The geographies of crisis: exploring accessibility to health care in Canada

• Published in: Canadian Geographies / Géographies canadiennes
• Main Authors: WILSON, KATHLEEN, ROSENBERG, MARK W.
• Format: Article in Journal/Newspaper
• Language: English
• Published: Wiley 2002
• Subjects: Canada; Newfoundland
• Online Access: http://dx.doi.org/10.1111/j.1541-0064.2002.tb00742.x; https://api.wiley.com/onlinelibrary/tdm/v1/articles/10.1111%2Fj.1541-0064.2002.tb00742.x; https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1541-0064.2002.tb00742.x

There is increasing concern in Canada that the health care system is in a state of crisis. It is argued that reductions in federal government transfers to the provinces have resulted in a health care system characterized by under‐funding in key areas and policy decisions based more on provincial fiscal concerns than the health needs of their constituents. Provincial governments have responded to reduced levels in federal funding by undertaking aggressive restructuring tactics such as the closure of hospitals and the deinsuring of medical services from provincial health plans. The end result of this restructuring, as argued by the media, consumer groups and indeed some health researchers, is a state of crisis' (i.e., lower levels of accessibility, long waiting lists, overcrowding in hospitals and increasing costs of medication). One crisis theme often mentioned is that fiscal decisions of various kinds are reducing economic and geographic accessibility, one of the five principles of the Canada Health Act (CHA) that defines the very essence of the Canadian health care system. Using data from the 1998‐99 National Population Health Survey (NPHS), this paper explores the extent to which an accessibility crisis exists within the Canadian health care system by examining access to health care services and the barriers encountered in trying to access services in each of the ten provinces. The results show that approximately 6.0 percent of Canadians report access problems, with values ranging from 4.5 percent in Newfoundland to 8.3 percent in Manitoba. Regional variations in barriers to accessing care were also observed. In particular, geographic accessibility appears to be a main barrier to care in Atlantic Canada while economic accessibility emerges as a main barrier to care in Western Canada. We discuss these findings in the context of the current debates on the Canadian health care system ‘crisis’. De plus en plus de Canadiens s'inquiétent que leur systéme de soins de santé soit en état de crise. On défend l'idée ...