While paying for one of the developed world’s most expensive universal health-care systems, Canadians endure chronic shortages of doctors, medical equipment and some of the longest wait times for treatment anywhere, according to a new report.

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“Comparing Performance of Universal Health Care Countries, 2024,” by Mackenzie Moir and Bacchus Barua, says that after adjusting for age, Canadians pay the fourth-highest amount for medical care among 31 industrialized countries with universal health care as a percentage of GDP (11.5%) and ninth-highest in spending per person (US$7,035 in 2022).

In addition to assessing costs, the study done for the fiscally conservative Fraser Institute measured the performance of each country’s health-care system using 40 indicators in the broad categories of the availability of resources, their use, access to them and quality and clinical performance.

Based on the latest available data from 2022, Canada ranked 28th out of 30 developed countries in the availability of doctors, 25th for hospital beds, 25th for psychiatric beds, 27th out of 31 for the number of MRI machines per million people and 28th for CT scanners.

Among nine comparable industrialized countries with universal health care, Canada ranked in eighth place, or second-worst, on wait times, with patients waiting more than a month to see a specialist (65.2%); in ninth place, or worse, for patients waiting two months or more for non-emergency surgery (58.3%) and in sixth place for the percentage of patients who reported that cost was a barrier to obtaining health and dental care (38%).

(The Trudeau government has introduced dental care and the beginnings of a pharmacare program to address this, but it will also raise costs.)

“The data examined in this report suggest that there is an imbalance between the value Canadians receive and the relative high amount of money they spend on their health-care system” the study says.

“Although Canada ranks among the most expensive universal access health-care systems in the Organization for Economic Co-operation and Development, its performance for availability and access to resources is generally below that of the average OECD country, while its performance for use of resources and quality and clinical performance is mixed.

“While Canada does well on six indicators of clinical performance and quality (such as rates of survival for breast, colon, and rectal cancers), its performance on … six others are either no different from the average or in some cases — particularly obstetric trauma — worse.”

The study did not include six members of the 38-member OECD because they lack universal health-care coverage, including the United States, Chile, Colombia, Costa Rica, Mexico and Poland, as well as excluding Turkey, which is not classified as a high-income country.

The 31 remaining countries whose universal health-care systems were evaluated were Canada, Australia, Austria, Belgium, Czechia, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Israel, Italy, Japan, Korea, Latvia, Lithuania, Luxembourg, Netherlands, New Zealand, Norway, Portugal, Sloveck Republic, Slovenia, Spain, Sweden, Switzerland and the United Kingdom.

“Canadians are increasingly aware of the shortcomings of their healthcare system,” said Moir.

“To improve health care for Canadians, policymakers should learn from other countries around the world that do universal health care better.”

The findings of this latest Fraser Institute study, along with similar findings in the past, does not mean our doctors, nurses, lab technicians and other medical staff are incompetent or shirking their duties.

It does mean the current template for funding health care in Canada — a joint provincial, and federal responsibility — remains broken.