Universal coverage a real possibility

The healthcare debate in the US has put the pros and cons of Canada's system in the spotlight

Universal coverage a real possibility
Canada’s demographic shift means the country’s healthcare system is in need of a refresh, according to Queen’s University academic Dr. Chris Simpson. As US Senator and former presidential candidate Bernie Sanders continues to advocate for universal coverage in the US, Canada’s mixed public-private healthcare has come under the spotlight.

Canada’s current healthcare system dates back to the 1960s, when the provinces followed the model devised by Saskatchewan premier Tommy Douglas. Sanders’ supporters have used Canada as an example for the US to follow, while opponents have pointed out the flaws in government plans, particularly long wait times. In Simpson’s view, there is much to admire about the Canadian system, but also much that can be improved upon.

“I think a lot of the arguments from American lawmakers are simplistic,” he says. “The famous video of Dr. Danielle Martin taking on the US senator [Richard Burr] – his arguments were very amateurish and designed as red meat for his base. The reality is, we need far more sophisticated arguments than that.”

Critics of government-funded plans argue that long wait times put the public’s health at risk, but this argument ignores the fact that for emergencies, there are few countries with better care than Canada, Simpson explains.

“There is no question that access and wait times are the Achilles’ heel of our system,” he says. “What’s often lost in that argument is that if you have an urgent problem, there may well be no better place than Canada to have your care. You will get it very quickly, and you will get world-class care.”

In a recent paper, the Queen’s University School of Policy Studies Health Policy Council identified potential efficiency improvements for Canadian healthcare. As one of the study’s authors, Simpson believes a strengthening economy means reform is more achievable. A national pharmacare plan is often cited as a first point of action; in Simpson’s view, the prospect of government-sponsored drug plans looks increasingly likely.

“We are probably closer than we ever have been, and there seems to be more credible economic analysis floating around,” Simpson says. “What I worry about are the some of the new drugs coming down the pipeline – biologics and some of these extraordinarily expensive drugs.”

While certain segments of the population currently receive drugs through a government plan, the majority of people rely on their employer’s group plan or pay out of their own pocket. It’s a considerable expense – and something policymakers need to address, Simpson says.

“We haven’t gotten together and created a larger bargaining unit,” he says. “If you take New Zealand as an example, they have been able to get prices right down. In Canada, the Council of the Federation has made some progress on bulk purchases. Critics say it impedes innovation and will drive the drug companies out, so it’s a double edged sword.”