Health Policies in Canada

Summary

The goal of this project was to raise the level of informed debate among policy makers and Canadians generally on a variety of subjects relating to the Canadian health care system. This series of reports was published over five years and addressed such topics as the possibility of introducing private hospitals in Canada, wait times experienced by patients in the current system, the restrictions doctors faced in practicing medicine in Canada, the degree to which Canadians access alternative or complementary medicines outside of the medical system, and the degree to which the government intervenes in health care provisioning. The project resulted in a number of publications.

Grant Outputs

Pharmaceutical Cost Containment –

Provincial Drug Benefits & Pharmacare
This series of publications examines the spending patterns of Canadian citizens and the Canadian government on pharmaceuticals. They argue that the Canadian government is paying too much for non-branded drugs, as compared with the rates private insurers have negotiated. To combat this, several reports suggest that Canadians should be free to purchase their own pharmaceuticals, without the government acting as a buyer for the population. Medical Savings Accounts are proposed as a means for Canadians to be in greater control of their own pharmaceutical financing. Several articles suggest that drug prices respond to normal market conditions, and that it would be in the best interest of Canadians to access pharmaceuticals independently of government control.

Financing Pharmaceuticals in Canada
http://oldfraser.lexi.net/publications/forum/2000/12/section_11.html

How Can Canadians Pay for Prescription Drugs?
http://oldfraser.lexi.net/publications/forum/2001/04/section_13.html

Saving Money with Generic Drugs
http://oldfraser.lexi.net/publications/forum/2001/10/section_11.html

Uniform Global Prices Mean Higher Prices for Drugs
http://oldfraser.lexi.net/publications/forum/2002/02/section_02.html

Prescription Price: Does the Payer Matter?
http://www.fraserinstitute.org/research-news/research/display.aspx?id=13256

A Lesson from Manitoba’s Means Test for British Columbia’s Pharmacare
http://www.fraserinstitute.org/research-news/research/display.aspx?id=13245

Government Intervention in Health Care –

Crisis in Health Care
This series of publications focuses on problems arising from fiscal mismanagement of the medicare system. Several reports suggest that Canadian health care could be improved if Medical Savings Accounts were established. Other reports suggest that hospital spending needs to be reallocated so that doctors receive higher wages and hospital support staff receive wages that are lowered to reflect wages in the private sector. These reports find that health care spending was being mismanaged, and could be reformed through less government control and greater competition.

Making Health Spending Work
http://oldfraser.lexi.net/publications/pps/54/pps54.pdf

Questioning Medicare’s ‘Advantages’: Does Risk Pooling Matter?
http://oldfraser.lexi.net/publications/forum/2000/12/section_10.html

Financing Malfeasance: Medicare’s Infectious Disease
http://oldfraser.lexi.net/publications/forum/2001/01/section_10.html

Labour Costs in the Hospital Sector Revisited
http://oldfraser.lexi.net/publications/forum/2002/01/section_13.html

Health Care’s City/Urban Divide
http://www.fraserinstitute.org/publicationdisplay.aspx?id=13179&terms=fr…

When Does More Doctors Mean Less Access
http://www.fraserinstitute.org/publicationdisplay.aspx?id=12814&terms=fr…

Dead Capital in Ontario’s Hospitals
http://www.hazmatmag.com/posted_documents/pdf/FraserForumFeb02.pdf

The Myth of Medical Monopoly and Monopsony
http://heartland.org/sites/all/modules/custom/heartland_migration/files/…

Waiting Your Turn, 9th ed. – http://www.fraserinstitute.org/publicationdisplay.aspx?id=13581&terms=waiting+your+turn+9th+edition

These reports document wait times for health services in Canada and find that in the years 1998 and 1999, they increased in all provinces except Ontario and Manitoba. Both reports review the standard wait times for a variety of treatments, and also measure the wait between the first primary care visit and first visit to the specialist. The survey asked doctors what a reasonable (medically safe) wait time was for various medical treatments, and found that on average, out of 121 treatments where data was available, actual wait times exceeded medically reasonable wait times 83 percent of the time (10th ed.). The reports conclude that the Canadian health care system is not providing equal health services to all Canadians, especially for treatments like cardiovascular surgery, as urban patients have greater access than rural patients, and famous and well-connected patients receive treatment more quickly than others.

How Private Hospital Competition Can Improve Canadian Health Care – http://www.fraserinstitute.org/research-news/display.aspx?id=13105

This report examines a proposal by the Alberta government to permit the provision of surgical services by private hospitals. It considers the existing literature that discusses private and public hospitals, which suggests that for-profit hospitals have no clear performance advantages or disadvantages compared to non-profits, though private hospitals tend to perform better than public hospitals. It concludes that competition has been beneficial for American health care consumers, and therefore that the Alberta government plan would ultimately improve Alberta health care.

Reform of the Canada Health Act –

Reform of Canadian Health Care
This series of articles examines the technical efficiency of the Canadian medical system and argues that government-run, universal health care should be more privatized. Several articles mentioned the results of the RAND study which found that when patients have to pay a fee for services, system use decreases with minimal negative health impacts for the majority of the population. This series articulates concerns that Medicare is delivering poor health care to patients and should be reformed – through the courts, if not in legislation – so that patients can purchase private insurance to provide for their own health care.

Will Alberta’s Health Care Reforms Succeed?
http://oldfraser.lexi.net/publications/forum/2000/01/section_03.html

Canadian Health Reformers Should Understand RAND
http://oldfraser.lexi.net/publications/forum/2000/02/section_01.html

Real Health Care Reform Begins with Choice
http://oldfraser.lexi.net/publications/forum/2000/02/section_03.html

The Ultimate Health Care Reform
http://www.fraserinstitute.org/publicationdisplay.aspx?id=13031&terms=fr…

Breaking the Code in the Health Care Politics
http://oldfraser.lexi.net/publications/forum/2000/02/section_02.html

Finding the Best View from the Titanic
http://oldfraser.lexi.net/publications/forum/2001/03/section_12.html

Canada’s Health Care System and Section 7 of the Charter
http://oldfraser.lexi.net/publications/forum/2001/09/section_09.html

The Quality of Health Care and Wages Both Increase with Swedish Health Care Privatization
http://oldfraser.lexi.net/publications/forum/2001/11/section_06.html

Don’t privatize Health Care: Genuine Concern or the Quest for Higher Wages
http://oldfraser.lexi.net/publications/forum/2001/11/section_07.html

Insuring Against the Canada Health Act
http://oldfraser.lexi.net/publications/forum/2001/12/section_10.html

Roy Romanov’s One Man Band
http://www.fraserinstitute.org/research-news/research/display.aspx?id=13179

The Attack on Medicare Reform
http://www.fraserinstitute.org/research-news/research/display.aspx?id=13430

A Court Challenge against Government Monopoly in Health Care
http://www.fraserinstitute.org/research-news/research/display.aspx?id=13256

New Zealand: Internal Markets for All, or Private Treatment for Some?
http://www.fraserinstitute.org/publicationdisplay.aspx?id=13245&terms=fr…

A Cure Worse than the Illness – Canada’s Proposed Regulatory Framework for Natural Health Products in Light of International Evidence – http://oldfraser.lexi.net/publications/pps/55/pps55.pdf

This report examines the potential outcomes of the federal government’s regulatory process for natural and alternative medicines. It suggests that the governments are increasing regulation of natural and alternative medications and remedies because a greater number of Canadians are using alternative products. The article concludes that the cost of regulating alternative medicines is very high, relative to the benefits proposed by the regulatory reforms proposed by Health Canada. It suggests that in order to justify the new regulatory process, more concrete data must be provided to show the benefits to Canadians of greater alternative medicine regulation.

Overkill: The Regulation of National Health Products in Canada – http://www.fraserinstitute.org/research-news/research/display.aspx?id=13033

This article suggests that natural and alternative medicines are indicated as the cause of unfavourable outcomes in less than 0.5% of reported health concerns in the United Kingdom, and 1.16% in Australia in 2000 and 2001 respectively. Consequently, it argues that the risks associated with natural medicines were too minimal to justify the costs of a new regulatory process for natural and alternative medicines in Canada.

Spend More, Wait Less? The Myth of Under-funded Medicare in Canada – http://www.fraserinstitute.org/research-news/research/display.aspx?id=12826

This report examines the argument that providing greater funding to the medical system will decrease waiting times. It compares waiting time data from the Canadian Institute for Health Information (CIHI) with Fraser Institute data measuring waiting times for various surgeries across Canada. It finds that increasing funding to health care has been ineffective in improving service delivery times, and that the number of treatments sometimes decreases where funding has been increased. It argues that the existing funding has been misallocated, and that reforming the existing system would have better overall outcomes than increasing health care spending.

Prescription Drug Prices in Canada and the United States: Parts I – IV –

This four-part series examines price differences between Canada and the United States. It finds that prices in Canada are lower than prices in the United States for both patented and branded, non-patented drugs. Generic drugs in Canada, however, are shown to be more expensive. This series suggests that Canadian drug prices are lower not because of government regulations, but because Canadians have a lower standard of living than Americans, and the weaker dollar results in less expensive prescription drugs. The report suggests that American and Canadian drug prices varied widely between regions based on relative income, provision of different pharmacy services, and different regional tax rates. The series concludes that American cross-border pharmaceutical shopping could threaten the Canadian drug market, and as such the Canadian government should instigate some kind of legal deterrent to stop Americans from purchasing less expensive Canadian drugs.

Part 1:
http://www.fraserinstitute.org/publicationdisplay.aspx?id=13295&terms=pr…
Part 2:
http://www.fraserinstitute.org/publicationdisplay.aspx?id=13296&terms=pr…
Part 3:
http://www.fraserinstitute.org/publicationdisplay.aspx?id=13297&terms=pr…
Part 4:
http://www.fraserinstitute.org/publicationdisplay.aspx?id=13299&terms=pr…