Canadian Healthcare vs UK Healthcare

Kindly Canada has worse health-care than U.K., says expertPeter O'Neil, Europe Correspondent

Canada's health-care system is more expensive and less effective than the United Kingdom's, according to a U.S. health policy analyst — and one reason may be the public's reluctance to protest.
Canada's health-care system is more expensive and less effective than the United Kingdom's, according to a U.S. health policy analyst — and one reason may be the public's reluctance to protest.

"Canadians are too nice," said Robin Osborn, vice-president and director of The Commonwealth Fund's international program. In an email interview, Osborn commented on the introduction Wednesday by Britain's coalition government of the most radical reforms in the history of the 62-year-old National Health Service.
Osborn said that while she supported the idea of giving British doctors greater control over the massive health budget, as the legislation proposes, she said the changes bring some risks to a system that has proven to be one of the most successful in Europe.

"The U.K. is on many levels a real success story," she said."And, while health spending as a per cent of GDP (gross domestic product) is less than Canada, performance is significantly better on key measures that reflect the core attributes of a high-performing health-care system."The Commonwealth Fund has for almost a century advocated improvements to the health-care system in the U.S., and regularly conducts comparative analysis to show the American system lags far behind those in other western democracies.A poll last year of 19,700 people in 11 industrialized countries, including Canada, found that the U.K. is the only country where wealth doesn't determine access to care.

Another 2010 Commonwealth Fund ranked the British system second of seven countries analyzed, behind only Holland, in terms of quality, efficiency, access to care, equity and healthy lives. On efficiency, the U.K. was No. 1. Canada ranked sixth overall in the survey, ahead only of the U.S.Osborn said Britain's success is due to the reforms — and a huge infusion of cash — introduced after Tony Blair became prime minister in 1997.They included national wait times targets, the establishment of star ratings for hospitals, the creation of a National Institute for Clinical Excellence, and the launch of a new auditing system."Most importantly, these were all pulled together as part of a coherent national policy and strategic vision that was implemented and sustained over 10 years, which in politics and in health policy, is a rare luxury."
The Labour government's move to allow greater private-sector involvement, harshly criticized by Canadian unions in the health sector at the time, didn't play a significant role in the success story, she said.

For instance, the government allowed private companies to provide diagnostic services, with "mixed results."
She pointed out that the NHS is far more comprehensive than Canada's, covering dental and prescription drug charges.But the U.K. also allows parallel private insurance, now used by about 12 per cent of the population, as a "safety valve."Insured people can use the insurance to avoid long waits for elective surgeries, to choose and quickly access specialists, and to go to private hospitals with more amenities.
"It's not controversial. The public accept it, and don't see it as a threat to the NHS. But they definitely would not let the government expand it to replace what they expect the NHS to cover."
She blamed Canada's poor ranking on the billions of dollars in cuts to federal-provincial transfers imposed by the Liberal government of the mid-1990s, which reduced supply of doctors and hospital beds.

"This produces high rates of emergency room use, which is expensive and poses quality problems."
Canada has had "lots of commissions" of inquiry with strong recommendations to fix the system, but politicians failed to bring in visionary changes to accompany the restoration of federal funding in 2004 that then-prime minister Paul Martin said would fix Canadian medicare for a generation.

"Provinces received federal funds but did not have to meet performance targets on access, quality, and public reporting," Osborn noted, adding that there has been a lack of incentives for doctors and hospital administrators to improve quality or productivity."And, probably, a last problem: Canadians are too nice. That is, (there is a) lack of public protest."
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