Charlottetown 
A recent report by the C.D. Howe Institute ranks Canada’s healthcare system ninth among 10 high-income countries, highlighting significant issues in access to care, timeliness, and equity.
The report, titled “Troubling Diagnosis: Comparing Canada’s Healthcare with International Peers,” evaluates Canada’s healthcare system, benchmarking it against nine other high-income countries and assessing performance across provinces and territories. The methodology relies on 118 measures across five categories: access to care, care process, administrative efficiency, equity, and healthcare outcomes. Data sources include Commonwealth Fund (CMWF) surveys from 2021 to 2023, the OECD, WHO, and CIHI.
Canada ranked ninth in access to care among international peers, outperforming only the United States. Despite higher healthcare spending, the system’s inefficiencies result in outcomes that lag behind those of other high-income countries.
The Netherlands and the United Kingdom led the rankings, with the Netherlands excelling in affordability, equity, and care accessibility due to robust primary care infrastructure and comprehensive coverage.
Canada ranked worst (10th out of 10 countries) in timeliness.
Credit: C.D. Howe Institute
The report states, “Canada placed at the bottom on four measures of timeliness: having a regular doctor or place (86 percent), saw a doctor or nurse on the same or next day (25 percent), waited two months or longer for specialist appointment (47 percent) and waited two months or longer for elective surgery (59 percent).”
Canada also fared poorly in affordability, administrative efficiency, and equity. However, it scored above average in the care process, excelling in preventative and safe care.
Healthcare in Provinces
All Canadian provinces and territories remain below the international average in overall healthcare performance.
PEI topped the Provincial Ranking of Healthcare Performance list with above-average international performance in the care process, equity, and healthcare outcomes.
Credit: C.D. Howe Institute
Quebec and Ontario ranked 2nd and 3rd among Canadian jurisdictions.
Newfoundland and Labrador, along with Nunavut, performed the worst. Both provinces ranked below average in all categories, with Nunavut placing last for care process and healthcare outcomes.
The report notes that “Using a restricted set of measures from the most recent survey,” Quebec showed significant improvement, rising from seventh place among provinces in 2018 to the top spot, while Alberta dropped from first to fifth.
British Columbia performed well in healthcare outcomes, measuring infant mortality, maternal mortality, and suicide rates. Nova Scotia, Saskatchewan, Newfoundland, Northwest Territories, and Nunavut scored poorly, with Nunavut ranking last.
“The road to a high-performing healthcare system is long. Improving Canada’s healthcare presents a complex challenge that requires the implementation of targeted and comprehensive strategies,” finds Tingting Zhang, the report’s author.
The study finds that improving Canada’s healthcare outcomes requires better patient attachment to care, after-hours care, expanded drug and dental access, and affordable mental health and home care services.
