Canadian politicians should learn about Australia’s better health-care system

Faced with record high wait times, a majority of Canadians now support partnerships between the government and private sector to deliver publicly-funded health care. And yet, advocates for the status quo—including the Trudeau government and several high-profile politicians—continue to criticize such arrangements. But in reality, public/private partnerships are the norm in more successful universal health-care systems worldwide.

For example, in Australia the private sector plays a key role in health-care delivery.

Unlike in Canada, patients in Australia can choose to be treated as a public or private patient in a public or private hospital. That’s a lot of choice. In fact, of Australia’s 1,355 hospitals in 2016 (the latest year of available data), nearly half were either private for-profit (40.1 per cent) or private not-for-profit (8.4 per cent). As a result, in 2021/22 (the latest year of available data), 41 per cent of “care episodes” for patients admitted to a hospital occurred in a private facility. And 70.3 per cent of elective (i.e. not including emergency) hospital admissions involving surgery occurred within a private hospital.

More broadly, the public system in Australia regularly pays private hospitals to treat patients. In 2021/22, 303,844 fully publicly-funded care episodes occurred in private facilities, and private hospitals delivered 73.5 per cent of the care funded by Australia’s Department of Veterans Affairs. At the same time, the government also partially subsidizes private care, often at a rate of 75 per cent of the public fee. In 2019/20 almost one-third (32.8 per cent) of private hospital expenditures came from government sources, including the federal government.

Put simply, there’s a deep integration between the public and private hospital sectors in Australia. So, what do Australians get in return?

Although Australians and Canadians spend a similar amount of money on health care (on a per-person basis), Australians receive far better value. After adjusting for age, Australia’s health-care system outperforms Canada’s on 33 (of 36) measures of performance including availability of physicians, nurses, hospital beds, CT scanners and MRI machines. And according to data from the Commonwealth Fund, a health-care research organization, Australia’s system outperforms Canada’s on several indicators of timely access to care including ease of access to after-hours care, same-day primary care appointments, and crucially, timely access to elective surgical care (e.g. hip replacements) and specialist appointments.

In other words, Australia outperforms Canada both in terms of access to health-care services and timely delivery of care. And yet, many Canadian politicians continue to resist meaningful reform.

The Canadian public has expressed a clear appetite for change that breaks with the status quo of simply increasing spending and fearmongering about reform. If policymakers in Canada want to emulate other high-performing universal health-care systems, they should look to countries such as Australia where patients enjoy more timely access to high-quality care.