September 19, 2024 – If provinces want to address Canadians’ growing dissatisfaction with the healthcare system, they need to take on special interests within the system and pass at least two key reforms, according to a new report by the C.D. Howe Institute.
In “Addressing the Crisis in Access to Primary Care: A Targeted Approach,” John Richards compares Canada to peer countries, and finds that the particularly low marks Canadians give our healthcare system at present can’t be explained by the chaos of the pandemic, the challenges brought by an aging population, or even funding issues.
Richards argues that the main cause for the dysfunction is the reluctance of provincial governments to undertake institutional reforms, due to a fear of provoking interest groups – particularly physicians' organizations. The provinces have not made major changes to their health delivery systems since they were forced to do so by the deficit crises of the 1990s.
Studies have repeatedly shown that nurse practitioners can deliver equally good care as family doctors in many situations, while costing the healthcare system less. Capitation, where healthcare providers are paid based on how many patients they currently have on their roster, gives clinics the flexibility to adjust their services in response to patient needs, allowing them to deliver better care at lower cost.
Richards concludes the time for reform has come, and two reforms are especially needed:
- An aggressive increase in the number of nurse practitioners working in community primary care, usually in multi-discipline clinics; and
- Expansion, beyond Ontario, in rostering patients and expanding capitation in multi-discipline clinics.
While there are many other healthcare reforms to consider, Richards concludes, these two “are imperative.”
For more information contact: John Richards, Simon Fraser University; and Daniel Kitts, Communications Officer, C.D. Howe Institute, 416-865-1904, Ext. 9520, dkitts@cdhowe.org
The C.D. Howe Institute is an independent not-for-profit research institute whose mission is to raise living standards by fostering economically sound public policies. Widely considered to be Canada's most influential think tank, the Institute is a trusted source of essential policy intelligence, distinguished by research that is nonpartisan, evidence-based and subject to definitive expert review.