It should come as no surprise to most of us that like a lot of other Alberta government expenditures, we spend more money on healthcare than any other province. So, do we get high value for what we pay for? Yes, we do get high value but relative to some other Canadian provinces, we should be getting more.

By contrast, Ontario and Quebec are low cost and high value healthcare provinces. They rank among the top provinces for high value healthcare but they pay a lot less than we do. These were just a few of the conclusions about the state of healthcare in Alberta presented by Nadeem Esmail, Director of Health Policy Studies at The Fraser Institute, to a sold out crowd last Thursday. Where don’t you want to get sick? British Columbia, Prince Edward Island and Saskatchewan are all on the low end of the healthcare value spectrum in Canada.

“There’s no province that does everything well,” says Esmail. Alberta gets high marks for lower waiting times when there is a higher risk of death and for keeping patients alive in these high risk cases. But we fall down on waiting times to be treated by a specialist when there is low risk of death. Ontario, Quebec and even BC generally have lower waiting times than Alberta.

“Healthcare in Canada is not equal;” if you are a WCB claimant, RCMP officer or a prisoner, you get to jump the queue. The wealthy often jump the queue by crossing the 49th parallel and paying for treatment outside of Canada. Esmail also indicated that while no one likes to admit it, politicians and other Canadians in positions of power and wealth often get preferential treatment – “80% of Internal Medicine practitioners and 53% of hospital CEOs admit to involvement in queue jumping for other than medical reasons.”

Compared to other developed countries on the international stage, only the United States pays more for healthcare than Canada as a percentage of gross domestic product. According to a 2011 study of OECD countries, Canada’s healthcare system is high cost with poor performance on wait times, which are the longest in the developed world and worsening. The implications for long wait times are significant including reductions in quality of life and increased risk of death while waiting. There are also enormous economic consequences. In one study, which calculated the cost of “excess wait times” for just four treatments (i.e., joint replacement, MRI scans, bypass surgery and cataract surgery), the total economic cost was estimated to be $14.8 billion. Canada also has poor access to doctors and technology and satisfactory performance on health outcomes. While we have one of the highest bed occupancy rates in developed world, which is very efficient, we have virtually no excess capacity to deal with epidemics or disasters. And shockingly, Canada is near bottom of the list for infant mortality. Our rate is going up while every other country is going down.

Alberta is currently looking at several changes to our provincial healthcare system that as Esmail puts it are tantamount to “shuffling deck chairs on the Titanic.” Alberta continues to put physician costs under the microscope when it should be looking at administration costs, which is much bigger slice of the healthcare pie. What’s the best approach for improving the system? Esmail suggests the best approach to fix our problems is simply to look internationally at the most successful systems.

Australia, Japan, Sweden, Switzerland and France all have lower costs, much lower wait times and better outcomes. All of these countries have user fees or co-payments and private treatment. He says, “People spend their own money better than they spend someone else’s.”

Esmail proposes that Canada needs to consider a system that includes both public and private healthcare and that user fees and competition will help to create efficiencies. We have an aging population and we can’t just keep throwing money at the system and expect to get high value for what we are spending.

Please mark your calendars for lunch on March 20th, when Brian Lindenberg, Senior Partner, Mercer and Stephen Diotte, Vice President, HR, IT and Corporate Services, MEG Energy will present – The Most Significant Employee Benefits Plan Issue: It’s Not What You Think! Click here for more information

- Kenneth MacDonald