According to a report in CMAJ (Canadian Medical Association Journal), alternative funding for health care in Canada will not result in lower costs or add to financial sustainability. Recent investigations from prominent think tanks have advised such solutions as severe cuts to health care, increased taxes, private health insurance, copayments for publicly funded services in addition to other methods of raising funds.

Health care costs in Canada are approximately 10.4% of gross domestic product (GDP), similar to many countries in the European Union, such as Germany (10.5%), France (11.2%), Sweden (9.4%) and others. Compared to the US which spends 16% of its GDP on health care. All countries have different methods of financing health care such as, through taxes in the UK and Canada, private health insurance in Switzerland and the US, a mix of government funding, employer-based insurance and user fees for patients.

Dr. Sacha Bhatia from Massachusetts General Hospital and Harvard Medical School writes,

“despite the variety of methods to finance health care, for the past 15 years the rate of spending has surpassed economic growth in almost every country in the OECD (Organization for Economic Co-operation and Development), and containment of the growth of heath care as the population ages is a huge worry for not just Canada, but all developed economies.”

Due to higher administrative costs to track multiple funders, evidence suggests that private health care does not result in large public savings. In addition, statistics from Ontario reveal that most of health care costs (84%) are spent on 5% of the population, usually individuals with chronic diseases, frail elderly and economically disadvantaged people. The majority of these individuals cannot afford private health insurance, meaning most health care costs would still fall within the public system.

Dr. Bhatia explains:

“The conclusion is that our health system, like many around the world, needs to continue to invest and modernize its delivery systems to improve the health of our citizens, which, in turn will make health care sustainable.”

He argues that a national pharmacare strategy and a bulk purchasing plan for medical equipment may result in billions of dollars in savings for governments. Increased, coordinated health promotion targeted at obesity and diabetes, home care supports to keep seniors and the chronically ill at home and accountability measures for health care providers would help reduce costs and improve delivery.

Dr. Bhatia concludes that suggestions that these financing models will somehow make our health care system financially sustainable are not supported by evidence. If anything, Canadians cannot afford to go down that road.

Written by Grace Rattue