Three lessons Canada can learn from Australia’s health care system

By Jason M. Sutherland

Closure of emergency departments. Long waiting times for surgeries and appointments with specialists. Millions of Canadians without a primary health care provider.

Health care systems across Canada are struggling to provide timely and equitable access to health care services – at a time when provincial governments are cutting spending amid economic uncertainty.

Canada must find solutions that improve health care affordability, access and costs. One promising avenue is to look to other countries for innovative health care policies and practices, starting with Australia.

Why look to Australia?

Australia has many similarities with Canada. Both have universal and publicly funded health care systems, with responsibility for health care delivery primarily in the Canadian provinces and Australian states.

Both countries face similar health care challenges – affordability, timely access and delivery of services to vast rural areas, and provision of culturally appropriate health care for indigenous populations.

Australia is seeing better results for its health care spending. A recent international comparison of health care systems ranked Australia as the top performer. Canada was ranked seventh by researchers.

Australia’s experiences offer insights for Canada. Here are three lessons we can learn from them:

First, expanding access and improving health outcomes can happen without massive increases in public spending.

Canada is already one of the largest health care spenders among Organization for Economic Co-operation and Development (OECD) countries. Public figures show health spending accounted for 11.2 per cent of Canada’s gross domestic product (GDP) compared to an average of 9.2 per cent for other OECD countries.

Despite spending big compared to other countries, provincial health care systems – facing an aging population, more medical complexity and population growth fueled by immigration – see long waits for services, overcrowded emergency rooms and a persistent shortage of health professionals.

In contrast, Australia spends approx 9.6 percent of GDP for health care. And yet it is ranked first among 10 countries studied for equitable access and health outcomes. Meantime Canada ranks seventh in equity and fourth in results.

Second, greater private sector involvement in health care is not a panacea.

Provincial governments are increasingly turning to private and for-profit providers to deliver publicly funded health care services to address deficiencies in the public system. Some provinces outsource thousands of surgeries to for-profit clinics.

The cautionary tale of Australian experiences has shown that dual private and for-profit healthcare does not guarantee more timely access to services.

In addition to Australia’s public healthcare system, the government allows Australians to purchase private healthcare insurance and access private or for-profit healthcare services, including hospital care.

Those with private coverage can choose to be treated as a public patient in a state’s public hospitals or to be treated as a private patient in either a public hospital or a private facility.

While proponents of this hybrid hospital system say it improves access to publicly funded health care by redirecting patients with the means to the private system — and freeing up space in public hospitals for those who can’t afford private insurance — There is no evidence that the private system has improved access to public hospital care or reduced waiting times for elective surgery.

In fact, Australia’s private hospitals are facing significant financial challenges due in part to rising costs and disruptions caused by the COVID-19 pandemic.

The dire financial situation in Australia’s private health systems has resulted rising premiums and higher co-payments for Australians and collapse of some private hospitals.

Third, minimizing administrative burden will foster a more efficient and effective health care system.

THE Commonwealth Report Australia ranked second in administrative efficiency while Canada ranked fifth.

The report credits Australia’s good results to electronic claims processing and efforts to minimize burdens on doctors.

Governments in Canada can build on these lessons by strengthening cooperation and communication with their counterparts in Australia.

Canada’s federal government should take the lead in coordinating and funding comparative analyzes of the two countries’ health care systems – examining policies and practices that affect affordability, accessibility and equity – with provinces and territories providing data and expertise.

It should also fund joint health policy research with Australia and support staff exchanges – allowing the two countries to learn from each other.

The knowledge gathered will only strengthen Canada’s health care systems.

It is time for governments to invest in collaboration and innovation to ensure that health care is affordable, accessible and fair for all Canadians.

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About Jason M. Sutherland

Jason M. Sutherland is Professor of Health Services and Policy at UBC and its Director Center for Health Services and Policy Research in the School of Population and Public Health at the University of British Columbia.

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This post was published on Quoimedia.com and is republished here under a Creative Commons license.

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