooms, even a kitchenette. while the report shines much-needed light on the shambolic state of ontario’s health-care system, and surely resonates with canadians across the country, it’s unfortunately unsurprising. here are three reasons why.
1) lack of resources . canada simply has fewer hospital beds than almost every other universal health-care system in the world. according to age-adjusted data from the oecd, we only have 2.0 acute-care beds per thousand people, ranking 26th out of 27 countries with universal health care. by contrast, germany has almost three times as many (5.5 per thousand) while switzerland, france and the netherlands all have approximately three or more acute care beds per thousand. to compound the issue, canada also generally has fewer physicians and diagnostic imaging scanners (mri scanners, for example) per capita than these other countries. not surprisingly, all these countries also report much shorter wait times than canada , both in the emergency room and for scheduled consultations.
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2) no pressure-valve . unlike canada, most other countries embrace the private sector as a partner (like in switzerland) or an alternative (like in germany). canada, meanwhile, continues to insist on a government monopoly for the funding and administration of care. in fact, canada is one of the only universal health-care systems in the world that effectively prevents patients from using their own money to receive treatment, locking them into a public system where they compete for space with each other.
3) no copays . unlike the majority of universal health-care systems, canada does not require patients to share the cost of treatment. data from the commonwealth fund show that canadians use the emergency department far more frequently (41% in the two years prior to 2016) than people in 10 other countries surveyed. many of these er visits may be unnecessary and are certainly expensive. an earlier report by the canadian institute of health information estimated that 1.4 million visits (many for minor medical complaints such as sore throats, earaches and skin conditions) to canadian emergency departments were potentially avoidable in 2013-2014. in other countries, copayments help provide direct financial incentives for patients to make more appropriate choices. to be clear, such payments are never designed to financially burden patients or prevent access to care based on income. they are usually a small fraction of the cost of care, and countries such as switzerland and the netherlands routinely employ annual caps and exempt vulnerable populations from copays.
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