Opening independent non-profit hospitals would improve access to care and efficiency in Canada’s healthcare system
2024年8月1日 - 9:04PM
Autonomous non-profit hospitals tend to perform better than
government-run hospitals, shows a study published this morning by
the Montreal Economic Institute.
“Interminable waits in Canadian hospitals show that our
healthcare systems are struggling to deliver basic services to the
population,” says Emmanuelle B. Faubert, economist at MEI and
author of the study. “By allowing independent non-profit hospitals
to open, our governments would help increase treatment capacity, to
the benefit of patients.”
In 2023, the median wait time in Quebec ERs was 5 hours and 13
minutes, up 42 minutes from five years earlier.
It is estimated that as a result of chronic overcrowding in
Canadian ERs, there are between 8,000 and 15,000 avoidable deaths
each year.
The Canadian health care system ranks 10th out of 11 comparable
industrialized countries, just ahead of the United States, in the
Commonwealth Fund’s ranking of healthcare systems. The French,
German, and Dutch systems are 8th, 5th, and 2nd respectively in the
same ranking.
While the Canadian system has no independent non-profit
hospitals according to the OECD’s definition, such facilities
account for 14 per cent of French hospital beds,
28 per cent of German hospital beds, and
100 per cent of Dutch hospital beds.
The researcher attributes a portion of the success of these
facilities to their greater managerial autonomy and to a funding
method that encourages the treatment of more patients.
“One of the strengths of these hospitals is how quickly they can
adapt, contrary to facilities micromanaged by government
ministries, as is the case in Canada,” explains Ms. Faubert. “Since
their financing depends on the type and the quantity of ailments
treated, administrators see the sustainability of their facilities
as being directly linked to their capacity to treat patients.”
Although Canadian hospitals generally have their own boards of
directors, the management of their daily activities and their
funding are subject to strict government control.
Aside from certain limited experiments, notably in Quebec,
Canadian hospitals still depend largely on a global budgeting
model, in which funding depends entirely on the level of activity
in the previous year.
Since the annual budgetary envelope is fixed, each additional
patient is seen as a cost, says the researcher.
In Europe, in contrast, hospitals are largely financed according
to an activity-based funding model, whereby a hospital receives a
set amount of money for each treatment carried out within its
walls. With this system, each additional patient treated represents
an immediate source of revenue for the facility, says the
researcher.
“It’s clear that our healthcare system can and must do better,
and that means changing the incentives of those who manage it,”
says Ms. Faubert. “By introducing non-profit hospitals, with a
better funding model, and by granting health professionals more
flexibility, we will be able to provide better care to more
patients, as they do in Europe.”
The MEI study is available here:
https://www.iedm.org/wp-content/uploads/2024/08/note082024_en.pdf
The MEI is an independent public policy think tank with offices
in Montreal and Calgary. Through its publications, media
appearances, and advisory services to policymakers, the MEI
stimulates public policy debate and reforms based on sound
economics and entrepreneurship.
Interview requestsNatalia AlcocerIntern,
CommunicationsCell: 514 974-7835nalcocer@iedm.org
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