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Five Priorities for Fixing the Canadian Health Care System

November 06, 2012

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Glen Hodgson
Senior Vice-President and Chief Economist
Forecasting and Analysis

The evidence is mounting that the Canadian health care system needs some serious repair. It is most certainly not “the best health care system in the world,” as many Canadians still incorrectly believe. Funding from governments is facing serious constraints, service delivery is fragmented and uneven within provinces and territories and across the country, and demand pressures will only grow with the rise of chronic diseases and with an aging population.

So how can we fix the Canadian health care system? To help develop an answer, the Conference Board of Canada held its first-ever Summit on Sustainable Health and Health Care last week in Toronto. The Summit heard from some of the leading thinkers in Canada on health care reform, including CMA president Dr. Anna Reid, Alberta Health Minister Fred Horne, Jeffrey Simpson of The Globe and Mail (with his new book Chronic Condition: Why Canada’s Health Care System Needs to be Dragged into the Twenty-First Century), and many other experts, including the Conference Board’s own leaders and health researchers.

In our view, five key priorities for reform emerged from the Summit.

Fix the gateway to the health care system. Primary care is the first contact point with the health care system. There was a strong consensus that interdisciplinary family care teams should be the standard model for primary care, and these teams should be expanded and strengthened in all provinces and territories.
Invest in and use technology more intensively in the health care system, particularly information technology. More intensive and standardized use of information technology would allow patient information to be collected and shared seamlessly, making treatment much more efficient and thereby boost productivity in the health care system.
Change health professional compensation. The compensation model for physicians and other health professionals should be linked to more patient outcomes, not to activities like treatment or consultation, within a clear accountability structure.
Build an appropriate support system to care for the elderly. Few older Canadians want to be hospitalized for chronic conditions. They want to be cared for and healed where they live: in their homes and communities.
Improve the state of Canadians’ overall health and wellness. A healthier population would slow the growth in chronic diseases and in health care demand—so Canada needs a “wellness system” as well as a health care system. Employers have an important role to play in supporting the wellness of their employees and their families.

All of this action should be taken within a more transparent and accountable health care system with respect to its management, performance and costs. Creating greater transparency and accountability would go a long way in mobilizing support for change from all stakeholders—patients, taxpayers and care providers. The health care system needs a lot more individuals like Helene Campbell and Dr. Chris O’Connor, who have been empowered by data and are using social media to mobilize action.

Finally, practical solutions will be needed to move forward on each priority area. These solutions should include appropriate incentives for delivering effective and fair health care and related economic outcomes. Not all solutions will be easily adopted, and they will need to create “winning conditions” for political action. But if fully implemented, the fundamental reforms identified above could allow Canadians to say once again that we indeed have “the best health care system in the world.”