Introduction how they achieve desired health outcomes, and


Countries all
around the world differ in how they provide healthcare services to its population
of citizens, residents, and visitors within its borders. That is, countries
vary significantly in how healthcare services are delivered, how the costs of
healthcare services are covered, how they achieve desired health outcomes, and
how long patients must wait to see a primary care physician or a specialist. While
some countries are either leading the way, or falling behind in terms of providing
quality healthcare to its citizens, this paper will focus on contrasting and
comparing the cost, access, and quality of the healthcare systems of Canada and



Canada’s healthcare
system is funded at both the federal and provincial level. The federal
government assumes responsibility for the health care of special groups such as
the Royal Canadian Mounted Police (RCMP), First Nations & Inuit, Veterans,
Federal Offenders, Canadian Forces, and Refugee Claimants (Parliament of Canada, 2004). At the provincial
level, the healthcare system consists of thirteen health insurance plans, which
are referred to as Medicare. Each province and territory employs its own health
insurance plan and “receives funding from the federal government through the
Canada Health Transfer” (Government of Canada, 2016). In order to receive
the healthcare funding, the provinces and territories must meet the conditions
and criteria outlined in the Canada Health Act. In Canada, medically necessary
services are fully covered by public health insurance.

In contrast, Sweden’s central
government imposes the country’s healthcare policy while the county councils
and municipalities are responsible for providing health services. The county councils
and municipalities are regulated by The Health and Medical Service Act. (Swedish Institute, 2017).

In both
countries, private health insurance is available through employers to fill in
the gaps of services that are not covered by public health insurance, for
example, prescription medications and dental care coverage. Although healthcare
is publicly funded, Swedish residents may still be required to pay small fees for
particular services, for example one-day hospital stays or visits to a

Moreover, another significant
consideration when comparing the costs of healthcare systems between countries
is how much a country spends on health care. According to the World Health
Organization (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 its
GDP, or $5,219 per capita, on health care” in the same year (World Health
Organization, 2017). In Sweden, health care funding comes
from local taxes (approximately 70%), national subsidies (approximately 20%),
and private insurance (less than 1%) (Swedish HealthCare, 2017). Although the health care systems in
both countries are funded similarly, Sweden spends more on its healthcare
system than Canada does and costs are not a significant barrier to healthcare since
people are able to access the care they need without having to worry about costs.



access to healthcare is a key indicator of an effective healthcare system. Studies
show that Canada’s wait times are the worst when compared to similar developed
countries. Almost 25% of older Canadians waited two months to see a specialist According
to the Canadian Institute for Health Information (2017), Canadians wait the
longest for primary and specialist care (Canadian
Institute for Health Information, 2017). Additionally,
long wait times also encourage Canadians to visit the emergency department
instead of seeking medical services from a primary care physician.

wait times in Sweden to see a specialist and to undergo surgery are relatively
shorter than in Canada. For example, a review by the Organisation for Economic
Cooperation and Development (OECD) found that the average wait time to see a
specialist is approximately twelve days compared to two months in Canada. Sweden
aims to keep wait times even lower at seven days for patients to visit a
primary care physician (TransferWise, 2017). What has also proved
effective is the healthcare guarantee, which was introduced in Sweden in 2005,
promising to reduce waiting times for treatment or operations to a maximum of
90 days. If this time is exceeded, patients are offered care elsewhere, the
cost for which, including travel costs, is covered by the patient’s county
council (InterNations, n.d.). Swedish patients
experience shorter wait times for access to primary and specialist care through
its healthcare guarantee and therefore outperforms Canada on access to
healthcare indicator.










Canada and Sweden both operate on a universal healthcare
system which is paid for through taxes and ensures that all residents have equal
access to healthcare services. Canadian citizens and permanent residents have access
to medical services by presenting their provincial health card during their
visit to the clinic or hospital. In Canada, a significant issue preventing
individuals from accessing a health care provider is the fact that most healthcare resources in Canada
exist within urban areas. Patients in rural and remote communities may have to
travel farther distances to access medical services. To improve healthcare
access for those living in remote or rural areas, Canada implemented the
Telehealth initiative throughout all provinces and territories which “allows patients to dial a number and connect with
nurses and doctors remotely” (MediResource Inc. , 2017). Similarly, all residents living in
Sweden also have equal access to medical care services.


Sweden recently updated its
national eHealth vision, which now states that, by 2020, all residents aged 16
or over should have access to all health-related information documented in county-funded
health and dental care
.when Uppsala became the first
region in Sweden to make EHRs accessible to patients.  This means that throughout Sweden, many
different EHR systems are in use and interoperability between them has
traditionally been low. (Hägglund, 2017)



There are
now 228 doctors per 100,000 people 

doctor-to-patient ratio has increased in all provinces since 2011. 

Swedish system performs well on quality indicators











Although Canada and Sweden’s healthcare
systems are funded quite similarly, they differ greatly the type of quality of
care and services provided to patients. Sweden leads Canada in terms of shorter wait times, improved services,
and quality performance indicators. “The Swedish health care system is often
considered a model for other countries to emulate, both because of its
excellent outcomes compared to OECD countries and several well-developed
strategies to assure and improve the quality of its health care” (Swedish HealthCare, 2017).

 Due to Sweden’s overall
effectiveness and quality healthcare outcomes, the Swedish healthcare system is
the optimal system when compared to Canada’s healthcare system.