In late November, the Canadian Institute for Health Information, released the report; Learning From the Best: Benchmarking Canada’s Health System, which examines Canadians’ health status, non-medical determinants of health, quality of care and access to care. It is based on international results that appear in the OECD’s Health at a Glance 2011, (released the same day), which provides the latest statistics and indicators for comparing health systems across 34 member countries.
How did Canada fare? I would say pretty well – better than many would expect given all the media hype about the terrible state the system is in. But some will argue that this report provides further proof that Canada’s health care is mediocre at best. I guess it depends on how you look at it and what’s important to you.
The good news or the bad news first? Really, the bad news is not terrible so I will start there. There were several measures for patient safety where Canada did less favourably than other countries. According to CIHI, Canada had some of the highest rates among 17 reporting countries of accidental puncture or laceration, as well as of foreign bodies left in during surgical procedures. We also had among the highest rates of obstetrical trauma of 20 countries reporting. The good news (even in this bad news) is that these are “fixable.” With an increasing amount of hospitals adopting surgical checklists and performing patient safety audits, these numbers will improve. Now that we know we are falling short in this area, we can focus on improvement.
The other problem area is obesity. Canada’s rates for obesity are among the highest in all the reporting countries. Adult Canadians’ self report rate for obesity is 16.5%, second only to the United States at 31%. Experts say these rates are actually higher given that people often underestimate their weight.
In contrast to the rates of obesity are the smoking rates. Canada has lower smoking rates than most OECD countries, and is on of only five OECD countries that decreased its smoking rate by than 30% since 1999.
So what does this mean? It means that Healthy Eating is the new Non Smoking. We need to focus the resources and energy we spent on getting people to quit smoking on getting people to make healthy lifestyle choices – eating right and exercising. It’s a tall order, but something that is already in the works as hospitals are revamping their own menus, providing healthier meals to patients and staff.
Now it’s time for the best news: Canada performs relatively well in screening and survival rates for cancer. While five year survival results were close to the OECD average for cervical cancer, they were above average for colorectal cancer and behind only the US and Japan for breast cancer.
We also are in or close to the top 25% of OECD countries on many measures of quality care. Canada has lower rates of hospital admissions for certain chronic conditions (diabetes, asthma, COPD) that can be managed by good primary care. What does this mean? It means that improvements have been made in ensuring Canadians have family physicians and that our primary care system is not broken like many say it is.
In spite of the bad news, I am not surprised by the results of a recent poll showing that a whopping 94 per cent of Canucks support public health care. We are do-gooders, known around the globe for our fine manners and willingness to help others. Our public health care system is something most of us hold quite dear, and are fiercely loyal to. Privatizing health care would be akin to burning our flag. And why shouldn’t we be proud and loyal to a system that provides care to all, not just the lucky ones who can afford it?
While it is not the time nor place for the public vs. private debate – I was quite pleased when I saw this public health care press release appear in my inbox. I am a proud Canadian. I am proud of all that is Canadian, including our health-care system. Is it perfect? Certainly not. Is there room for improvement? Most definitely. But we have come a long way in not only detecting and treating disease but keeping Canadians healthy and out of hospital. The system does fall short in some areas, but we are finding innovative ways to measure and quantify these shortfalls so we can formulate solutions. And what makes me most proud to be Canadian is that we will all reap the rewards of the solutions – not just those who can afford it.