It’s tempting to overcomplicate the debate over health care. There are so many intriguing aspects of the system to examine, from the usefulness of diagnostic imaging (often overrated) to the necessity of timely psychiatric care (often overlooked).
But these subjects, worthy as they are of close attention, are not the reason Canadians fret about their system. The reason is waiting. If we could find a family doc without months of searching, see a specialist without weeks of worry, and visit an emergency room without the prospect of hours of sitting, we’d be satisfied.
So let’s not lose sight of the point. The countries with the best performance on timeliness of care, according to the Commonwealth Fund, a U.S. health research foundation, are the Netherlands and Germany. OECD statistics for the Netherlands are somewhat harder to compare with Canadian data, so let’s take a look at Germany.
There are 3.89 active physicians in Germany for every 1,000 people, compared to 2.27 per 1,000 in Canada. Can there be a more straightforward explanation for why it takes longer to see a doctor here? There are 5.7 acute care hospital beds in Germany for every 1,000 people, compared to 4.3 per 1,000 in Canada. Since any emergency room doctor will tell you the main reason for backlogs in the ER is too few hospital beds upstairs to accept new patients, doesn’t the German edge here tell much of the story?
Any debate that doesn’t focus on sheer numbers of hospital beds and physicians is dodging the most obvious point. Debate the way we pay for care, argue over how it’s managed—fine. But don’t kid yourself that we’re going to see doctors as quickly as they do in countries with more doctors, or run our ERs as smoothly as they do in countries with more hospital beds.