Introduction Canadian Forces, and Refugee Claimants (Parliament

Introduction

Countries all
around the world differ in how they provide healthcare services to its population
of citizens, residents, and visitors within its borders. That is, countries
vary significantly in how healthcare services are delivered, how the costs of
healthcare services are covered, how they achieve desired health outcomes, and
how long patients must wait to see a primary care physician or a specialist. While
some countries are either leading the way, or falling behind in terms of providing
quality healthcare to its citizens, this paper will focus on contrasting and
comparing the cost, access, and quality of the healthcare systems of Canada and
Sweden.

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Cost

Canada’s healthcare
system is funded at both the federal and provincial level. The federal
government assumes responsibility for the health care of special groups such as
the Royal Canadian Mounted Police (RCMP), First Nations & Inuit, Veterans,
Federal Offenders, Canadian Forces, and Refugee Claimants (Parliament of Canada, 2004). At the provincial
level, the healthcare system consists of thirteen health insurance plans, which
are referred to as Medicare. Each province and territory employs its own health
insurance plan and “receives funding from the federal government through the
Canada Health Transfer” (Government of Canada, 2016). In order to receive
the healthcare funding, the provinces and territories must meet the conditions
and criteria outlined in the Canada Health Act. In Canada, medically necessary
services are fully covered by public health insurance.

In contrast, Sweden’s central
government imposes the country’s healthcare policy while the county councils
and municipalities are responsible for providing health services. The county
councils and municipalities are regulated by The Health and Medical Service Act. (Swedish Institute, 2017).

In both
countries, private health insurance is available through employers to fill in
the gaps of services that are not covered by public health insurance, for
example, prescription medications and dental care coverage. Although healthcare
is publicly funded, Swedish residents may still be required to pay small fees for
particular services, for example one-day hospital stays or visits to a
specialist.

Moreover, another significant
consideration when comparing the costs of healthcare systems between countries
is how much a country spends on health care. According to the World Health
Organization (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 its
GDP, or $5,219 per capita, on health care” in the same year (World Health
Organization, 2017). In Sweden, health care funding comes
from local taxes (approximately 70%), national subsidies (approximately 20%),
and private insurance (less than 1%) (Swedish HealthCare, 2017). Although the health care systems in
both countries are funded similarly, Sweden spends more on its healthcare
system than Canada does and costs are not a significant barrier to healthcare
since people are able to access the care they need without having to worry
about costs.

 

Access

Timely
access to healthcare is a key indicator of an effective healthcare system. Studies
show that Canada’s wait times are the worst when compared to similar developed
countries. The Canadian Institute for Health Information (CIHI) states that almost
25% of older Canadians waited two months to see a specialist and that Canadians
wait the longest for primary and specialist care (Canadian
Institute for Health Information, 2017). Additionally,
longer wait times also encourage Canadians to visit the emergency department for
a condition that could have been treated by a primary care physician.

Conversely,
wait times in Sweden to see a specialist and to undergo surgery are relatively
shorter than in Canada. For example, a review by the Organisation for Economic
Cooperation and Development (OECD) found that the average wait time to see a
specialist is approximately twelve days compared to two months in Canada. Sweden
aims to keep wait times even lower at seven days for patients to visit a
primary care physician (TransferWise, 2017). To battle wait times, Sweden
introduced the healthcare guarantee in 2005, which is one of the national
strategies aimed at reducing waiting times for treatment or operations to a maximum
of ninety days. If the wait time goes beyond ninety days, the costs of care are
covered by the patient’s county council (InterNations, n.d.). Swedish patients
experience shorter wait times for access to primary and specialist care through
its healthcare guarantee and therefore outperforms Canada on the access to
healthcare indicator.

 

Quality

To improve the quality of healthcare in Canada, The
Government of Canada funds a not-for-profit organization called the Canadian Foundation
for Healthcare Improvement (CFHI), whose mission it is to “support initiatives
that engage patients and families in designing, delivering and evaluating
health services, with the goal of improving the quality of care” (Canadian Foundation for Healthcare Improvement, 2017). The CFHI supports, educates, and funds healthcare
organizations across Canada to work with patients, providers, and families to
improve quality improvement initiatives. The goal is to encourage shared
decision-making between patients and providers and to encourage a higher level
of program planning to improve quality of care.

Furthermore, one of Sweden’s national strategies to
improve quality of care is to incorporate policies that aim to improve
patient-centred care for better quality outcomes. One of the ways Sweden plans
to achieve this is through the nation’s Vision for 2025 strategy. This vision
states that, “Sweden will be best in the world at using the opportunities offered by
digitisation and eHealth to make it easier for people to achieve good and equal
health and welfare, and to develop and strengthen their own resources for
increased independence and participation in the life of society” (Government
Offices of Sweden, 2016). Through this vision, patients will be more engaged in their own health care
and will have the opportunity to participate more directly with their
healthcare providers through communication technologies. Both Sweden and Canada
share a common vision to improve quality healthcare outcomes through their
initiatives and strategies to make their healthcare increasingly
patient-centred.

 

Conclusion

Overall, Canada
and Sweden’s healthcare systems share similarities and differences. Both
countries operate on a universal healthcare system that provides everyone with
equal access to healthcare while sharing a vision to drive patient-centred care
forward in order to improve quality outcomes. Canada falls behind Sweden in
terms of longer wait times to see a primary care physician, to see a
specialist, and to undergo surgery. The Swedish health care system is often
used as a model for other countries to imitate for its quality performance
indicators. Due to the shorter wait times and overall quality outcomes, the
Swedish healthcare system is the optimal system when compared to Canada’s
healthcare system.