OPINION: Bill Maher is right about Canadian health care

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Recently, popular American comedian and talk show host Bill Maher focused on some of Canada’s public policy shortcomings in one of his monologues. Maher entertainingly highlighted our high housing costs, unemployment rates and ‘vaunted’ healthcare system.

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Citing work published by the Fraser Institute, he explained that after adjusting for age, Canada spends 13.3% of our economy on health care (2020), the highest level of spending by any developed country with universal coverage that year. And that Canada has some of the worst access to timely appointments with primary care physicians compared to our peers.

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Although that’s where his part about healthcare ended, the bad news for the Canadian system unfortunately doesn’t stop there.

On top of the fact that Canada remains one of the most expensive universal health care systems in the world, we get little in return in terms of both available medical resources and wait times. For example, among high-income countries with universal health care, Canada has one of the lowest numbers of doctors, hospital beds, MRI machines and CT scanners.

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And in Canada, only 38% of patients report visiting a specialist within four weeks (compared to 69% in the Netherlands) and only 62% report having non-emergency surgery within four months (compared to 99% in Germany ).

Unfortunately, wait times in Canada aren’t just long compared to other countries, they’re the longest they’ve ever been. Last year, the average wait for a Canadian patient seeking non-urgent care was 27.7 weeks – almost three times longer than the 9.3-week wait that Canadians experienced 30 years ago.

This begs the obvious question. How do other countries outperform Canada’s healthcare system while also often spending less as a percentage of their economies? In short, their approach to universal health care, and in particular their relationship with the private sector, differs dramatically from the approach here at home.

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For example, Australia partners with private hospitals to perform the majority (58.6%) of all non-emergency surgeries within the universal healthcare system. Australia also spends less of its total economy (i.e. GDP) on healthcare, but outperforms Canada in timely care.

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Even with restrictions on the private sector, Canada has limited experience that should encourage policymakers to embrace greater private sector involvement. For example, starting in 2010, Saskatchewan contracted with private surgical clinics to provide publicly funded services as part of a four-year initiative to reduce wait times, which were among the longest in the country. Between 2010 and 2014, waiting times in the province fell from 26.5 weeks to 14.2 weeks. After the initiative ended, wait times across the province began to grow.

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More recently, Quebec, which has one of the shortest wait times for medical services in the country, outsources one in every six day surgeries to private clinics within its publicly funded health care system.

Maher’s monologue, which was viewed by millions of people online, highlighted key shortcomings of Canada’s health care system. If policymakers in Ottawa and the provinces want to improve Canadian health care, they must learn from other countries that provide universal health care at the same or even lower costs, often with better access and better outcomes for patients.

-Mackenzie Moir is an analyst at the Fraser Institute

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