by David Korzinski | September 11, 2022 9:00 pm
September 12, 2022 – Staffing shortages and experiences of poor care across the country have public health officials and politicians searching for answers to Canada’s health care challenges. In some cases, this includes opening debate about a topic tantamount to sacrilege in some circles – privatization.
The latest data from the non-profit Angus Reid Institute – the third and final installment in a series of studies looking at health care in Canada – finds half of Canadians rejecting the idea of more private care, and another half less certain. Indeed, one-in-three (32%) say that more private care would improve the health-care system, while one-in-five (18%) say they’re not sure where they stand in this discussion.
Notably, this idea receives plurality support in both Saskatchewan (43%) and Quebec (40%), suggesting the conversation may continue to heat up provincially, if not federally. In Ontario, where health minister Sylvia Jones recently commented that “all options are on the table” when asked about privatization, residents voice the highest levels of opposition in the country (57%).
One thing is certain, a majority of Canadians are concerned about the future of health care. Three-in-five (61%) say care in their community is poor or terrible currently. And while two-in-five (39%) report the opposite, concerns about bigger issues including doctor (87%) and staffing shortages (94%) and wait times for surgeries (92%) and emergencies (93%), are near-unanimous.
Among those who say care is poor where they live, half (49%) say both the federal and provincial governments share equal responsibility, while 37 per cent blame their province more than Ottawa. In Quebec, where three-in-five residents say care is poor, half say Premier François Legault’s government shoulders most of the responsibility, the highest proportion in any province.
The Angus Reid Institute (ARI) was founded in October 2014 by pollster and sociologist, Dr. Angus Reid. ARI is a national, not-for-profit, non-partisan public opinion research foundation established to advance education by commissioning, conducting and disseminating to the public accessible and impartial statistical data, research and policy analysis on economics, political science, philanthropy, public administration, domestic and international affairs and other socio-economic issues of importance to Canada and its world.
Canada’s health-care system has been dealing with plenty of negative press in recent months. It’s been described as ‘unforgivably disastrous’, ‘broken’, ‘failing’ or in ‘crisis’. Many Canadians have struggled with poor access or know friends or family who have received inadequate medical care in recent months. The country is dealing with a shortage of family doctors, the primary point of contact for Canadians for the medical system. The Canadians who don’t have a family doctor are struggling to find one.
With this in mind, a majority of Canadians (61%) describe the current state of their local health care as ‘poor’ or ‘very poor’. Two-in-five (39%) disagree, instead describing their local health-care system as ‘good’ or ‘very good’ with no issues:
In no region is there a majority of respondents who would describe the system as ‘good’. Instead, at least three-in-five in every part of the country say their local health care is in a poor state. Perceptions are especially negative in Atlantic Canada, where four-in-five (80%) say health care there is in rough shape, including two-in-five (43%) who would describe it as ‘in crisis’.
In Quebec, where Coalition Avenir Québec have promised during the ongoing campaign to build private medical centres to ease the strain on that province’s medical system, three-in-five (58%) say health care there is in bad shape:
The Angus Reid Institute’s Health Care Access Index scored responses on ease of access to the health-care system (read a fuller description of the Index here, and methodology here). For the group with Comfortable Access – those encountering fewer or no barriers to required health services in the last six months – a majority (61%) believe their local health-care system is in good shape. For all other groups in the Index, a majority would disagree, including two-in-five in the Chronic Difficulty group who believe the health-care system is ‘in crisis’:
Along political lines, past NDP voters hold the most negative sentiment about the state of their local health care. Seven-in-ten (69%) among those who voted NDP in 2021 say health care is ‘poor’ or ‘very poor’ where they live. More than three-in-five (63%) past Conservative voters agree. They are also joined by a majority (55%) of those who voted Liberal last year. Those who voted for the Bloc Québécois are more likely to offer a positive evaluation of health care, with approaching three-in-five (57%) describing Quebec’s health care as ‘good’ or ‘very good’:
In Canada, the provinces are responsible for delivering health care. However, there have been many calls by the provinces in recent months for the federal government to increase its share of funding the system.
Half of respondents in this country (49%) believe both levels of government share the blame for the poor state of health care. More are likely to lay more blame at the feet of their provincial government (37%) than who would point the finger more at the federal government (12%).
This perception of blame varies significantly by region. In B.C., seven-in-ten say both the provincial and federal government have caused the poor state of health care they are seeing. This means people in that province are the most likely to level blame at the federal government at more than four-in-five (85%). This comes after months of messaging from B.C. Premier John Horgan asking the federal government to contribute more to health care.
In Quebec, half (51%) believe the provincial government is most responsible for the poor health-care system:
*Smaller sample size, interpret with caution
Past Conservative voters are most likely among partisans to blame the federal government partially or fully for poor health care. Those who voted for the ruling-by-minority Liberals are most likely to blame the provinces more of the two levels of government, at three-in-five (58%). Still, two-in-five (41%) who voted for Prime Minister Justin Trudeau’s party in last fall’s election believe the federal government shares some blame:
*Smaller sample size, interpret with caution
The American health-care system often acts as a foil for Canadians when evaluating their own medical system. ARI conducted a parallel poll in the United States to gauge Americans opinions on their own health-care system. Americans have a much more positive impression of their health-care system than Canadians. Three-quarters describe the state of their health care as ‘good’ or ‘very good with no real issues’, a rate nearly double the Canadians who say the same. Still, one-quarter (24%) of Americans say their own health system is poor, a figure which represents more than 62 million adults:
While two-in-five Canadians are relatively comfortable with the state of health care in their community, concern about the broader network is ubiquitous. Nearly all say they are concerned about staffing shortages, wait times in emergency departments, and delays getting surgery. Approaching nine-in-ten (87%) say they are worried about a local lack of family doctors.
As the Canadian health system has struggled in recent months, the debate around private health care in the country has intensified. In a recent summit, the Progressive Conservative premiers of New Brunswick, Nova Scotia, P.E.I. and Ontario floated private care as a solution to long wait times in the current health system. Indeed, Ontario Premier Doug Ford’s ‘creative’ solution to health care problems has included publicly covering surgeries at private clinics to address long wait lists for certain procedures. Alberta and Saskatchewan have taken similar steps to ease the strain on their health systems.
Canadians are more likely to believe more private health care will worsen the medical system than improve it. Half say increasing private care will only damage the health system. One-third (32%) believe allowing more access to for-profit health care could improve care where they live.
Those in Saskatchewan are the most likely to believe the latter, at two-in-five (43%). Though in that province, nearly as many (39%) believe more private health care won’t solve anything. Quebec is the only other province where support for private care reaches a plurality level, as Premier François Legault announced during his election campaign a plan to build for-profit clinics reimbursed by medicare in that province.
Meanwhile, three-in-five (57%) in Ontario believe expanding for-profit care in that province will only make things worse:
Men are much more likely than women to believe private care could improve the health-care system. But, still, men who say that are outnumbered by those who disagree in every age group. Meanwhile, at least half of women of all ages say more for-profit clinics will only make health care worse:
More than half (54%) of past Conservative voters believe increasing private care options would improve the health-care system, the most of any group of past party voters. The concept was debated during that party’s leadership race, when leadership hopeful, and past Quebec premier, Jean Charest, said he would allow provinces to use more private health care delivery. Rival Pierre Poilievre would only say that he would leave it up to the provinces to decide what mix of public and private health care is best.
Past Liberal voters are more open (18%) to the belief that private health care could help the system than past NDP voters (10%), but still two-thirds of the former group believe it would do harm.
Past Bloc Québécois voters are split in their belief of how more private health care would affect the system.
A major concern with the addition of private health care is the potential of inequity. Indeed, the president of the Canadian Medical System warned as much as Canadians have debated solutions to the ongoing problems in the health-care system.
Along the income spectrum, those in the lowest income households are the least likely to believe more private care could improve the health-care system at one-quarter (24%). Still, for all income brackets except those earning more than $200,000 annually, more people believe adding private care will hurt the system more than help:
Those who have faced significant barriers to accessing health care in recent months are more enthusiastic about the idea of adding more for-profit care to the mix in Canada’s health system. Two-in-five (37%) of those in the Chronic Difficulty group on the Health Care Access Index say more private care would improve the health system. Still, half in that group believe the opposite:
The Angus Reid Institute conducted two online surveys in August 2022. Sample in Canada was drawn from Angus Reid Forum, while sample in the United States was drawn from Angus Reid Forum USA. The survey was self-commissioned and paid for by ARI.
In Canada: The Angus Reid Institute conducted an online survey from Aug. 8-10, 2022, among a representative randomized sample of 2,279 Canadian adults who are members of Angus Reid Forum. For comparison purposes only, a probability sample of this size would carry a margin of error of +/- 2.0 percentage points, 19 times out of 20.
In United States: The Angus Reid Institute conducted an online survey from Aug. 16-17, 2022, among a representative randomized sample of 1,209 American adults who are members of Angus Reid Forum USA. For comparison purposes only, a probability sample of this size would carry a margin of error of +/- 3.0 percentage points, 19 times out of 20.
For detailed Canadian results by age, gender, region, education, and other demographics, click here.
For detailed Canadian results by the Health Care Access Index, click here.
For detailed American results by age, gender, region, education, and other demographics, click here.
To read the full report, including detailed tables and methodology, click here.
To read the questionnaire in English and French, click here.
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