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. AccessTimely access to healthcare is a key indicatorof an effective healthcare system. Studies show that Canada’s wait times arethe worst when compared to similar developed countries.
The Canadian Institutefor Health Information states that almost 25% of older Canadians waited twomonths to see a specialist and that Canadians wait the longest for primary andspecialist care (Canadian Institute for Health Information, 2017). Additionally, longerwait times also encourage Canadians to visit the emergency department for acondition that could have been treated by a primary care physician. Conversely, wait times in Sweden tosee a specialist and to undergo surgery are relatively shorter than in Canada. Forexample, a review by the Organisation for Economic Cooperation and Development(OECD) found that the average wait time to see a specialist is approximatelytwelve days compared to two months in Canada. Sweden aims to keep wait timeseven lower at seven days for patients to visit a primary care physician (TransferWise, 2017). To battle wait times, Sweden introduced the healthcareguarantee in 2005, which is one of the national strategies aimed at reducingwaiting times for treatment or operations to a maximum of ninety days.
If thewait time goes beyond ninety days, the costs of care are covered by thepatient’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. QualityOne of Sweden’s nationalstrategies is to incorporate policies that aim to improve patient-centred carefor better quality outcomes.
One of the ways Sweden plans to achieve this isthrough the nation’s Vision for 2025 strategy. This vision states that, “Sweden will be best in the world at usingthe opportunities offered by digitisation and eHealth to make it easier forpeople to achieve good and equal health and welfare, and to develop andstrengthen their own resources for increased independence and participation inthe 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.