Three lessons Canada can learn from Australia’s healthcare system

A recent international comparison of healthcare systems ranked Australia as the top performer — Canada was ranked seventh.

Emergency department closures. Long wait times for surgeries and specialist appointments. Millions of Canadians without a primary healthcare provider.

Healthcare systems across Canada are struggling to provide timely and equitable access to healthcare services – at a time when provincial governments are reining in spending in the midst of economic uncertainty.

Canada needs to find solutions that improve affordability, access and healthcare costs. A promising path is to look to other countries for innovative healthcare policies and practices, beginning with Australia.

Why look to Australia? 

Australia shares many similarities with Canada. Both have universal and publicly funded healthcare systems, with responsibility for delivering healthcare resting primarily with Canadian provinces and Australian states.

Both countries are grappling with similar healthcare challenges – affordability, timely access and delivering services in vast rural areas and providing culturally appropriate healthcare for Indigenous populations.

Australia is seeing better results for its spending on healthcare. A recent international comparison of healthcare systems ranked Australia as the top performer. Canada was ranked seventh by the researchers.

Australia’s experiences offer insights for Canada. Here are three lessons that we can learn from them:

First, expanding access and improving health outcomes can happen without massive increases in public spending.

Canada is already one of the top healthcare spenders among Organisation for Economic Co-operation and Development (OECD) countries. Public data show that health spending accounted for 11.2 per cent of Canada’s gross domestic product (GDP) compared with an average of 9.2 per cent for other OECD countries.

Despite spending a lot compared with other countries, provincial healthcare systems – faced with an aging population, more medical complexity and immigration-fueled population growth – are seeing long waits for services, overcrowded emergency rooms and an ongoing shortage of healthcare professionals.

In contrast, Australia spends about 9.6 per cent of GDP on healthcare. Yet it is the top-ranked of 10 countries studied for equitable access and health outcomes. Meanwhile Canada places seventh in equity and fourth in outcomes.

Second, more private-sector involvement in healthcare is not a cure-all.

Provincial governments are increasingly turning to private and for-profit providers to deliver publicly funded healthcare services to address deficiencies in the public system. Some provinces are contracting out thousands of surgeries to for-profit clinics.

The cautionary tale of Australia’s experiences has shown that having dual private and for-profit healthcare does not guarantee more timely access to services.

In addition to Australia’s publicly funded healthcare system, the government allows Australians to purchase private healthcare insurance and access private or for-profit healthcare services, including hospital care.

Those with private coverage can choose to receive treatment as a public patient in a state’s public hospitals or be treated as a private patient in either a public hospital or at a private facility.

While proponents of this hybrid hospital system say it improves access to publicly funded healthcare by redirecting patients with the financial means to the private system – and freeing up space in public hospitals for those who cannot afford private insurance – there is no evidence that the private system has improved access to public hospital care or reduced wait times for elective surgery.

In fact, Australia’s private hospitals are facing considerable financial challenges due in part to rising costs and disruptions caused by the COVID-19 pandemic. 

The dire financial situation in Australia’s private health systems has resulted in rising insurance premiums and higher copayments for Australians and the demise of some private hospitals.

Third, minimizing administrative burdens will foster a more efficient and effective healthcare system. 

The Commonwealth report ranked Australia second in administrative efficiency while Canada placed fifth.

The report credits Australia’s good results to electronic claims processing and efforts to minimize burdens on physicians.

Governments in Canada can build on these lessons by fostering collaboration and communication with their counterparts in Australia.

Canada’s federal government should take the lead in co-ordinating and funding comparative analyses of the two countries’ healthcare systems – examining policies and practices that affect affordability, accessibility and equity – with provinces and territories providing data and expertise.

It should also fund joint health policy research with Australia and support personnel exchanges – enabling both countries to learn from each other.

The knowledge gleaned will only strengthen Canada’s healthcare systems.

It is time for governments to invest in collaboration and innovation to ensure that healthcare is affordable, accessible and equitable for all Canadians. 

Jason M. Sutherland is the UBC Professor of Health Services and Policy and Director of the Centre for Health Services and Policy Research in the School of Population and Public Health at the University of British Columbia.