Canada’s healthcare ranks 9th out of 10, study says

TORONTO – A new report says Canada’s healthcare system has fallen behind international peers in access to care, equity and wait times, outperforming only the United States. The not-for-profit think tank C.D. Howe Institute says Canada ranks ninth out of 10 countries evaluated, including the Netherlands and United Kingdom, who were top performers.

In “Troubling Diagnosis: Comparing Canada’s Healthcare with International Peers,” C.D. Howe researcher Tingting Zhang (pictured) uses the widely respected Commonwealth Fund International Health Policy surveys to determine how Canada’s healthcare system and its provinces and territories compare to those in other countries – and to each other.

Canada fared poorly compared to its peer countries in various measures, such as affordability, administrative efficiency and equity and ranked worst (10th out of 10 countries) in timeliness. However, for those who can access to care, the quality of care is relatively high.

In equity Canada ranked seventh in the latest findings. Approximately one-quarter of Canadians with low or average incomes reported at least one cost-related barrier to accessing healthcare in the past year – double the rate of higher-income earners.

Affordability stood as a significant barrier to healthcare in most Atlantic provinces, Alberta, British Columbia and Yukon, where many adults reported forgoing medications, and mental health services or homecare due to cost concerns.

In measures of health outcomes Canada fell slightly below average with the second-highest infant mortality rate, and second-highest 30-day-in-hospital mortality rate following a stroke.

Using a restricted set of measures from the most recent survey to compare it to a similar study in 2018, Quebec saw the biggest improvement in its healthcare system: It jumped from seventh among Canadian jurisdictions in 2018 to first in the newest study. Meanwhile, Alberta saw the biggest drop, going from first to fifth today.

The performance gap between the top-performing Canadian jurisdictions and those lagging behind highlights the potential for interprovincial knowledge sharing to improve healthcare delivery across the country.

However, domestic solutions alone may not be enough. Drawing insights from countries like the Netherlands and Germany could provide Canadian jurisdictions with actionable strategies to achieve better healthcare outcomes.

The study concludes that enhancing Canada’s healthcare outcomes hinges on improving patients’ attachment to care and after-hours care availability, expanding drug and dental access and improving the affordability of mental health and homecare.

“The road to a high-performing healthcare system is long. Improving Canada’s healthcare presents a complex challenge that requires the implementation of targeted and comprehensive strategies,” Zhang writes.

Nevertheless, she argues Canada has the potential to significantly enhance its healthcare system performance by leveraging its existing strengths and learning from both international and interprovincial examples.