- Reaction score
According to the WHO https://www.who.int/healthinfo/paper30.pdf
A new report has ranked Canada's health system second last, ahead of the United States, when comparing 11 high-income countries.www.google.com
While you do make "some" valid points about lacklustre performance in Canada's health care system your argument would be better with a more judicious use of references.
While the WHO paper has no date indicated, all its cited references are from the earliest in the 1970s to the latest in 2000, so the data used is more than 20 years old. That doesn't necessarily invalidate its conclusions but it may possibly change some of the rankings.
The other chart you included (I've also used - not here - the bigger the size, the louder the argument method) is more recent. I had a quick look at that Commonwealth Fund Mirror, Mirror 2021 study. What caught my attention more than the chart you used was this one which broke down the rankings - Access to Care, Care Process, Administrative Efficiency, Equity, and Health Care Outcomes.
Recognizing that the Commonwealth Fund's aim (with this and previous versions of the study) is to encourage the adoption of universal health coverage in the USA (or as close to universal as would be recognized in an American mindset), it didn't surprise me that the USA ranked lowest in all the categories except for "Care Process", which leads me to the conclusion that "if" (and that's a big if) an American can avail themselves of the full spectrum of care/services, they get very good care. What did surprise me was the low ranking of Canada in Access to Care, Equity and most of all, Health Care Outcomes; our ranking in Care Process is a respectable (better than most) fourth place. My thought thus went to "what do these categories mean, how did they arrive at the rankings, and is there a measurement other than placing that marks the differences". For example, in the last Olympic 100 metre sprint final, between first and sixth place (the final two did not finish) there was only a difference of 0.18 seconds (Canada's Andre Degrasse's 0.09 second slower speed relegated him to a Bronze Medal - how pitiful ).
There is some explanation in the study as to my questions but a lot of it is a broad brush (at least too broad a brush for the detail I would like), however the 2017 version of the Commonwealth Fund's study did link to a bit more detail of the criteria used to arrive at those rankings. The 2021 study does explain that there were some changes (additions/deletions to criteria/questions) since than earlier survey. Even thus, all my questions were not met but my takeaway from the study (they don't say it, it's my conclusion) is to reinforce my already formed opinion that the most viable path to improving our health system - or at least our rankings in these sort of studies is (in order of priority):
a. universal drug coverage
b. universal dental coverage
c. increase output of medical graduates
There are other things I could suggest but those three are good first bites of the apple.
Those are three things that differentiate us from many of the countries ranking higher in these type of studies. While many will raise the issue of the public/private health insurance and provider mix for the more successful European countries, my best response is - we're not Europeans, we don't think like them, we don't have their history (in this issue), we aren't governed like them and most important of all, they don't sit next to and are not culturally and economically influenced to the same extent by the USA.
For those who may be interested in background on other countries' health systems Country Profiles | Commonwealth Fund
And some charts related to my suggested improvement
Medical graduates churned out.
Extent of Coverage - note for Canada the percentage for Dental and Pharm compared to other players in the study