OECD and Health Care: Canada’s $4.8 trillion national net worth
January 22, 2007
Canada’s health care system is similar to most members of the Organisation for Economic Co-operation and Development (OECD). The only OECD members who do not have a public health system on par with other members are the USA and Mexico. In spite of that the United States continues to pay a higher percentage of its GNP to its health care system than Canada .
Canadians view its medicare system as “a moral enterprise, not a business venture (Romanow 2002:21)” and they overwhelmingly support the tenets of the Canada Health Act which states that need not money determines access to health care. “Canada’s Medicare system since its inception in 1966 has become one of the “most fully socialized health care systems.” In the 1960s medical systems in Canada and the US were similar. Medicare was a$100 billion enterprise in 2002, one of our Canada’s’s largest expenditures (Romanow2002:20). However, this amounts to a smaller percentage of Canada’s national net worth which was $4.8 trillion as of December 2006 (StatisticsCanada 2006) than that of in 1992. Commissioner Ray Romanow’s mandate in 2001 was to “review medicare and engage Canadians in a national dialogue on its future”(Romanow 2002:6). This was accomplished through an 18-month investigation resulting in a report that was evidence-based and values-driven making recommendations to strengthen and improve medicare’s quality and sustainability making it more truly national, more comprehensive, responsive and accountable (Romanow2002:6).” In the 1970s pharmaceutical costs accounted for a small percentage of total medicare costs. By 2002 they were among the highest costs in the systemand they continue to rise. The report did not confirm claims that user fees, medical savings accounts, de-listing services, greater privatization, a parallelprivate system, as proposed by the leaner goverment lobbyists, were the cure for the medicare system (Romanow2002:21).
More surgeries, treatments and tests are being performed, but demands often outstrip their ability to deliver the necessary services on a timely basis. As a participant in the Commission’s “Policy Dialogue on Access”at Dalhousie University put it, long waiting times are not caused by the system performing fewer diagnostic and surgical procedures but because medical advances now allow us to deliver more of these services and to a wider range of people (Romanow 2002:192)
Public and private sector care providers (including fee-for-service doctors) have been part of our health care system since the inception of medicare in Canada.
Whereas in the 1970s medicare costs consisted mainly of physican fees and hospital expenditures (Romanow2002), currently the cost of pharmaceutical expenditures is the most rapidly increasing part of medicare (Lexchin 2007). In his recent Canadian Centre for Policy Alternatives report Lexchin (2007) reveals how the cost of pharmaceuticals accounted for $18.5 billion in 2004 and $20.6 billion in 2005. Spending on physicians was c. $18 billion in 2005. It is crucial to note that shareholders in pharmaceuticals enjoyed substantially greater returns than shareholders (20.1% in 2003; 23.5% in 1996) in other forms of manufacturing (10.8% in 2003 and 12.2 % in 1996) in Canada. Canada, Mexico and the United States do not have as comprehensive public plans for pharmaceuticals as do other OECD countries where the greatest expenditures on pharmaceuticals come from the public purse. OECD governments have more control over amounts spent on pharmaceuticals.
CIHI Canadian Institute for Health Information
OECD Organisation for EconomicCo-operation and Development
PMPRB Patented Medicine Prices Review Board a part of Health Canada, sets an upper limit on how much companies can charge
for new patented medications.
 The US spent more on administrative costs. They also spent more per person $2548 (US) compared to $1886 (US) in Canada. See http://www3.who.int/whosis/core/core_select_process.cfm
 Given that pension plans returns are based on the strength of investment portfolios we find ourselves in 2006 with a moral dilemma. How do we ensure the future of pension plans with a healthy investment portfolio while calling for ethical management of that same portfolio?
Lexchin, Joel. 2007.”CanadianDrug Prices and Expenditures: Some statistical observations and policyimplications.” Ottawa, ON:CanadianCentre for Policy Alternatives. ISBN 978-0-88627-520-4.
Romanow, Ray. 2002.Buildingon Values: The Future of Health Care in Canada –Final Report. ISBN0-662-33043-9.
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