The Costs of Free Health Care: Lessons From Canada

The survey goes on to show that 1 in 5 Canadians reported waiting over 7 days to see a family doctor, and 1 in 2 reported waiting 4+ weeks to see a specialist – and chances are, if it’s a progressive ailment, you will need a specialist.

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A survey published by the Pew Research Center on June 23rd, 2017 shows that support for a ‘single-payer’ healthcare system is growing, led by pushes from American Democrats. The survey shows that 60% of Americans now say that the federal government should be responsible for providing health care, while only 39% say it should not be the government’s responsibility.

This is unchanged from figures released earlier last year and appears to remain unchanged, but the shift comes from more citizens now favoring a universal system, rather than a mixed system, such as a two-tier combination of private and public health care.

This survey also shows a major divide between Republicans and Democrats, with 85% of Democrats saying the government should be responsible, and only 32% of Republicans sharing the view. However, even among Republicans, 57% say that government-run programs, such as Medicare and Medicaid, should be continued for the elderly and very poor. Furthermore, Republicans younger than 30 are more in favor of tax-funded ‘single-payer’ health care than their older counterparts, suggesting that this trend is likely to be the norm in the decades to come.

This shift in views also underlines a common trend among first-world countries. However, if this shift is only going to continue, it would be advantageous for Americans to know exactly what they’re getting into, especially in terms of the quality of care provided by a universal, government-run system.

In Canada, we have tax-funded Medicare, which ensures that all Canadians have universal free access to the services of all physicians and hospitals; the Provincial and Territorial governments are responsible for maintaining these institutions. There are other additional costs on the side and this doesn’t ensure rights to receive free treatment from certain specialists, such as dentists, dermatologists, etc. However, there are usually supplementary benefits one can apply for, and enough privatization is still intact to allow businesses to provide health insurance to cover the costs of medicine and any other necessary medical treatment not covered by Medicare.

On the surface, this sounds fantastic; however, as is the case with everything subsidized, there’s an associated cost beyond just taxes. This shows itself in Canada most explicitly in the form of substantially slower services, resulting from overuses of emergency services and hospitals, as opposed to privately contracted physicians and nurses.

According to the Commonwealth Fund Survey 2016 (CIHI, 2017), which looks at 11 developed countries and the times citizens of those countries reported waiting during their last emergency room visit, 29% of Canadians reported having waited 4+ hours, comparable with the 11% international average. The United States fared better, hitting just over the international average at 11.2% (CIHI, 2017).

The survey goes on to show that 1 in 5 Canadians reported waiting over 7 days to see a family doctor, and 1 in 2 reported waiting 4+ weeks to see a specialist – and chances are, if it’s a progressive ailment, you will need a specialist.

41.1% of Canadians reported that the last time they went to a hospital’s emergency department, it was for something that they themselves acknowledge could have been treated by a family doctor, nurse practitioner, at a health clinic, etc. The use of emergency services is only too abused under a universal system. The consequence is that those who are truly in need of emergency services – those with lacerations, broken arms, etc. – are seated next to and made to wait on individuals with common colds and sprained wrists before receiving treatment.

Though, if you know you have no choice but to pay into the health care system, why not take advantage of it?

With that said, 74% of Canadians reported very good service, and are ‘generally satisfied’ with the quality of their care, comparable to the 65% international average of the 11 countries surveyed. This suggests that when Canadians do finally receive services, those services are generally good. However, the irony here should also be noted: this means that Canadians are ‘generally satisfied’ with a system which they themselves report is ineffective in terms of administration speed. In other words, it’s far from a perfect system.

Specifically, on the 4+ week wait time for specialists, many of whom specialize in treating the most urgent of illnesses, there’s a Canadian colloquialism that should serve to illustrate the underlying point:

‘If it’s something serious, you go to the States.’

However, with taxes in Canada already very high, in part thanks to our universal health coverage which takes up 11.1% of the annual GDP – approximately $6299.00 per person annually – many of those occupying the lower income brackets simply can’t afford to make the trip, nor the faster service waiting beyond the border.

Unfortunately, Canada’s ‘free’ health care system has become one of Canada’s sacred cows – something which is held with a degree of reverence, something to be proud of. Because of this, politicians who even bring up the possibility of health care reform are few and far between.

Put simply, it doesn’t look as though this is changing anytime soon.

This is not to absolve the United States’ health care system for its faults, of which there are many. On May 18th, 2017, the Global Burden of Disease Study 2015, published the first-ever Health Care and Quality Index, which juxtaposes the capacity of 195 different countries to provide health care for patients who have serious illnesses, disorders, and diseases, for which a treatment exists and is available, with mortality rates for those diseases. While Canada placed 17th, America only ranked 35th.

Clearly Democrats’ claim that people who need treatment aren’t getting it isn’t wholly misplaced; there is some truth to their argument. However, if the ineffectiveness of Obamacare is anything to learn from, and furthermore the dismal slowness of Canada’s single-payer system, the answer is not as simple as universality.

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  1. My experiences with Canadian healthcare have been horrific, and I am seeing other people with terrible care situations, as well. One woman (okay, admittedly, it was really foolish to get one) has a hormonal IUD imbedded in the wall of her uterus and has not been able to have any actual action to get it removed in well over a year. She just goes to appointment after appointment, sometimes months apart, only to have zero action to remedy the situation.
    And, they are regularly asking if she is going to get another one when this is out.
    For myself, I was refused healthcare in Ontario, and specifically told it was because of where I came from. When I contacted Ontario Human Rights, I was told it didn’t matter if I was refused care, because I am caucasian. I specifically asked, so if I was from India, I would have human rights? The response was yes.
    We left Ontario.
    Thank God, with undergraduate allopathic related studies, and graduate studies in naturopathy, I have enough knowledge to take care of my family myself. If I had to rely on the system here, I don’t know what I would do.

Dylan Gibbons

Dylan is a student in his senior year at Ryerson University, double majoring in Philosophy and English with aspirations to study Global Affairs at the graduate level. During his time at Ryerson, Dylan has occupied various director roles and assisted in both event planning and business correspondence. His primary political interests are in Canadian public policy, foreign relations, and emerging technology.
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