IntroductionCountries allaround the world differ in how they provide healthcare services to its populationof citizens, residents, and visitors within its borders. That is, countriesvary significantly in how healthcare services are delivered, how the costs ofhealthcare services are covered, how they achieve desired health outcomes, andhow long patients must wait to see a primary care physician or a specialist. Whilesome countries are either leading the way, or falling behind in terms of providingquality healthcare to its citizens, this paper will focus on contrasting andcomparing the cost, access, and quality of the healthcare systems of Canada andSweden. CostCanada’s healthcaresystem is funded at both the federal and provincial level. The federalgovernment assumes responsibility for the health care of special groups such asthe Royal Canadian Mounted Police (RCMP), First Nations & Inuit, Veterans,Federal Offenders, Canadian Forces, and Refugee Claimants (Parliament of Canada, 2004).
At the provinciallevel, the healthcare system consists of thirteen health insurance plans, whichare referred to as Medicare. Each province and territory employs its own healthinsurance plan and “receives funding from the federal government through theCanada Health Transfer” (Government of Canada, 2016). In order to receivethe healthcare funding, the provinces and territories must meet the conditionsand criteria outlined in the Canada Health Act. In Canada, medically necessaryservices are fully covered by public health insurance.
In contrast, Sweden’s centralgovernment imposes the country’s healthcare policy while the county councilsand municipalities are responsible for providing health services. The county councilsand municipalities are regulated by The Health and Medical Service Act. (Swedish Institute, 2017). In bothcountries, private health insurance is available through employers to fill inthe gaps of services that are not covered by public health insurance, forexample, prescription medications and dental care coverage. Although healthcareis publicly funded, Swedish residents may still be required to pay small fees forparticular services, for example one-day hospital stays or visits to aspecialist.Moreover, another significantconsideration when comparing the costs of healthcare systems between countriesis how much a country spends on health care.
According to the World HealthOrganization (2017), Canada spent “10.4% of its Gross Domestic Product (GDP),or $4,641 per capita, on health care in 2014, whereas Sweden spent 11.9% of itsGDP, or $5,219 per capita, on health care” in the same year (World Health Organization, 2017). In Sweden, health care funding comesfrom local taxes (approximately 70%), national subsidies (approximately 20%),and private insurance (less than 1%) (Swedish HealthCare, 2017). Although the health care systems inboth countries are funded similarly, Sweden spends more on its healthcaresystem than Canada does and costs are not a significant barrier to healthcare sincepeople are able to access the care they need without having to worry about costs. AccessTimelyaccess to healthcare is a key indicator of an effective healthcare system.
Studiesshow that Canada’s wait times are the worst when compared to similar developedcountries. Almost 25% of older Canadians waited two months to see a specialist Accordingto the Canadian Institute for Health Information (2017), Canadians wait thelongest for primary and specialist care (Canadian Institute for Health Information, 2017). Additionally,long wait times also encourage Canadians to visit the emergency departmentinstead of seeking medical services from a primary care physician.
Conversely,wait times in Sweden to see a specialist and to undergo surgery are relativelyshorter than in Canada. For example, a review by the Organisation for EconomicCooperation and Development (OECD) found that the average wait time to see aspecialist is approximately twelve days compared to two months in Canada. Swedenaims to keep wait times even lower at seven days for patients to visit aprimary care physician (TransferWise, 2017). What has also provedeffective is the healthcare guarantee, which was introduced in Sweden in 2005,promising to reduce waiting times for treatment or operations to a maximum of90 days. If this time is exceeded, patients are offered care elsewhere, thecost for which, including travel costs, is covered by the patient’s countycouncil (InterNations, n.d.).
Swedish patientsexperience shorter wait times for access to primary and specialist care throughits healthcare guarantee and therefore outperforms Canada on access tohealthcare indicator. Canada and Sweden both operate on a universal healthcaresystem which is paid for through taxes and ensures that all residents have equalaccess to healthcare services. Canadian citizens and permanent residents have accessto medical services by presenting their provincial health card during theirvisit to the clinic or hospital. In Canada, a significant issue preventingindividuals from accessing a health care provider is the fact that most healthcare resources in Canadaexist within urban areas. Patients in rural and remote communities may have totravel farther distances to access medical services.
To improve healthcareaccess for those living in remote or rural areas, Canada implemented theTelehealth initiative throughout all provinces and territories which “allows patients to dial a number and connect withnurses and doctors remotely” (MediResource Inc. , 2017). Similarly, all residents living inSweden also have equal access to medical care services.
Sweden recently updated itsnational eHealth vision, which now states that, by 2020, all residents aged 16or over should have access to all health-related information documented in county-fundedhealth and dental care.when Uppsala became the firstregion in Sweden to make EHRs accessible to patients. This means that throughout Sweden, manydifferent EHR systems are in use and interoperability between them hastraditionally been low. (Hägglund, 2017) There arenow 228 doctors per 100,000 people Thedoctor-to-patient ratio has increased in all provinces since 2011.
Swedish system performs well on quality indicators ConclusionAlthough Canada and Sweden’s healthcaresystems are funded quite similarly, they differ greatly the type of quality ofcare and services provided to patients. Sweden leads Canada in terms of shorter wait times, improved services,and quality performance indicators. “The Swedish health care system is oftenconsidered a model for other countries to emulate, both because of itsexcellent outcomes compared to OECD countries and several well-developedstrategies to assure and improve the quality of its health care” (Swedish HealthCare, 2017). Due to Sweden’s overalleffectiveness and quality healthcare outcomes, the Swedish healthcare system isthe optimal system when compared to Canada’s healthcare system.