Rethink Healthcare on Five Areas of National Priority

Posted on January 21, 2016 in Health Policy Context – Media Releases – Canadians spend a lot of money on healthcare and get middling results
January 20, 2016

Canadian governments must rethink healthcare on five areas of national priority, according to a new report from the C.D. Howe Institute. In “Challenging Vested Interests: National Priorities for Healthcare,” authors Åke Blomqvist and Colin Busby find that compared to the healthcare systems of a large group of peers, Canadian systems do not produce enough high-quality care for the money spent.

“Canadians are passionate supporters of their provincial healthcare systems, but the widespread support is also puzzling in light of the many gaps in coverage: for prescribed drugs, continuing care and mental health,” states Blomqvist. He adds that, “prospects for improvement also seem stymied by vested interests, which results in a state of policy gridlock – a general reluctance to try new things to get more efficient services.”

The report draws on two overarching themes for its policy priorities; getting value for money and a renewed federal role. According to Busby, “with dim prospects for revenue growth, healthcare systems need to get better value for money in order to cope with increasing demand for services and access to effective new technologies.” For the latter, Busby recommends that “rather than imposing national strategies in all areas of healthcare, the federal government could play a valuable leadership role by advocating core principles while encouraging diverse strategies. Large variation in provincial performance in international rankings means that the provinces have plenty to learn from one another.”

Using these two themes, the authors outline five healthcare policy priorities for 2016. They are:

1) Policies to Improve Value for Money
Despite a history of paying family doctors on a fee-for-service basis, there are many good reasons to move to a new payment model for family doctors and give hospitals the budget to engage in negotiations with hospital-based specialists.

2) Gaps in Public and Private Coverage
There is nearly 100 percent public coverage for doctors and hospitals, but for all remaining healthcare costs – in particular for drugs, continuing care and mental health – the public share is much lower. No other advanced country takes this approach.

3) The Canada Health Transfer – Hold the Line and Tweak
While federal transfers for health help support a basic level of services across the country, they also imply a risk that provincial accountability for financing and delivering health services is undermined.

4) A New Health Accord
The federal government has an opportunity to animate the discussions in which provinces compare notes on their reform efforts and international experience. But, Ottawa should make it crystal clear that failure to make the system better will not result in an implicit bailout in the form of increased federal transfers for healthcare.

5) Direct Federal Health Programs
The federal government needs to focus on the health services that it is directly responsible for, such as programs for First Nations and Inuit, as well as veterans, refugees, Canadian Forces and Royal Canadian Mounted Police. An early step would see the federal government identify the gaps relative to non-Aboriginals for a set of key health measures, such as life expectancy, enrolment with a family doctor, and early diagnosis of cancer.

The report concludes that Canadians spend a lot of money on healthcare and get middling results, but Blomqvist and Busby see a willingness by Ottawa to play a more active role on healthcare as something that should be welcomed. “There are areas where the federal government can facilitate the dissemination of successful policies between provinces and encourage diverse approaches to others.” But caution is advisable, they warn, “some approaches to federal intervention risk further blurring the accountability for healthcare financing and delivery – the provinces must do the heavy lifting.”

Click here for the full report:  < >

The C.D. Howe Institute is an independent not-for-profit research institute whose mission is to raise living standards by fostering economically sound public policies. Widely considered to be Canada’s most influential think tank, the Institute is a trusted source of essential policy intelligence, distinguished by research that is nonpartisan, evidence-based and subject to definitive expert review.

For more information contact: Åke Blomqvist, Adjunct Research Professor at Carleton University and Health Policy Scholar at the C.D. Howe Institute; and Colin Busby, Senior Policy Analyst, C.D. Howe Institute: 416-865-1904 or email:

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