Hope for our health care system

NL Health Matters by Mardi Collins

In previous articles, I pointed out the sad fact that not only is health care failing in Newfoundland, but it is also in trouble across Canada. Universal health care is supposed to ensure all residents have access to necessary, quality health service, regardless of their ability to pay. It is funded through taxation and insurance. It is in place in a number of the world’s wealthiest nations, but not the U.S., which has a for profit system.

In 2025, State Street, a health care think tank, did a detailed comparison of our system with that of eight nations that had a similar system to ours, but that had outperformed Canada. The countries were Sweden, the United Kingdom, Australia, New Zealand, France, Germany, Switzerland and the Netherlands. Canada failed due to wait times, for everything. A study in 2019 found that 75,000 Canadians a year die while on wait lists. Today that number is probably much higher. This is the ultimate measure of failure for any health care system.

The leading countries had three things in common:

• They practised Activity Based Funding (ABF): It puts the patient in the centre and payment is made when care is given. In Canada, we use global budgeting, where hospitals are given a set amount of funding to use as they see fit. ABF incentivizes facilities to improve efficiencies and reduce unnecessary paperwork. The more appointments, procedures and tests done, the more funding.  
• The governments encouraged purchase of health Insurance: Both government and the private sector offer health insurance, so many Canadians already have it. It is estimated that 40 per cent of citizens in Newfoundland have it, with only modest benefits. It is “free money” for our health care system because it provides funds that can be used to pay for health care without requiring more funding from the province. Why not use it?  
• Private health care:  This third essential aspect of successful universal health care programs creates several benefits. Over decades resistance has grown in Canada to private health care because it has been equated to “U.S. style health care.” This is not an accurate comparison because in the US, health care is for profit. Private health care used in a universal health care program has no profit motive. Procedures have the same cost regardless of where they are given and all citizens have access to them.  Each of the eight countries proved that private health care is beneficial. When included with public options, private health care has expanded supply, reduced wait times, reduced costs, recruited doctors from other locations and often created innovation. 

So hopefully, we can all agree that:

• we would like our facilities to be incentivized to do more for patients. If so, ABF is the solution.
• We want our health care to accept free money. If so, insurance is the solution.
• We want to help more medical workers stay in their field, and we want a system that expands health care options for all of us. If so, more private health care is the solution.

If you have a health care concern, I would like to hear from you. email:mardicollins7@gmail.com