Canada - World Health Organization Regional Office for Europe

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Health systems in transition Canada
lengthening waiting times for non-urgent surgery. In a 2010 survey of patients
by the Commonwealth Fund, for example, Canada ranked behind Australia,
France, Sweden, the United Kingdom and the United States in terms of patient
experience of waiting times for physician care and non-urgent surgery (HCC,
2011b). Using more objective indicators of health system performance such
as amenable mortality, however, Canadian health system performance is
more positive, with much better outcomes than the United Kingdom and the
United States, although not quite as good as Australia, Sweden and France.
Canadian performance on an index of health care quality indicators has also
improved over the past decade as provincial governments, assisted by health
quality councils and other organizations, more systemically implement quality
improvement measures. Finally, governments, health care organizations and
providers are making more efforts to improve the overall patient experience.
7.1 Stated objectives of the health system
Based on the history of medicare supported by provincial and territorial
medicare laws as well as the Canada Health Act, Canadians expect to continue
receiving universal access to medically necessary hospital and physician
services without any direct charges. This expectation – which is often perceived
as a basic right by Canadians – highlights the role of both orders of government
in financially protecting individuals in the event that health care is needed. It
also implies that Canadians should have equitable access to medically necessary
services, an assumption that is reflected in the criteria of universality and
accessibility in the Canada Health Act and the restatement of these principles
in provincial and territorial medicare laws. However, health care involves much
more than medicare, and there is less financial protection and equity of access
when it comes to prescription drugs, long-term care, dental care and vision care.
Although results vary depending on the sector in question, in general, health
and health service outcomes, including quality, based on a series of measures
are reasonably good in Canada. However, patient satisfaction ratings are not
as good, at least when compared with selected OECD countries. While this
is, no doubt, a consequence of a number of factors, dissatisfaction with long
waiting times is probably one of the most important – if not the most important
– contributing factors. Another may be the historic lack of transparency and
accountability in Canadian health care, something that governments are now