Canada is fiercely proud of its single payer model, public funded healthcare system and bristles at suggestions of privatisation. Indeed, no politician may speak of the healthcare system in negative terms, although it eats up half of provincial budgets and long waiting lists for elective procedures are common.
Family Medicine services are understaffed and dissatisfaction with the whole system has led to the appearance of a two tier system in which the wealthy travel abroad for treatment to avoid the long queues in Canada.
Emergency care is excellent and rapid, but non acute treatments are subject to considerable delays and at times, not available at all. Canadians who seek new drugs or surgical procedures not available in Canada are travelling abroad, often to the USA, but at times further afield with the Canadian healthcare system having to pick up the pieces of botched surgery or complications when they return home.
One in six Canadians does not have a family physician to provide primary care and diagnose illness in its early stages. Morbid obesity is one of the chronic problems which is best prevented with education or treated early with lifestyle and dietary changes. Bariatric surgeries for this condition have risen by 400% in recent years but in Canada a patient cannot be placed on a list for surgery until a state of morbid obesity has been reached making surgical treatment impossible in the early stages of the condition where successful outcomes are more likely.
The Ontario Chamber of Commerce (OCC) is reported to have launched a one-year consultation to examine ways of making healthcare more sustainable by considering how the private sector could enter into partnership with the public system as the Government reforms the latter.
The OCC found that 80% of people resident in Ontario thought the present system unsustainable but the OCC stressed it was not looking at ending the single payer system or following the USA model, which is also in major difficulties, although of an entirely different nature. It aims to create innovative ways in which the private sector may work with and support the public system to achieve better healthcare outcomes.
Under the Canada Health Act, Canadians cannot buy privately the treatments which are not available in the system. In the UK, which also has a single payer model, the NHS, there is a parallel private system to which patients can turn if the waiting lists are too long or the treatment is not available.
The Commonwealth Fund 2015 International Health Policy Study of Primary Care Physicians showed that Canada ranked below most countries in terms of access to primary care. Timely primary care (an appointment on the same day or next day after request) is available to just 53% of patients in Canada. This is below the average which is 72% but an improvement on the 2009 figure which was just 39%. Switzerland and Germany were in joint top place at 85% with New Zealand showing strong performance at 83%. Australia was above average but the UK and Sweden scored below average at 69% and 42% respectively.
A battle is heating up in Ontario between the OCC and the trade unions which accuse the OCC of seeking to push acceptance of privatisation of parts of the healthcare system.