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Figure 1: Support for Canadian Health Care System Model
Very important88%
Neutral9%
Not important3%
How important is it to you to have a strong national system of publicly-funded health care?
Source: Ekos, 2000
Figure 2: Support for Universality
Government should pay for all
people86%
Should pay for low income people
only11%
Individuals should pay their own
3%
Currently, Canada’s system of medicare is supported by tax dollars. Do you think governments should pay for health care for all people as they do now, just for lower income people, or should individuals and families pay their own health care costs?
Source: Environics 1999.
Figure 3: Evolution of Assessments of the Quality of the Health Care
System
6155
41 40
28 2925
29 30 31
3832
12 13 1521
41
34
30
3432
0
10
20
30
40
50
60
70
1991 1992 1993 1994 1995 1996 1997 1998 1999 2000
Excellent/ very good Good Fair/ poor/ very poor
Source: Angus Reid.
3% 4% 7%
91%
9%
84%
0%
20%
40%
60%
80%
100%
Canada US Don't know
1987
2001
Source: 1987, Environics; 2001, Centre for Research and Information on Canada
Figure 4: Is the American System Better?When you think about Canada and the US, which country would you say has a better health care system?
Figure 5: Preference for Care in Canada Rather than the U.S.
Agree Moderately
4%
Disagree Moderately
17%
Disagree Strongly
75%
DK/NA1%
Agree Strongly
3%
Do you agree or disagree with the following statement:“If I had a serious illness or injury, I would prefer to be treated in the U.S.”
Source: Angus Reid, September 1995.
Figure 6: Health Care and National Identity
82%
14% 3% 1% Very ImportantSomewhat importantNot very importantNot at all important
How important are the following to the Canadian identity… Canada’s health care system?
Source: Environics Focus Canada Survey, March 1996
Figure 7: Health Care Should be Guaranteed by the Government
10%
4%
3%
72%
95%
96%
0% 20% 40% 60% 80% 100%
1978
1985
1991
YesNo
“Should medical care be guaranteed by the government?”
Source: Environics Focus Canada Surveys
Figure 8: Support for the Canadian Health Care
Model
79
63
52
48
5
12
8
20
21
3
6
9
19
17
11
1
4
2
4
9
2
16
7
7
69
0% 20% 40% 60% 80% 100%
Care should be based on need, not ability topay
Better care for rich is not right
Medicare embodies Canadian values
Medicare is right of citizenship
Prefer US system
Completely agree Agree Neither Disagree Completely disagree
Do you agree or disagree with the following statements?
Source: Earnscliffe/POLLARA, 1998.
Figure 9: Five Year Trend on Perceptions of
Quality
68
58 57
6672 71
66 64 65
2431 32
2419 22
26 26 24
7 8 8 9 8 6 8 9 10
0
20
40
60
80
Oct.'97
Apr.'98
Oct.'98
Apr.'99
Oct.'99
Apr.'00
Oct.'00
Apr.'01
Oct.'01
Deteriorated Same Improved
Has the quality of health care over the past two years improved,deteriorated, or stayed the same?
Source: Ekos Research, Rethinking Government and Health Care Surveys
Figure 10: Options for Reform
30
54
33
98
60
38
47
107
62
27
8
56
30
48
10
36
13
51
33
9
49
39
0
10
20
30
40
50
60
70
Increase Spending Limit Services Private Services
Canada
Atlantic
Quebec
Ontario
Manitoba
Saskatchewan
Alberta
BC
Source: Centre for Research and Information on Canada, 2001.
Health care costs are expected to rise in the future because of our aging population and because of the costs of new treatments and medications. Which of the following statements comes closest to your view? Would you say (a) governments should significantly INCREASE THEIR SPENDING on health care to cover these rising costs; (b) governments should LIMIT THE AVAILABILITY of some treatments or medications; or (c) governments should allow THE PRIVATE SECTOR to provide some health care services to those people who can afford to pay for them.
Figure 11: Future Directions for the Health Care
System
It is time to move toward private
health care10%
Changes are needed, but the
principles of Medicare should be preserved.
68%
Most problems can be fixed if the
provincial government puts more money into
health10%
NR/ DK12%
Which of the following three directions do you support for the futureof Saskatchewan’s health care system?
Source: Saskatchewan Commission on Medicare, 2001
Figure 12: Is more money alone the answer?
Agree76%
Neutral10%
Disagree14%
“Money alone is not the solution to securing health care for the future.”
Source: Ekos, Ontario Health Care Funding Survey, 2000.
Figure 13: Knowledge of the Canada Health Act
59
62
67
68
70
71
74
71
65
68
31
26
23
18
21
20
19
19
24
21
19
11
7
14
10
11
7
11
13
12
8
4
9
12
11
6
9
8
8
8
7
7
3
2
1
4
3
3
4
4
Alberta
B.C.
Manitoba
Quebec
Sask.
Ontario
Atlantic
Women
Men
TOTAL
Do not know Universality AccessibilityComprehensiveness Portability
What are some of the key principles of the Canadian Health Act?
Source: Earnscliffe/POLLARA, 1998.
Figure 14: Canadians’ Highest Priorities
0 0 04 3
1215
29
40 39
51
18
8
21
3632
4045
3128
23
1310
22
42
33
21 23
1720 18
138
0
10
20
30
40
50
60
1988 1990 1992 1993 1994 1996 1997 March98
Nov.98
1999 2000
Health Care Unemployment The economy Education
Source: Angus Reid
Figure 15: Images of the Future of Health Care
What will it look like 10 years from now?
87
82
81
68
39
5
6
7
11
16
7
9
10
19
40
0% 20% 40% 60% 80% 100%
More demand forhealth care services
Care outside hospitalswill be more important
It will cost more tomaintain
There will be moreout-of-pocket costs
More government role
Agree Neither Disagree
Source: Ekos, 1999.
Figure 16: Is Progress Being Made?
54
14
28
4
49
16
32
4
59
12
25
4
0
10
20
30
40
50
60
70
Losingground
Makingprogress
Staying thesame
DK/ NR
National Men Women
Is Canada making progress or losing ground on the health caresystem?
Source: Earnscliffe/POLLARA, 1998.
Figure 17: A Funding Crisis?
In crisis now76%
Will be in crisis in 5-10 years
12%
No crisis11%
NR/ DK1%
Do you think the Canadian health care system is facing a major funding crisis? (For those who say “NO”: Will the system face a major funding crisis in the new 5-10 years?)
Source: Angus Reid, 2001
Figure 18: Satisfied with Medicare?
37%
0%
20%
40%
60%
80%
% Agree
“Medicare in Canada works fine just the way it is.”
Sources: Angus Reid, 2000.
Figure 19: System in Crisis? International Comparisons
56
20
10
17
27
25
9
19
38
56
60
46
52
58
57
49
5
23
29
33
17
14
32
30
0% 20% 40% 60% 80% 100%
Canada '88
Canada '98
US '88
US '98
UK '88
UK '98
New Zealand '98
Australia '98
Working pretty well Needs major changes Needs to be completely rebuilt
On the whole, the health care system: 1) works pretty well and only minor changes are necessary; 2) There are some good things in our health care system but fundamental changes are needed; 3) Our health care system has so much wrong that we need to completely rebuild it?
Source: Commonwealth Fund International Health Policy Survey, 1998.
Figure 20: Federal/Provincial Satisfaction
Per cent responding “strongly approve” or “approve”Source: Environics Focus Canada Surveys
6964
70 6661
70 6963
54
41 43
2923
33 34 2953 53
6253
64
46
35 32 29
1926 29 27
0
20
40
60
80
100
'85 '86 '87 '88 '89 '90 '91 '92 '93 '94 '95 '96 '97 '98 '99 '00 '01
Federal Provincial
Generally speaking, do you approve or disapprove of the currentfederal /provincial government’s handling of health care?
Figure 21: Government Performance on Health Care 1988-99
56%
46%
57%62%
34%
58%
46%
56% 57%
30%
0%
20%
40%
60%
80%
1988 1992 1993 1994 1999
FederalProvincial
Is the federal/provincial govt doing an excellent, good, fair or poor job of ensuring that Canadians get good health care? (percent saying excellent or good).
Source: Berger Health Monitor.
Figure 22: Who is Responsible for
Deterioration?
6356
4248
58
5148 46
55
3034
4138 36
4144 45
39
710
1714
6 8 8 106
0
10
20
30
40
50
60
70
Jan.'97
Jul.'97
Jan.'98
Jul.'98
Jan.'99
Jul.'99
Jan.'00
Jul.'00
Jan.'01
Jul.'01
Provincial Federal DK/ NR
Which level of government is most responsible for the deterioration?
Source: Ekos Research, Rethinking Government and Health Canada Surveys
Figure 23: Satisfaction With Care: Own Family versus Province
79%
59%
20%
38%
0%
20%
40%
60%
80%
Self and Family All residents of province
Very/ somewhat satisfied Not very/ not at all satisfied
Are you satisfied with the system’s ability to meet health care needsof you and your family? Of all residents of your province?
Sources: Merck Frost/Coalition of National Voluntary Organizations/POLLARA National Survey of HealthCare Providers and Users, 1999
Figure 24: Quality of Care: 2000-01
37%
43%
16%
4%
35%
15%
5%
45%
0%
15%
30%
45%
60%
Excellent Good Fair Poor
May 2000
March 2001
Overall, how would you rate the quality of care you personally receivedin the past twelve months (from the health care system)?
Among respondents who used health services in the previous year.Source: Berger Health Monitor, May 2000, March 2001.
Figure 25: Personal Experiences With the System
43
56
56
56
58
61
56
59
58
26
23
23
15
21
20
22
17
20
16
9
9
13
8
10
10
11
10
7
5
5
5
5
4
5
4
5
7
7
7
10
8
5
6
9
7
Sask.
Alberta
Manitoba
Quebec
B.C.
Ontario
Men
Women
TOTAL
Completely agree AgreeNeither agree nor disagree DisagreeCompletely disagree
Agree or disagree: “My experience with the system was positive.”
Source: Earnscliffe/POLLARA, 1998.
Figure 26: Confidence in Health Care Services
23%
60%
16%
0%
20%
40%
60%
80%
Not Confident Confident Neither
I am confident that if I or a family member were to become seriouslyill, we would be able to access the necessary health care services.
Source: Ekos Research, Rethinking Government, January 2001
Figure 27: Inability to Access Health Care: 1989-
2001
2%
12% 15%
0%
20%
40%
60%
80%
1989 2000 2001
Over the last twelve months, were you ever unable to obtain healthcare services when you needed them?
Among respondents who used health services in the previous year.Source: Berger Health Monitor, 1989, May 2000, March 2001.
Figure 28: Inability to Access Health Care by Province: 1989-2000
1%
1%
1%
1%
3%
1%
2%
11%
16%
14%
12%
11%
16%
12%
0% 5% 10% 15% 20%
B.C.
Alberta
Manitoba, Sask.
Ontario
Quebec
Atlantic
NATIONAL
1989 2000
For those expressing difficulty obtaining health services in the previousyear: Had difficulty or did not eventually obtain services…
1989: “Had difficulty” and “did not receive services.” 2000: “Unable to obtain health services when needed.”Source: Berger Health Monitor.
Figure 29: Difficulty Obtaining Health Care: 1989-
2000
18%
14%
14%
17%
24%
15%
18%
24%
31%
39%
25%
50%
43%
34%
0% 10% 20% 30% 40% 50% 60%
B.C.
Alberta
Manitoba, Sask.
Ontario
Quebec
Atlantic
NATIONAL
1989 2000
In the past year have you or members of your immediate family haddifficulties obtaining medical or health-related services…
“Had difficulty,” “a bit, somewhat,” or “very difficult,” for a variety of reasons.Source: Berger Health Monitor.
Figure 30: Difficulties in Seeing Specialists:
International Comparisons
16 15 1410
17
3024 21 19 18
47
57 54 55 56
0
10
20
30
40
50
60
Canada UnitedStates
Australia UnitedKingdom
NewZealand
Extremely/ very difficult Somewhat difficultNot too/ Not at all difficult
Per cent who reported difficulties, 1998
Source: Commonwealth Fund 1998 International Health Policy Survey
Figure 31: Concerns About Waiting Times
18%
31%18%
30%Strongly agreeSomewhat agreeSomewhat disagreeStrongly disagree
“My local hospital emergency room provides services in a reasonable amount of time”
Source: Ipsos-Reid, 2000.
Figure 32: System Performance
10
10
10
11
13
17
22
16
19
21
23
25
27
29
29
32
34
27
26
25
21
28
22
23
27
23
21
18
14
6
7
9
7
7
7
Use best available drugs
Waiting/ optional surgery
Length of hospital stay
Morale of medical staff
Waiting/ prescribed surgery
Waiting/ specialist
Waiting/ ER
Very poor Poor Average Good Very good DK/ NR
How is the health system’s performance on…
Source: Earnscliffe/POLLARA, 1998.
Figure 33: Support for Equalization
45
55
41
50 4844
34
4538
32
4237 40 41 40 39
0
80
National Atlantic Quebec Ontario Manitoba Sask. Alberta BC
Strongly Support Moderately Support
As you may know, under the federal equalization program money is transferred from the richer provinces to the poorer ones, in order to ensure that Canadians living in every province have access to similar levels of public services. Do you strongly support, moderately support, moderately oppose, or strongly oppose the equalization program?
Source: Centre for Research and Information on Canada, 2001.
Figure 34: Growing Empowerment
65%
64%
72%
69%
0% 20% 40% 60% 80% 100%
I prefer when my doctor gives medifferent treatment options to choose
from rather than just writing out aprescription
I always ask my doctor questionsabout the medicine he/ she prescribes
me
20001995
Angus Reid Report.
Figure 35: Use of Health Related Internet Sites
39%43%
0%
10%
20%
30%
40%
50%
2000 2001
In the past month, have you surfed or visited any Internet sites or looked up any information regarding health, health information, health organizations, medical conditions, medication, health products, alternative remedies, or anything having to do with health and well being? (percent saying “yes”)
Source: Berger Health Monitor, May 2000, March 2001.
Figure 36: Discussions with Physicians Regarding Internet
Information
17%
24%
0%
10%
20%
30%
40%
1999 2001
The last time you visited or consulted your doctor, did you take or referto information you had obtained over the Internet? (percent saying “yes”).
1999: Asked only of those who had visited a health related site in the previous month, or had had someone visit a site for them.2000: Asked only of those who had visited a health related site in the previous month.Source: Berger Health Monitor.
Figure 37: Communication with Physicians by E-mail and Internet
67% 63%
52%
0%
20%
40%
60%
80%
100%
Arrangeappointments
Get information onyour health condition
Discuss yourtreatment
Would you be interested in communicating with your doctor using e-mailand the Internet, for example… (percent saying “yes”).
Among visitors to Internet health sites in previous monthSource: Berger Health Monitor, March 2001.
Figure 38: Use of e-mail and Internet: Sociodemographic Differences
61%67%
56%64%
55%48%
28%
0%
20%
40%
60%
80%
100%
Visitorsto health
sites
Men Women 15-19 55-64 65-74 75+
Average "Yes" to three options
Would you be interested in communicating with your doctor using e-mailand the Internet, for example: 1. To arrange appointments. 2. To getinformation on your health condition. 3. To discuss your treatment.
Among visitors to Internet health site in previous monthSource: Berger Health Monitor, March 2001.
Figure 39: Health Related Purchases Over the
Internet
1% 1% 1% 1%0
1%
5%7%
2%3%
5%3%
2%
13%
0%
5%
10%
15%
20%
Books,magazines
Organicfoods
Naturalhealth
products
Over thecounter,
non-prescriptionmedication
Prescriptionmedication
Medical,other healthconsultation
One or more
2000 2001
In the past month have you bought anything over the Internet that was related tohealth, for example…
Among visitors to Internet health site in previous month. Percent saying they had made such a purchase in the previous month.Source: Berger Health Monitor, March 2001.
Figure 40: Use of Natural Health Products
60
36
15 14
28
1
70
26
60
36
14 15
33
1
72
28
61
36
1916
38
15
75
31
0
20
40
60
80
Vitamins Mineralsupplements
Foodsupplements
Homeopathicremedies
Herbalremedies
Others 1+ items 3+ items
March '99 May '00 March '01
In the past six months, have you taken any of the following…
Source: Berger Health Monitor.
Figure 41: Use of Alternative Health Providers
12%10%
3% 3%1% 2% 2% 2% 1% 1% 1%
24%
3%
0%
10%
20%
30%
40%
Source: Berger Health Monitor, 1999.
In the past six months, have you used any of the following services…
Figure 42: Use of Natural Health Products By
Region
15%
27%
33%30%
34%
41%
0%
20%
40%
60%
Atlantic Quebec Ontario Manitoba,Sask.
Alberta B.C.
Percentage reporting using three or more natural health products in the previous six months.
Source: Berger Health Monitor, March 2001.
Figure 43: Health Information on the Internet
56%
18%
8%
19%
0%
10%
20%
30%
40%
50%
60%
Mainstreaminformation
Alternativeinformation
Both Notlooking/ DK
The last time you used the Internet for health-related information, wouldyou say you were looking for…
Among direct and indirect Internet users for health related purposes.Source: Berger Health Monitor.
Figure 44: Use of the Internet: Which Sites?
16%
7% 7%
33%
24%
16% 18%
28%
44%
0%
10%
20%
30%
40%
50%
HealthCanada On-
line
CanadianHealth
Network
Provincialgovt, health
ministry
University Disease,condition site
May-00 Mar-01
The last time you used the Internet for health-related purposes did youvisit any of the following health-related sites:
Internet users who visited a health-related site in previous month, or had someone look for them in pastsix months.Source: Berger Health Monitor, May 2000, March 2001.
Figure 45: Support for the Principles of the Canada Health Act: 1991-99
93
8589 89
8589
7881
7976
88
73
80 8078
76
63 64
595650
60
70
80
90
100
1991 1994 1995 1999 2000
Universality AccessibilityPortability ComprehensivenessPublic Administration
The Canadian health care system is based on five principles developed some years ago. Please tell me how important you think it is to keep each of these five principles… (detailed explanation of each principle provided in question.)
Per cent answering “very important” (3 other response choices: “somewhat important,” “not very important,” and “not at all important”.Source: Berger Health Monitor.
36
60
24
74
4447
29
66
4551
39
58
41
57
0
20
40
60
80
Allow Private Entirely Public
NATIONAL
Atlantic
Quebec
Ontario
Man / Sask
Alberta
BC
Source: Centre for Research and Information on Canada, Environics/CROP, 2000.
Figure 46: Entirely Public or Some Private?
In your opinion, should Canada allow privately-owned companies to deliver some health care services in Canada, or should the health care system be operated entirely as a public program?
Figure 47: Support for Some Private Care: 2000-2001
4139
45
29
47
36
24
48
4042
3434
42
51
0
10
20
30
40
50
60
Canada Atlantic Quebec Ontario Man /Sask
Alberta BC
2000
2001
Source: Centre for Research and Information on Canada.
In your opinion, should Canada allow privately-owned companies to deliver some health care services in Canada, or should the health care system be operated entirely as a public program?
Figure 48: Opposition to Funding Cuts
5%12%
5% 4%
78%
18%
0%
90%
1989 1995 1999 2001
Support cuttingspending/ we'respending too muchRight amount
Spending too little
Source: Environics Focus Canada Surveys
1989-1999: Some people think that the federal government should cut back its spending in some areas while other people disagree. Could you tell me whether you support the following measures… cutting back federal funds for health care.
2001: Keeping in mind that increasing services could increase taxes, do you think the federal government is spending too much, just the right amount, or is spending too little on each of the following?
Figure 49: Coverage of Public Health Care
9%
42%47%
0%
10%
20%
30%
40%
50%
60%
Covers too much About right Doesn't coverenough
Does Canada’s public health care system cover enough servicesand programs?
Source: Angus Reid, The Public Domain, May 2000.
Figure 50: Restore Funding or New Programs:
1996
26.8%
70.9%
0% 20% 40% 60% 80%
New Programs
RestoreFunding
One of the areas for which the government may announce some new spending is health care. Now, in your view, which of the following should be the government’s first priority: 1. Restoring to the provinces the funding intended for Medicare that was cut by the federal government to help reduce the deficit; or 2. Funding new national healthcare programs such as a new pharmacare program or a new homecare program?
Source: Angus Reid, March 1996.
Figure 51: Quality vs. Equal Access
31% 33%
40%
53%
45%41% 43%
43%
0%
10%
20%
30%
40%
50%
60%
1995 1997 1998 2000
Quality Access
Which of the following aspects of health care is of greatestimportance to you?
Source: Ekos Research, Health Issues Tracking Survey.
Figure 52: Equal Access vs. Quality of Care
68
44
17
20
9
16
3
8
3
11
0% 50% 100%
We need one system with equalaccess even if it costs more
Maintain equal access even if wecan't have highest level of care
Completely agree AgreeNeither agree nor disagree DisagreeCompletely disagree DK/ NR
Do you agree/disagree with each of the following?
Source: Earnscliffe/POLLARA, 1998.
Figure 53: Where Should the Money Come From? (Saskatchewan)
Increased taxes21%
Cuts to other programs
9%
Individuals pay29%
No response41%
If more money is required for the health care system, where do youbelieve this extra money should come from?
Source: Saskatchewan Commission on Medicare, 2001.
Figure 54: Where should the money come from? (National)
71%
70%
40%
33%
22%
0% 20% 40% 60% 80%
Take money from other non-socialprograms
Have those who can afford to pay someof their health care costs
Take money from other social programs
Increase taxes
Reduce access or quality of health care
Source: Merck Frost/Pollara, 1999.
Figure 55: Tracking Privatization
26
28
31
71
68
67
0 20 40 60 80
Mar. '99
Dec. '99
Aug. '01
Once private health care services start to become widely available, itwon't be long before quality public health care services are hard to find.
Allowing some privatization of the health care system is a good thingbecause it will relieve the pressure on public institutions like hospitalsthat are already overcrowded.
Which statement is closer to your own view?
Source: Ekos Research, Rethinking Government Surveys
Figure 56: Opposition to Privatization
31
64
40
20
40
60
80
100
Good way to dealwith funding cutsand waiting lists
Will erode thehealth care system
Don't know
Source: Environics, 2000.
In some provinces, there is talk of allowing private health clinics to charge patients a fee for using the facility and also receive the usual payment from the province for performing a particular operation. Some people say these clinics are a good way to deal with health care cutbacks and waiting lists by allowing some people to pay for a health service. Others say that this development, if it continues, will erode Canada’s universal health care system. Which of these views is closer to your own?
Figure 57: Opposition to a Mixed Public/Private
System
29%33%
55%50%
16% 17%
0%
60%
A Two-Tiered System A Mixed Public/ Private System
SupportOpposeNeither
Do you personally support or oppose moving more money towards [a two-tiered system/a mixed public-private system] where people are free to pay for faster or better health care services.”
Source: Ekos Research, Benchmark Survey, August 1999.
Figure 58: Some Support for Two-Tiered?
19%
28%
14%
38%
0%
10%
20%
30%
40%
50%
Acceptable if there is two-tiered
Strongly agreeSomewhat agreeSomewhat disagreeStrongly disagree
“It is alright if Canada’s health care system evolves into a two-tier system where privately owned and public health institutions offer all health services.”
Source: Angus Reid, 2000.
Figure 59: Paying for Quicker Access? 1996-2001
34%
23%
35%29%
36%
55%
67%
54%61%
52%
0%
20%
40%
60%
80%
Nov. '96 Nov. '97 Mar '99 Dec. '99 Jan. '01
Agree Disagree
Individuals should be allowed to pay extra to get quickeraccess to health care services.
Source: Ekos Research, Rethinking Government Surveys
Figure 60: Paying for Quicker Access?
Regional Breakdown
35
36
33
36
44
42
36
11
12
11
15
7
12
11
53
51
56
48
49
44
52
0% 20% 40% 60% 80% 100%
ATL
QC
ONT
MB/ SK
AB
BC
National
Agree Neither Disagree
Individuals should be allowed to pay extra to get quickeraccess to health care services.
Source: Ekos Research, Rethinking Government, January 2001
Figure 61: Paying for Quicker Care?
15%9%
13% 12%
49%
0%
10%
20%
30%
40%
50%
60%
Completelyagree
Agree Neither agreenor disagree
Disagree Completelydisagree
Do you agree with people paying extra for quicker care?
Source: Earnscliffe/POLLARA, 1998.
Figure 62: Paying to get to the Head of the Line?
67 64 6761
68 66 67
4650
4438
4941
46
5 4 7 5 4 7 5
1813 13
2114
27
13
0
10
20
30
40
50
60
70
80
NATIONAL B.C. Alberta Man, Sask Ontario Quebec Atlantic
Strongly disapprove, '99 Strongly disapprove, '96Strongly approve, '99 Strongly approve, '96
1996: Would you approve of an arrangement where people could pay to wait a shorter time for health care services? 1999: Would you approve of a provincial health system where people could pay to go to the head of the line for health care services?
Source: Berger Health Monitor.
Figure 63: Perception of Treatment in Private System
5651
4652 51 50
8 7 9 714
10
0
40
80
B.C. Alberta Man, Sask Ontario Quebec Atlantic
Strongly agree Strongly disagree
“You and your family would be treated fairly in a system where people could pay to get to the front of the line.”
Source: Berger Health Monitor, 1999.
Figure 64: Paying for timely access?
98%
73%
2%
27%
0%
50%
100%
"All Canadians shouldreceive timely access"
"Canadians withouttimely access should have
option of using privatefacility"
AgreeDisagree
Source: Merck Frost/Pollara, 1999.
Figure 65: Attitudes toward “Bill 11” Model
15%
35%
21%26%
3%
0%
10%
20%
30%
40%
50%
Stronglysupport
Somewhatsupport
Somewhatoppose
Stronglyoppose
Don't know
The provincial government in Alberta recently announced its intention to allow privately owned health institutions to offer services like hip replacements and they will be paid by the government with taxpayers’ dollars. From what you know, would you support or oppose the proposal put forward by Premier Klein?
Source: Angus Reid, April 2000.
Figure 66: Attitudes toward Bill 11
11%
39%
18%
27%
6%
0%
10%
20%
30%
40%
50%
Stronglysupport
Somewhatsupport
Somewhatoppose
Stronglyoppose
Don't know
The provincial government in Alberta recently announced its intention to allow regional health authorities to contract with private health care providers to provide some surgical services. The Government of Alberta’s intent is to have these private providers operate under the jurisdiction of a regional health authority and that under this arrangement these private providers will be paid by the government and not by individual Albertans. From what you know, would you say…
Source: Angus Reid, April 1999.
Figure 67: Arguments in opposition to Bill 11
38%
40%
41%
28%
25%
30%
0% 50% 100%
Decisions like this move Canada one stepcloser to a two tier health care system
Decisions like this put Canada one step closerto having an American style health care system
This decision undermines universality and theprinciple that access to health care in Canadais based on medical need, not ability to pay
Very effective argument Somewhat effective
Source: Angus Reid, 1999.
Figure 68: Arguments in opposition to Bill 11 #2
37%
58%
71%
29%
19%
34%
0% 50% 100%
Public funds are better spent on improving thepublic system rather than creating a parallel
private health care sector
The government of Canada has a significantrole to play in ensuring the government of
Alberta's actions are consistent with the intentand spirit of the CHA
Private health institutions that receive publicfunding should have to open their financialbooks to public scrutiny the same way that
public hospitals do
Strongly agree Somewhat agree
Source: Angus Reid, 1999.
Figure 69: Arguments in support of Bill 11
25%
25%
16%
42%
37%
36%
0% 50% 100%
Paying the private system with public fundswill improve services and reduce waiting times
Decisions like this are necessary because thecurrent public system is not able to meet the
rising demand
Paying the private system with public fundswill reduce the costs to tax payers because thegovernment will not have to pay to build new
facilities. As a result more money will gotoward the provision of services
Very effective argument Somewhat effective
Source: Angus Reid, 1999.
Figure 70: Arguments in support of Bill 11 #2
41%
17%
19%
30%
31%
19%
0% 50% 100%
Anything that can be done to improve healthcare services and reduce waiting times inCanada should be done, including paying
private facilities to provide certain health careservices
It's all right if Canada's health care systemevolves into a two-tier system where privateand pubic health institutions offer all health
services
This is an Alberta issue to be solved byAlbertans and any intervention by the
Government of Canada is inappropriate
Strongly agree Somewhat agree
Source: Angus Reid, 1999.
Figure 71: Arguments in opposition to
Privatization
78%
77%
72%
0% 50% 100%
The only ones who would benefit from allowingpeople to pay for faster or better health care
services would be wealthy Canadians
Allowing people to pay for faster or betterhealth care services will not be necessary ifgovernments make the right decisions todayabout how to make the system more efficient
Universal publicly-funded health care is part ofwhat it means to be Canadian and reflects ourcore values; we would be a poorer society if we
shifted to a 2 tier health care system
Very effective argument
Source: Ekos, 1999. Arguments introduced with: “Some people talk about the need to allow Canadians to buy quicker or higher quality care than what is offered by the publicly-funded health care system.”
Figure 72: Arguments in support of Privatization
56%
41%
40%
0% 50% 100%
By having Canadians pay to use private clinics,waiting times in publicly-funded clinics and
hospitals would be reduced
It makes no sense for governments to try tokeep up with the rising cost of the public
health care system because the system is sodemanding that it will absorb any amount of
money put into it
Allowing people to pay for faster or betterhealth care services is fairer because it allowsthe freedom to choose as is the case in other
areas of the economy
Agree
Source: Ekos, 1999.Source: Ekos, 1999. Arguments introduced with: “Some people talk about the need to allow Canadians to buy quicker or higher quality care than what is offered by the publicly-funded health care system.”
Figure 73: User Fees
46%
58%
46% 44%47% 48%
44%
NATIONAL Atlantic Quebec Ontario Man/ Sask Alberta B.C.
Thinking about the hospitals and your family use, do you agree that hospitals must charge because there is not enough money anymore? (percent saying “yes”)
Source: Berger Health Monitor. 1995
Figure 74: Options for Raising Funds
42%
29%
31%
56%
Hospital user fees
Physicians extra bill
Raise taxes
User fees if people usemore than a certain
amount
Keeping in mind that right now all Canadians are entitled to necessary health services without charge, if your provincial government had to increase its health care budget, please tell me if you would strongly approve, somewhat approve, somewhat disapprove or strongly disapprove of these ways to raise money to pay for health care costs?
Percentage “strongly” and “somewhat” approving combined and presentedSource: Berger Health Monitor. 1995
Figure 75: Deep Support for User Fees?
15%
27%
49%
People would find a wayto pay for services they
really need
You and the communitywould help people pay
Government should pay,which may require
higher taxes
If you found that user fees discouraged sick people from getting the health services they needed, which of the following approaches would you choose for these people?
Source: Berger Health Monitor. 1995
Figure 76: How good an idea is each of the following?
41
34
32
29
24
20
51
56
60
54
52
47
7
9
7
14
22
30
0% 20% 40% 60% 80% 100%
Tax breaks for the poor
Homecare
Research
Increase provincial transfers
Provide money to poor
Pharmacare
One of the best ideas A good idea but not the bestNot a good idea DK/ NR
Source: Earnscliffe/POLLARA, 1998.
Figure 77: Canadians Giving Informal Care
16%
17%
25%
0% 5% 10% 15% 20% 25% 30%
1991
1998
2000
Yes, care giving…
Are you giving care to anyone in or out of your home, a child or adult who needs care, attention, errands done for them or similar kinds of help?
Source: Berger Health Monitor, May 2000.
Figure 78: The Financial Burden of Informal
Care
33%
56%
13%
32%
42%
22%
0% 10% 20% 30% 40% 50% 60%
Two or more
One or more
Borrow
Use savings
Make some cuts topersonal spending
Make major cuts topersonal spending
Among those providing informal care: Would you say that in helping out as you do, you have to…
Source: Berger Health Monitor, May 2000.
Figure 79: General Support for Pharmacare
27%
0% 10% 20% 30% 40% 50%
Leave situationas it is
Among all the countries with national insurance programs, Canada is theonly one that does not include prescription drugs as part of its nationalhealth care system. Do you believe Canada should leave the situation as itis or should it include prescription drugs?
Source: Berger Health Monitor, August 1998.
Figure 80: Pharmacare: What Drugs to Include?
39%
57%
0% 40% 80%
All drugsprescribed by
doctor
Only drugs forserious illness
Keeping in mind that the more drugs that are included, the more expensivethe program will be – if governments expanded the coverage for prescriptiondrugs, should this increased coverage include…
Source: Berger Health Monitor, August 1988.
Figure 81:Support for Primary Health Service
Teams
49%
14%
24%
13%
0%
10%
20%
30%
40%
50%
60%
PositiveNegativeUnsureNo Response
Source: Saskatchewan Commission on Medicare, 2001
Delivering care through Primary Health Service Teams (PHST’s) is another idea for everyday health care. These teams would include nurse practitioners, physicians, nutritionists, pharmacists, therapists and others working together. Some team members could serve more than one community. Services would be on call 24 hours a day, seven days a week. In general, do you think the PHST approach would be positive or negative for the quality of health services you receive?
Figure 82: Doctors or Specialized Professionals?
54%
25%20%
0%
10%
20%
30%
40%
50%
60%
Satisfied Neutral Not satisfied
If you were in need of routine health care services, such as ear or throat infections, managing diabetes, or monitoring high blood pressure, would you want to visit a doctor, or would you be satisfied with seeing a general or specialized nurse who works with a doctor?
Source: Ekos, 2000.
Figure 83: Support for Team Practices
74%
24%
3%0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
Part of a team On his/ her own Don't know
For the health care needs of you and your family, would you prefer a family doctor working as part of a team, or a family doctor practicing on his/her own?
Source: Ekos, 1999.
Figure 84: Importance of Keeping Hospitals
Open
51%
32%
17%
0%
20%
40%
60%
Keep Hospitals Fewer Hospitals No Response
Source: Saskatchewan Commission on Medicare, 2001.
Below are two different views about how to make sure that people get everyday health services when they need them: 1. We should keep hospitals open in as many communities as we can; 2. We could have fewer hospitals if there were more ambulances and more trained ambulance staff available, and people could get hospital care in larger centres when needed.
Figure 85: Hospitals or Community care?
32%
51%
17%
0%
20%
40%
60%
Investing more in thecurrent system of
doctors and hospitals
Investing more in newapproaches such as
home care, community-based care and earlyprevention programs
Both equally(volunteered)
Source: Ekos 1999.
If you were responsible for improving the health care system in Canada, which of the following would you put more emphasis on?
Figure 86: Options for Hospital Restructuring
35%
52%
73%
82%
Patients won't receivesame attention if
hospitals combined
Travelling 20 minutesdoesn't hurt patients
Combined service meansbetter quality
Hospitals which providesame services should be
combined
Thinking about hospitals you and your family use, please tell me whether you would strongly agree, somewhat agree, somewhat disagree or strongly disagree with the following reasons for changing the way these hospitals provide services to the public?
Percent “strongly” and “somewhat” agreeing combined and presented.Source: Berger Health Monitor, 1995.
Figure 87: How important should each of the following goals be for the health care
system?
64% 62% 60%
33%
0%
25%
50%
75%
Enhance thequality of life
Promote healthand wellness
Reduce disabilityand increase
ability tofunction
Provide life-extendingtreatments
Source: Merck Frost/Pollara 1999.
Percentage saying the goal should be “very important.”
Figure 88: Physician Assisted Suicide
Agree Strongly35%
Agree Moderately
28%
Disagree Moderately
9%
Disagree Strongly
24%
DK/ NA4%
“There are some circumstances under which physicians should definitely be free to help patients commit suicide.”
Source: Angus Reid, September 1995.
Figure 89: Treating Disease or Promoting
Health?
29%
59%
11%
0%
20%
40%
60%
80%
focus only on the treatmentof disease, illness and injury
do more than treat disease,illness and injury, and alsopromote health through
things like improvedparenting skills, better
nutrition and helping peoplequit smoking
DK/ NA
Is it the job of the health care system to…
Source: Saskatchewan Commission on Medicare, 2001.
Figure 90: Short-Term Policy Options
60
54
48
47
45
40
31
27
31
34
27
33
33
32
8
9
13
17
12
18
17
2
3
2
4
4
3
7
2
2
2
4
4
5
12
0% 20% 40% 60% 80% 100%
Guarantee on waiting
More equipment
Telemedicine
Charter of Rights for health care
ER quick response teams
Rural ambulance service
Paying doctors extra in rural areas
Completely support SupportNeither support nor oppose OpposeCompletely oppose DK/ NR
Source: Earnscliffe/POLLARA, 1998.
Figure 91: Importance of various goals
6.44
5.51
5.77
5.72
5.78
5.57
3.08
2.4
2.54
2.23
6.44
6.01
5.83
5.78
5.67
5.13
3.18
2.88
1.96
1.93
0 1 2 3 4 5 6 7
Adequate numbers of nurses, doctors, specialists across thecountry
Expanded support for community health clinics
Expanded home and community care services
Improved access to medical specialists
Available 24-hours a day, 7 days a week
Better patient access to modern medical technology
Increased health promotion
Expanded use of health information technology
Increased performance reporting to the public
Governments cover the cost of prescription drugs
Pre dialogue Post dialogue
Source: Ekos 2000 (Respondents were asked to rank each goal in order of importance. Score of 10 indicates “most important”)
Figure 92: Preferences for Spending
25%
32%
47%
50%
58%
61%
70%
Increased health promotion activities
Making better use of information technology
Increased reporting on the performance of thehealth care system
Increase the availability of modern technology
Expanded home and community care programs
Upgrading and modernizing hospitals
Improved access to family doctors and nurses
If you were Prime Minister for a day and had an additional $1 billion to invest in health care, which would be in the best interest of the public?
Source: Ekos 2000. Responses presented in a series of random pair choices.
Figure 93: Causes of Inefficiency
39
74
63
64
54
84
69
70
71
84
55
72
65
87
52
73
0 20 40 60 80 100
People in hospital would do as well athome.
People use unnecessary services
Hospitals don't manage finances well
Doctors prescribe unnecessarily
1989 1992 1994 1995
What are the leading causes of inefficiency in Canada’s health caresystem?
Source: Canada Health Monitor.
Figure 94: Causes of Inefficiency: Do Doctors Abuse the System?
Agree Strongly35%
Agree Moderately
29%
Disagree Moderately
18%
Disagree Strongly
16%
DK/ NA2%
“I feel some doctors encourage people to come for more visits thanare strictly necessary, in order to maintain income levels.”
Source: Angus Reid, September 1995.
Figure 95: Causes of Inefficiency: Do Patients Abuse the System?
Agree66%
Neutral23%
Disagree11%
“Many Canadians misuse the health care system and this increases the costs.”
Source: Angus Reid, 2000.
Figure 96: Two Views on Ensuring Quality
13%
75%
12%
0% 50% 100%
Rely on judgement ofhealth care providers
Decisions based onbest research evidence
No response
Source: Saskatchewan Commission on Medicare, 2001
Should we rely only on the judgement and independence of health care providers, or should we ensure that decisions made by providers are supported by the best research evidence?
Figure 97: Two Views on New Drugs and
Procedures
12%50%
38%
0% 10% 20% 30% 40% 50% 60%
Even if it means that some new technologies, procedures or drugs are notavailable, we should carefully examine the medical evidence and adoptonly those that offer a clear improvement over other available solutions.Even if it means we have to pay more for health care, it is important thatall new procedures, drugs and technologies are made available as soon asthey are approved.No Response
Source: Saskatchewan Commission on Medicare, 2001.
Figure 98: Willingness to Try Experimental
Therapies
7578
60
78 80 8387
0
20
40
60
80
100
National Atlantic Quebec Ontario Manit/ Sask Alberta B.C.
If you were very ill and conventional medicine did not work, should youhave the right to try a therapy which was experimental and which couldmake you even sicker than you were?
Per cent responding “yes”.Source: Berger Health Monitor, March 2001.
Figure 99: Hours of Hospital Emergency Use
23%28%
37%
12%
0%
10%
20%
30%
40%
50%
Between 6amand noon
Between noonand 6pm
Between 6pmand midnight
Betweenmidnight and
6am
Thinking of the last time you went to the emergency room for yourselfor somebody else, at approximately what time in the day or night didyou go?
Source: Berger Health Monitor, March 1999.
Figure 100: Alternatives to Hospital Emergency
Service
89% 86%
46%
87%
12%
0%
25%
50%
75%
100%
Provide atelephone
service
Send peopleto walk-in
clinic
Charge aspecial fee
Familydoctors worknights andweekends
Publicawarenesscampaign
If hospitals wanted to discourage people who did not really have anemergency from using hospital emergency services, which ways would you approve of…
Source: Berger Health Monitor, March 1999.
Figure 101: Support for Community Report Cards
71%
20%
9%
0% 20% 40% 60% 80%
Support
Oppose
DK
“The federal government should give report cards about how well each province is doing on things like health care and education.”
Source: iPoll Research Group, 2000.
Figure 102:Focus of Community Report Cards
24%
51%
17%
0% 20% 40% 60%
Both
Performance of the system on thingssuch as waiting times for treatment and
quality of treatment
Health of the population in thecommunity, on things such as people’s
health and fitness, illness in thecommunity, and nutrition.
Some people have said there should be Community Report Cards on Health so that Canadians would have more information on health issues in their community. If community health cards were established, should they concentrate on..
Source: Berger Health Monitor, August 1998.
Figure 103:Importance of Community Report
Cards
77%
19%
Providing moreservices
Reporting onhealth in thecommunity
Setting up a system of health report cards in communities would cost several million dollars. Some people say that if we spend billions on health care weshould spend at least a few million to let people know the state of health intheir communities. Others say the money would be better spent on providingmore health services . Would you prefer to spend “several million dollars” on...
Source: Berger Health Monitor, August 1998.
Figure 104: Role of the Federal Government
81%
16%
3%0%
20%
40%
60%
80%
100%
Federal government isimportant in Medicare
Federal governmentshould not have a say
DK/ NR
Which opinion reflects your view of what the federal government’srole in Medicare should be?
Source: Earnscliffe/POLLARA, 1998.
Figure 105: Should the Government Regulate Natural Health Products?
91% 93%
75%
0%
25%
50%
75%
100%
Purity Quality Effectiveness
Regarding natural health products, do you think the government shouldregulate their: a) purity; b) quality; c) effectiveness?
Source: Berger Health Monitor, May 2000.
Figure 106: Support for National Pharmacare
63%
32%
0% 20% 40% 60% 80%
Nationalprinciples
Provincialprinciples
If there were a national pharmacare program, should the pharmacare program be based on a set of national principles or should each province have its own pharmacare principles?
Source: Berger Health Monitor, August 1998.
Figure 107: Federal Role
59%
39%
The government of Canada's role in the healthcare system includes more than helping theprovinces pay for the system -- it should also
ensure that all Canadians, no matter where theylive, have access to similar levels of health care
services
The government of Canada's role in the healthcare system is to give money to provincial
governments to help cover the costs of provincialhealth care systems
Source: Ekos 2000.
Which of the two following statements more closely reflects your own view?
Figure 108:Federal Contribution to Health Care
2%
11%
29%
19%
8%
31%
1%
9%
32%
21%
4%
32%
0%
20%
40%
None About10%
About25%
About50%
Morethan50%
Don'tKnow
BCAlberta
How much of the money for health care in your province comes from the federal government? Would you say it is about…
Source: iPoll Research Group, 2000.
Figure 109: Under Whose Authority?
38%40%
44%
16%
24%
15%
42%
31%
39%
0%
10%
20%
30%
40%
50%
1990 1994 2000
Primarily federal
Both equally (had to bevolunteered)Primarily provincial
Please tell me whether you think each of these things should be under the authorityof only the federal level of government, primarily the federal level of government, primarily the provincial level of government, only the provincial level of government… health?
Source: Environics Focus Surveys.
Figure 110: Who Should Take the Lead?
13%3%
83%
0%
25%
50%
75%
100%
Provincial Federal Both
“Which government should be in charge of trying to fix problems with the health care system: the federal government, the provincial government, or should they have to work together on this?”
Source: iPoll Research Group, 2001.
Figure 111: Who Should Lead?
11
15
17
18
20
21
23
24
14
19
8
7
22
6
8
12
7
14
9
11
80
76
60
74
71
67
68
60
75
68
Sask.
B.C.
Quebec
Atlantic
Manitoba
Alberta
Ontario
Men
Women
TOTAL
Federal Provincial Both DK/ NR
Which level of government is the most appropriate to take thelead role on health care?
Source: Earnscliffe/POLLARA, 1998.
Figure 112: Who is to Blame?
12
15
23
23
27
28
29
19
21
31
17
22
15
15
13
23
62
45
53
47
48
48
47
50
4
6
5
7
7
7
8
6
1
3
2
1
3
2
3
2
Quebec
Ontario
Saskatchewan
Alberta
Atlantic Canada
Manitoba
British Columbia
TOTAL
Federal Provincial Both Neither DK/ NR
Who is to blame for the health care system’s problems?
Source: Earnscliffe/POLLARA, 1998.
Figure 113: The Importance of National Standards
63%
25%
7% 4%
0%
25%
50%
75%
Very Essential Somewhat Essential Not Very Essential Not At All Essential
There’s been some discussion recently about the issue of “national standardsfor health care” – that is, requiring all the provinces to provide the same basicaccessibility and quality of health care. In your view, how essential is it tohave national standards for health care across the country?
Source: Angus Reid, March 1996.
Figure 114: Who should set national standards?
47%
25%24%
0%
10%
20%
30%
40%
50%
The fed and prov gov'tsshould set nationalstandards together
The fed gov't should setstandards
Each prov should set itsown standards
In Canada, different provinces often have different standards for things like health care. Which of the three following statements most closely reflects your own view:
Source: iPoll Research Group, 2000.
Figure 115: Enforcement of the Canada Health
Act
44%49%
7%
0%
10%
20%
30%
40%
50%
60%
Withhold transfers Not appropriate towithhold money
DK/ NR
Should the federal government enforce the Canada Health Act by withholding transfers?
Source: Earnscliffe/POLLARA, 1998.
Figure 116: Regional variations on withholding
money
56%
45%
65%
55%52%
49%
57%
0%
40%
80%
National Atlantic Quebec Ontario Manit/ Sask Alberta BC
Would you strongly support, somewhat support, somewhat oppose or strongly oppose withholding federal government funds from those provinces which do not meet the five principles (defined in previous question)?
Source: Berger Health Monitor, 1995.
Figure 117: Who Should be Involved in Policy?
62%
39%
38%
30%
23%
21%
12%
35%
31%
28%
37%
45%
34%
21%
0% 25% 50% 75% 100%
Health care professionals
Provincial governments
Federal government
The public
Voluntary health organizations
Academics
Business leaders and employers
The lead roleA significant role
“Who should play a lead role in setting policies to protect patients and ensure the best care?”
Source: Merck Frost/Pollara, 1999.
Figure 118: Spending on Social Programmes: Socioeconomic Differences
45
48
60
71
68
49
58
37
34
21
14
18
28
23
17
18
19
14
13
23
18
0% 20% 40% 60% 80% 100%
$80K+
$60K-80K
$20K-$60K
<$20K
Females
Males
OVERALL
Investing in social programs Paying down debt Tax cut for all
In planning its budget for next year, which of the following do youthink the Government of Canada should put the most emphasis on?
Source: Ekos Research, Health Issues Tracking Survey, December 1998
Figure 119: Quality and Access Trade-off:
Socioeconomic Differences
43%
50%
30%
48%
23%
47%
58%
38%37%
43%
0%
70%
Overall Income60K +
Income<20K
Age <65 Age 65+
Quality of health careservices
Equal access to allCanadians
Which of the following aspects of health care is of greatest importance to you?
Source: Ekos, 2000.
Figure 120: Support for Pharmacare: Sociodemographic Differences
32%
36%
44%
52%
68%
49%
0% 20% 40% 60% 80%
$75, 000
$50-$74,999
$30-$49,999
$20-$29,999
<$20,000
National
Do you think the Canada Health Act should be extended to coverprescription drugs?
Source: Berger Report, Canada Health Monitor, May-July 1996. Percentage saying “yes”.
Figure 121: Regional Variations on Privatization
Models?
12%
33%
18%
30%
8%
19%
24%
7%
18%
32%
0%
40%
Stronglysupport
Somewhatsupport
Somewhatoppose
Stronglyoppose
DK
AlbertaRest of Canada
Do you personally strongly support, somewhat support, somewhat oppose, or strongly oppose the proposal put forward by Premier Klein? (Bill 11 proposal defined in earlier questions).
Source: Angus Reid, 1999.
