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 countycouncils and 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 healthcaresince people are able to access the care they need without having to worryabout 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. The Canadian Institute for Health Information (CIHI) states that almost25% of older Canadians waited two months to see a specialist and that Canadianswait 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 fora 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 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). To battle wait times, Swedenintroduced the healthcare guarantee in 2005, which is one of the nationalstrategies aimed at reducing waiting times for treatment or operations to a maximumof ninety days. If the wait time goes beyond ninety days, the costs of care arecovered by the patient’s county council (InterNations, n.d.). Swedish patientsexperience shorter wait times for access to primary and specialist care throughits healthcare guarantee and therefore outperforms Canada on the access tohealthcare indicator. QualityTo improve the quality of healthcare in Canada, TheGovernment of Canada funds a not-for-profit organization called the Canadian Foundationfor Healthcare Improvement (CFHI), whose mission it is to “support initiativesthat engage patients and families in designing, delivering and evaluatinghealth services, with the goal of improving the quality of care” (Canadian Foundation for Healthcare Improvement, 2017).
The CFHI supports, educates, and funds healthcareorganizations across Canada to work with patients, providers, and families toimprove quality improvement initiatives. The goal is to encourage shareddecision-making between patients and providers and to encourage a higher levelof program planning to improve quality of care.Furthermore, one of Sweden’s national strategies toimprove quality of care is to incorporate policies that aim to improvepatient-centred care for better quality outcomes. One of the ways Sweden plansto achieve this is through the nation’s Vision for 2025 strategy.
This visionstates that, “Sweden will be best in the world at using the opportunities offered bydigitisation and eHealth to make it easier for people to achieve good and equalhealth and welfare, and to develop and strengthen their own resources forincreased 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 careand will have the opportunity to participate more directly with theirhealthcare providers through communication technologies. Both Sweden and Canadashare a common vision to improve quality healthcare outcomes through theirinitiatives and strategies to make their healthcare increasinglypatient-centred.
ConclusionOverall, Canadaand Sweden’s healthcare systems share similarities and differences. Bothcountries operate on a universal healthcare system that provides everyone withequal access to healthcare while sharing a vision to drive patient-centred careforward in order to improve quality outcomes. Canada falls behind Sweden interms of longer wait times to see a primary care physician, to see aspecialist, and to undergo surgery. The Swedish health care system is oftenused as a model for other countries to imitate for its quality performanceindicators.
Due to the shorter wait times and overall quality outcomes, theSwedish healthcare system is the optimal system when compared to Canada’shealthcare system.