Who Decides? How Health Care Resources Are Allocated in Canadian Provinces

Who Decides? How Health Care Resources Are Allocated in Canadian Provinces

• An assessment of how money is spent throughout the health-care system concludes that the needs and preferences of patients play a small and indirect role in the allocation of health-care resources, having only limited input through the political process.
• The health-care system is oriented towards the needs and preferences of governmental decision-makers and bureaucrats, while health-care providers do not compete to serve patients but rather compete for government funding and their share of the health-care budget.
• The problems facing Medicare today, including remarkably long wait times for necessary health care, a shortage of advanced medical technologies and physical infrastructure, and scarcity of physicians, are the result of legislation and government policy that suppress market prices and competition.
• The absence of market prices and their replacement with bureaucratic planning processes means government planners are missing the knowledge typically available to private-sector businesses and consumers. Consequently, health-care resources are not readily directed to the areas of greatest need or highest value to patients. Nor is feedback effectively provided to decision-makers about where shortages may be looming or where service costs might be reduced through innovation. These shortcomings have serious consequences for both patients and providers of health care.
• A way forward to improve health care in Canada is to follow the example of other universal health-care countries that deliver more timely health-care service at similar or even lower costs than Canada’s health-care system. These countries have implemented reforms that reduce the role of bureaucratic decision-making in favour of allowing a greater role for competition and market prices.