Canadians are so used to reading stories about our struggling healthcare system, it’s actually shocking to hear something good.
But that is what happened recently when the American magazine Newsweek issued its annual list of the top 250 hospitals in the world. Toronto’s own University Health Network (UHN) was rated the second-best hospital in the world, behind only the internationally well-known Mayo Clinic.
In the words of Globe and Mail reporter Trevor Cole, that makes UHN “the top publicly funded hospital on the planet.” (As many Canadians know, the American system is mainly privately funded as compared to this country’s publicly funded system).
Newsweek uses various hospital quality metrics, patient experience information and statistics from international data platform Statista, as well as advice from medical experts to compile its list. More than 2,500 hospitals from 32 countries are included in the survey.
UHN, known for its cardiac care, organ transplants and ability to treat complex patient illnesses, is already Canada’s top research hospital, spending some $600 million in 2024 on a range of research into new models of care and treatment, with a particular focus on potential artificial intelligence technology (AI) solutions.
It should be noted that UHN has ranked amongst the top 10 on the list since 2019 and that it was not the only Canadian institution included. Mount Sinai, Sunnybrook Health Sciences Centre, North York General Hospital and St. Michael’s Hospital were also included among the top 250.
But while this is good news, it should not cause Canadians to puff up our chests in that typical complacent style we so frequently adopt, assuming that our largely publicly funded health system is superior. Far from it.
Dr. Kevin Smith, UHN’s CEO, is not shy about highlighting the challenges. Coming from someone with his track record of success, it is worth listening to his concerns about our healthcare future.
In a recent media interview with the Globe and Mail, he highlighted that the number one challenge is access to the system whether it be for a primary care physician or a local emergency room. And yes, funding is a major problem.
“Our growth potential economically is limited by the public purse,” he says. “Every year, every government of every stripe spends way more money on health care…but it is not keeping pace with the expansion based on inflation, population growth, aging and amazing new therapies.”
“How do you fund this on a tax base at a time when we have a lot more demand, and when we’re looking to government to stabilise a whole bunch of other industries at this time of rupture?” he asks.
His solution? “I fully support universal access, but are there other funding models we can work with? I don’t see how a place like UHN can remain among the best in the world if we only look at the public purse.”
Before people start clutching their pearls — again a typical Canadian reaction when someone mentions private funding in the same breath as health care — he hastens to add that he is not advocating the U.S. model. Universality is important.
But he is advocating that we adopt some of the more successful blended delivery and funding models from European and other Commonwealth countries whose outcome data shows are doing a better job than we are as a system.
“We need to look at what other funding mechanism might be possible. What would a not-for-profit medical insurer look like in Canada,” he asked, offering Ontario’s Workplace Safety and Insurance Board as one such example. It is a private health care system for workers, funded by employers.
Complaining about funding shortfalls is nothing new. But Dr. Smith also offers a long list of changes that could help expand the tax base in ways that could increase its ability to support growing health costs.
For example, he advocates increasing our ability to commercialize the new technologies and discoveries that Canada’s home-grown talent produces through a more supportive tax system that rewards success. Investing more in scientific research and talent is also important, as is focusing on how AI can literally transform how patient care is provided.
“Translate science into products and products into wealth and wealth into taxes that fund our system.” he concludes.
The success of Dr. Smith and his team deserve to be recognized. But we can’t let it pause our push for major health care reform.
Janet Ecker is a former Ontario Finance Minister, Minister of Education, Minister of Community and Social Services and Government House Leader in the governments of Premier Mike Harris and Premier Ernie Eves. After her political career, she served as the founding CEO of the Toronto Financial Services Alliance, a public-private partnership dedicated to building Toronto region into an international financial centre. She currently sits on a number of corporate and non-profit boards, agencies and advisory committees.
Ms. Ecker received the Order of Canada for her public service contributions and was recognized as one of the “Most Influential People in the World’s Financial Centres” by Financial Centres International. She also received a “Canada’s Most Powerful Women: Top 100 Award” from the Women’s Executive Network and the Richard Ivey School of Business, among other awards. She is also one of the founders of Equal Voice, a national, multi-partisan organization working to elect more women.
