Health Care in Canada 2005

1
Health Care in Canada Survey 2005
2
Health Care in Canada Partners

• Association of Canadian Academic Health Care
  Organizations
• Canadian College of Health Service Executives
• Canadian Healthcare Association
• Canadian Home Care Association
• Canadian Medical Association
• Canadian Nurses Association
• Canadian Pharmacists Association
• Canadian Public Health Association
• Health Charities Coalition of Canada
• Merck Frosst Canada Ltd.
• POLLARA
• Rogers Media

3
Table of Contents

• Methodology 4
• Detailed Findings 5
• Overview of the Health Care System 6
• Health and Well-Being 13
• Quality and Safety in the Health Care System 24
• Pharmaceuticals and Pharmacists 45
• Role of Public Vs. Private Insurance 57
• Transforming the Health Care System/Innovation 89
• Ensuring Accountability 112
• Experience Vs. Perceptions, and Behaviour 114

4
Methodology

• Survey results are based on telephone interviews
  with nationally representative samples of the
  Canadian public, doctors, nurses, pharmacists and
  health administrators.
• Fielding of the core questionnaire was conducted
  between August 17 and September 2, 2005.
• Groups Sample Size Margin of Error
• Canadian Public 1,207 2.8
• Doctors 203 6.9
• Pharmacists 202 6.9
• Nurses 201 6.9
• Health Administrators 201 6.9
• Questionnaires were developed by POLLARA working
  in close consultation with the HCIC partners.

5
Detailed Findings
6
Overview of the Health Care System
7
Most Important Issue Facing Canada Tracking
Important
24 Health Care
14 Concerns Politicians
5 Economy Deficit/Govt. Spending
3 Education Unempl. 2 Taxes
Q In your opinion, what is the single most
important issue facing Canada today?
Source Perspectives Canada
8
Very Concerned Tracking
64 Health Care
61 Politicians
49 Environment
47 Education
44 Fed. Taxation
41 Prov. Taxation
35 Trade Dispute with U.S.
Natl Resources
28 Crime
24 Cdas Security
Very Concerned
22 Cda U.S. Border
Q Now thinking more generally, would you say you
are very concerned, somewhat concerned, not too
concerned, or not at all concerned about the
following issues? How about (READ AND ROTATE)
Source Perspectives Canada
9
Overall Confidence in the Health Care System

• 50 of Canadians indicate they have falling
  confidence in the system.
• Confidence drops even further for women and for
  those between the ages of 35 and 55. (A middle
  aged angst that is consistent through many of the
  survey results).
• The percentage of those saying they have falling
  confidence differs across the country for a low
  of 41 in Atlantic to a high of 58 in
  Manitoba/Saskatchewan.
• Only 5 of Canadians say they have rising
  confidence in the system.

10
Tracking of Canadians Confidence in the Health
Care System
1998 1999 2000 2001 2002 2003 Spring 2004 Fall
2004 Spring 2005 Aug/Sept. 2005
Q Overall, would you say that your confidence in
the Canadian health system is rising or falling,
or is it about the same as it ever was? Base
GENPOP
Source HCIC 2005
11
Canadians Confidence in the Health Care System
Demographics - Aug/Sept. 2005
Q Overall, would you say that your confidence in
the Canadian health system is rising or falling,
or is it about the same as it ever was? Base
GENPOP
Source HCIC 2005
12
Canadians Confidence in the Health Care System
Demographics - Aug/Sept. 2005
Q Overall, would you say that your confidence in
the Canadian health system is rising or falling,
or is it about the same as it ever was? Base
GENPOP
Source HCIC 2005
13
Health and Well-Being
14
Public Health Measures

• Public perceive that behavioral factors such as
  eating habits and amount of stress have a high
  influence on the health of Canadians. They
  perceive that genetic make-up, education level
  and income have less of an influence.
• Canadians indicate strong support for initiatives
  to improve health and prevent illness and injury,
  such as physical education and health eating
  programs in schools and police checkstop
  programs.
• When asked about taxes as a healthy public policy
  measure to encourage lower consumption 41 felt
  that taxes were too low on cigarettes while only
  18 felt they were too low on alcohol 85 of
  Canadians felt taxes were too high on gasoline.

15
Public Health Measures

• Canadians strongly support a national
  immunization strategy, with 64 indicating
  ensuring the security of Canadian supply of
  vaccines for Canadians would be very important
  along with improved access to timely immunization
  programs.
• While citing control of vaccine prices as
  important in a national strategy equally
  important was ensuring that regulatory and
  pricing systems encourage companies to conduct
  vaccine research
• 67 of Canadians believe government should
  subsidize products like nicotine patches to help
  people quit smoking. This is strongest among
  those 18-24 with 80 supporting subsidization,
  and drops to 59 for those over 65 years of age.

16
Factors Influencing Health of Canadians
Mean ScoreMax75.8 5.7 5.5 5.5 5.2 4.5 4.4
A person's eating habits How much stress a person
has in their life Access to quality health care
services Quality of air we breathe Genetic
make-up inherited from parents A person's level
of education A person's level of income
Q Im going to read you a list of things that
may or may not be important factors influencing
the health of Canadians. Please tell me how you
would rate what impact you think each has.
Please use a 7-point scale where 1 means it has
No impact at all and 7 means it has a Very strong
impact on health (2005 HCIC)Base GENPOP
17
Factors Influencing Health of Canadians
Q Im going to read you a list of things that
may or may not be important factors influencing
the health of Canadians. Please tell me how you
would rate what impact you think each has.
Please use a 7-point scale where 1 means it has
No impact at all and 7 means it has a Very strong
impact on Health (HCIC 2005 CPHI Public Views
of the Determinants of Health Survey, 2003)Base
GENPOP
18
Importance of Initiatives to Improve Health and
Prevent Illness and Injury
Physical Education programs in schools Healthy
eating programs in schools Police checkstop
programs to check drivers' blood alcohol
levels Community access programs (i.e. community
centres) Public information on dietary
requirements Fines for not wearing bicycle
helmets seatbelts
Very Important (9,10)
Somewhat Important (7,8)
Neutral (5,6)
Somewhat Not Important (3,4)
Not At All Important (1,2)
Don't Know/Refused
Q How important do you think it is that
Canadians be encouraged to improve and maintain
their own wellness and take measures to protect
their health through each of the following
programs, on a scale from 1-10 where 1 means Not
at all important and 10 means Extremely
important?Base GENPOP
19
Publics View of Healthy Public Policy Taxes
Gasoline Alcoholic beverages Cigarettes and other
tobacco products
Q Thinking about how taxes might encourage
reduced use of certain products, do you think
taxes on the following items are too high, too
low or just right? Base GENPOP
20
Publics View of Tobacco Taxes
Q Thinking about how taxes might encourage
reduced use of certain products, do you think
taxes on the following items are too high, too
low or just right? - Cigarettes and other
tobacco products.Base GENPOP
Source HCIC 2005
21
Publics View of Alcohol Taxes
Q Thinking about how taxes might encourage
reduced use of certain products, do you think
taxes on the following items are too high, too
low or just right? - Alcoholic Beverages Base
GENPOP
Source HCIC 2005
22
Publics View of Gasoline Taxes
Q Thinking about how taxes might encourage
reduced use of certain products, do you think
taxes on the following items are too high, too
low or just right? - GasolineBase GENPOP
Source HCIC 2005
23
Government Subsidies For Products and Programs
Such as Nicotine Patches
Q Do you believe that the government should
subsidise products like nicotine patches to help
people quit smoking and other similar products
and programs? Base GENPOP
24
National Immunization Strategy
Ensuring the security of the Canadian supply of
vaccines for Canadians Control of vaccine
prices Improved access to timely immunization
programsEnsuring that regulatory and pricing
systems encourage companies to conduct vaccine
research
Very Important (9,10)
Somewhat Important (7,8)
Neutral (5,6)
Somewhat Not Important (3,4)
Not At All Important (1,2)
Don't Know/Refused
Q The federal and provincial governments are
working together on a national immunization
strategy to ensure that Canadians have access to
the latest vaccines. On a scale from 1 to 10
where one means it is not at all important and
ten means that it is extremely important, how
important are each of the following? (READ AND
ROTATE) BASE GENPOP
25
Quality and Safety in The Health Care System
26
Waiting Times

• A majority of all groups except managers believe
  that waiting times for elective surgery have
  become longer in the past 2 years public (66),
  nurses (64), physicians (58), pharmacists
  (58). 43 of managers felt they had gotten
  longer.
• Few people feel waiting times have gotten shorter
  ranging from 3 of the public to a high of 17 of
  managers believing wait times have decreased.
• Women (71) are more likely than men (61) to say
  waiting times have gotten longer.

27
Waiting Times

• When looking at perceptions of average waiting
  times for specific procedures the Canadian
  public believes that waiting times for breast
  biopsies are longer than health care providers do
  - with 59 of the public, 45 of physicians and
  32 of managers expecting it would take 3 weeks
  or more.
• 70 of the public expect emergency room waits to
  take two hours or more compared to 42 of nurses
  who believe that.
• By contrast, the public is more optimistic than
  health care providers when it comes to waiting
  time for hip replacements, with 58 saying they
  would expect to wait six months or more compared
  to 77 of physicians and 69 of managers.

28
Safety In Hospitals

• 59 of the public, felt it was likely or very
  likely that someone might be subject to a serious
  medical error while being treated at a Canadian
  hospital. This compared to 39 of physicians, 51
  of pharmacists, 62 of nurses and 57 of
  managers.
• More women (66) than men (51) feel this is
  likely to occur.

29
Emergency Preparedness

• Few people (6) feel we would be very prepared
  for a public emergency situation, like the SARS
  outbreak.
• 44 of the public, 47 of physicians, 34 of
  pharmacists, 33 of nurses, 30 of managers feel
  we would be unprepared.
• Health providers are concerned a situation like
  the SARS outbreak will occur again Physicians
  (81), Nurses (85), Pharmacists (60), Managers
  (91).
• 40 of managers and 37 of nurses indicate they
  are very concerned.

30
Perceptions of Waiting Times for Breast Biopsies
saying three weeks or more 59 45 32
Public Doctors Managers
Q Consider a patient with the following
symptoms. A 50 year old woman with a lump in her
breast who requires a biopsy. On average, how
long do you think a patient like this would
generally wait from the time a doctor first
recommends the test until the time it is carried
out? (HCIC 2005 Commonwealth fund IHP 2003)
31
Perceptions of Waiting Times for Breast Biopsies
saying three weeks or more 59 57 60 56 68
55 60
Q Consider a patient with the following
symptoms. A 50 year old woman with a lump in her
breast who requires a biopsy. On average, how
long do you think a patient like this would
generally wait from the time a doctor first
recommends the test until the time it is carried
out? (HCIC 2005 Commonwealth fund IHP
2003) Base GENPOP
32
Perceptions of Waiting Times for Hip Replacements
saying six months or more58 77 69
Public Doctors Managers
Q Consider a patient with the following
symptoms. A 65 year old man who requires a
routine hip replacement. On average, how long do
you think a patient like this would generally
wait from the time a doctor first recommends
treatment until the time the treatment is
received? (HCIC 2005 Commonwealth fund IHP 2003)
33
Perceptions of Waiting Times for Hip Replacements
saying six months or more 58 55 54 54 70 5
9 77
Q Consider a patient with the following
symptoms. A 65 year old man who requires a
routine hip replacement. On average, how long do
you think a patient like this would generally
wait from the time a doctor first recommends
treatment until the time the treatment is
received? (HCIC 2005 Commonwealth fund IHP
2003) Base GENPOP
34
Average Hospital Waiting Times for....
Notes The Commonwealth Fund Survey asked the
questions only of hospitals that perform the
procedures. The Commonwealth Fund wording was A
50 year-old woman with an ill-defined mass in her
breast but no Adenopathy.
35
Perceptions of Emergency Room Waiting Times
saying two hours or more706342 50
Public Doctors Nurses Managers
Q On average, how long do you think patients
wait to be seen in the hospital emergency
room?(HCIC 2005 Commonwealth fund IHP 2003)
36
Perceptions of Emergency Room Waiting Times
saying two hours or more70 66 78 73 60 6
4 64
Q On average, how long do you think patients
wait to be seen in the hospital emergency
room?(HCIC 2005 Commonwealth fund IHP
2003) Base GENPOP
37
Perceptions of Emergency Room Waiting Times
Q On average, how long do you think patients
wait to be seen in the hospital emergency
room?(HCIC 2005 Commonwealth fund IHP 2003)
38
Perceptions of Waiting Times for Elective Surgery
in the Past 2 Years
Public Doctors Pharmacists Nurses Managers
Q In the past 2 years, do you think that waiting
times for elective surgery have become longer or
shorter or have they remained the same? (HCIC
2005 Commonwealth fund IHP 2003)
39
Perceptions of Waiting Times for Elective Surgery
in the Past 2 Years
Q In the past 2 years, do you think that waiting
times for elective surgery have become longer or
shorter or have they remained the same? (HCIC
2005 Commonwealth fund IHP 2003) Base GENPOP
Source HCIC 2005
40
Perceptions of Waiting Times for Elective Surgery
in the Past 2 Years
Q In the past 2 years, do you think that waiting
times for elective surgery have become longer or
shorter or have they remained the same? (HCIC
2005 Commonwealth fund IHP 2003)
41
Likelihood of Serious Medical Errors
Total Likely 59 39 51 62 57
Public Doctors Pharmacists Nurses Managers
Q How likely do you feel it is that someone
might be subject to a serious medical error while
being treated at a Canadian hospital? Would you
say that it is not at all likely, somewhat
unlikely, somewhat likely or extremely likely?
42
Likelihood of Serious Medical Errors
TotalLikely 59 68 54 62 63 52 54 51 66
51 53 54 60 67 61
Q How likely do you feel it is that someone
might be subject to a serious medical error while
being treated at a Canadian hospital? Would you
say that it is not at all likely, somewhat
unlikely, somewhat likely or extremely
likely? Base GENPOP
43
Preparedness for Public Emergency Situations
Total Unprepared 44 47 34 33 30
Public Doctors Pharmacists Nurses Managers
Q If we experienced a pandemic or public
emergency situation, like the SARS outbreak for
example, how prepared do you think the Canadian
public health system would be to deal with it?
Would it be very prepared, somewhat prepared,
somewhat unprepared, very unprepared?
44
Concerned About Another SARS Type Situation
Total Concerned 81 60 85 91
Doctors Pharmacists Nurses Managers
Q How concerned are you that this type of
situation might occur again? Are you very
concerned, somewhat concerned, not very
concerned, not at all concerned?
45
Pharmaceuticals and Pharmacists
46
Pharmaceuticals and Pharmacists

• Pharmacists are facing many issues two of the
  priority concerns of the profession are - roles
  for pharmacists in primary health care teams
  reimbursement for services other than dispensing
  medication.
• 77 of the public, 95 of pharmacists, 77 of
  nurses and 88 of managers believe that
  pharmacists should have access to patients lab
  results and diagnostic tests to verify prescribed
  medication is most appropriate. Only 45 of
  physicians support this idea.

47
Pharmaceuticals and Pharmacists

• Canadians believe that all Canadians should have
  access to all needed medications 92 feel that
  government drug plans should cover any medication
  that a patient and their doctor agree are the
  most effective treatment and 87 believe if one
  province provides a drug that other provinces
  should automatically cover it as well.
• 84 of Canadians believe there should be a
  maximum people should have to personally pay out
  of their own pocket for drug costs.
• 80 of Canadians believe that people take too
  many medications but 71 also believe there are
  many people who should be taking medication
  regularly are not.

48
Pharmaceuticals and Pharmacists

• 77 of Canadians believe that prices for drugs
  have to be competitive with the rest of the world
  to attract research and development (RD) to
  Canada.
• About two thirds of physicians believe that
  formulary restrictions interfere with their
  ability to provide necessary care, and more than
  80 consider whether a patients insurance
  coverage when making prescribing choices.

49
Issues Facing the Pharmacy Profession
Mean ScoreMax108.5 8.4 8.4 8.0 7.5 7.3 6.8 6.4
Roles for pharmacists in primary health care
teams Continuing education needs Reimbursement
for services other than dispensing Working
conditions Supply and distribution of pharmacies
pharmacists Prescribing rights for
pharmacists Credentialing of pharmacy
technicians Internationally trained pharmacists
practising in Canada
Extremely Important (9,10)
Somewhat Important (7,8)
Moderately Important (5,6)
Somewhat Not Important (3,4)
Not At All Important (1,2)
Don't Know/Refused
Q On a scale from 1 to 10 where ten means
extremely important and one means not at all
important, how important do you think the
following issues are for the profession of
pharmacists? (READ AND ROTATE) BASE
Pharmacists
50
Giving Pharmacists Access To Patients Lab Values
and Diagnoses
TotalAgree77 45 95 77 88
Public Doctors Pharmacists Nurses Managers
Somewhat Disagree
Strongly Agree
Somewhat Agree
Strongly Disagree
Dont Know
Q Do you strongly agree, somewhat agree,
somewhat disagree or strongly disagree that
pharmacists should have access to patients lab
results and diagnoses in order to verify that a
prescribed medication is the most appropriate and
effective for that individual?
51
Pharmaceuticals
TotalAgree 92 87 84 80 77 71 43
Govt. drug plans should include coverage for any
medications that a patient and their doctor agree
are the most effective treatment If a drug is
covered by one province, it should automatically
be covered by other provinces Governments should
ensure that there is a maximum limit to how much
individuals should have to personally pay for
drug costs Generally, patients take too many
medications Pharmaceutical prices in Canada need
to be competitive with the rest of the world to
attract RD funding to Canada Many patients who
should be taking medication regularly are
not The Canadian drug approval system is faster
than the systems in other countries
Somewhat Disagree
Strongly Agree
Somewhat Agree
Strongly Disagree
Dont Know
Q I am going to read you a number of
statements, and Id like you to tell me if you
strongly agree, somewhat agree, somewhat
disagree, or strongly disagree with each. (READ
AND RANDOMIZE) BASE GENPOP
52
Agreement - Many Patients Who Should Be Taking
Medication Regularly Are Not
TotalAgree71 85 88 82 80
Public Doctors Pharmacists Nurses Managers
Somewhat Disagree
Strongly Agree
Somewhat Agree
Strongly Disagree
Dont Know
Q I am going to read you a number of
statements, and Id like you to tell me if you
strongly agree, somewhat agree, somewhat
disagree, or strongly disagree with each. A) Many
patients who should be taking medications
regularly are not
53
Agreement - Canadian Drug Approval System Is
Faster Than Other Countries
TotalAgree43 27 36 28 21
Public Doctors Pharmacists Nurses Managers
Somewhat Disagree
Strongly Agree
Somewhat Agree
Strongly Disagree
Dont Know
Q I am going to read you a number of
statements, and Id like you to tell me if you
strongly agree, somewhat agree, somewhat
disagree, or strongly disagree with each. B) The
Canadian drug approval system is faster than the
systems in other countries.
54
Agreement Pharma. Prices in Canada Need to Be
Competitive to Attract RD Funding
TotalAgree77 75 69 80 56
Public Doctors Pharmacists Nurses Managers
Strongly Agree
Somewhat Agree
Somewhat Disagree
Strongly Disagree
Dont Know
Q I am going to read you a number of
statements, and Id like you to tell me if you
strongly agree, somewhat agree, somewhat
disagree, or strongly disagree with each. C)
Pharmaceutical Prices in Canada need to be
competitive with the rest of the world in order
to attract research and development funding to
Canada
55
Agreement Govt Drug Plans Should Include
Coverage For Any Medications Deemed to Be Most
Effective Treatment
TotalAgree92 81 64 90 62
Public Doctors Pharmacists Nurses Managers
Somewhat Disagree
Strongly Agree
Somewhat Agree
Strongly Disagree
Dont Know
Q I am going to read you a number of
statements, and Id like you to tell me if you
strongly agree, somewhat agree, somewhat
disagree, or strongly disagree with each. D)
Government drug plans should include coverage for
any medications that a patient and their doctor
agree are the most effective treatment.
56
Agreement Effects of PharmaCare
TotalAgree84 63
When prescribing medications, I consider whether
the patient has private coverage or can afford
to pay for drugs not covered by
PharmaCarePharmacare formulary restrictions
interfere with my ability to provide medically
necessary care to my patients
Somewhat Disagree
Strongly Agree
Somewhat Agree
Strongly Disagree
Dont Know
Q (PHYSICIANS ONLY) I am going to read you a
number of statements, and Id like you to tell me
if you strongly agree, somewhat agree, somewhat
disagree, or strongly disagree with each.
57
Role of Public Vs Private Insurance
58
Private Insurance and Delivery

• 45 of those surveyed had heard of the Supreme
  Court re private health insurance (55 of men
  and 37 of women).
• Of those who had heard of the ruling 59 said
  they agreed with it (men 65, women 49).
• 45 of the public, 49 of nurses, 48 of
  managers, 72 of pharmacists and 73 of
  physicians support the idea that Canadians should
  be allowed to pay out of pocket to purchase
  faster access to health services that are
  currently funded under the public system.

59
Private Insurance and Delivery

• When asked whether they would personally be
  willing to pay out of pocket to purchase faster
  access to health services that are currently
  funded under the public system support came from
  49 of the public, 60 of nurses, 63 of
  managers, 74 of physicians and 76 of
  pharmacists.
• A majority of Canadians believe that allowing
  expanded private insurance will create a two
  tier health care system (68) lead to a shortage
  of physicians in the public system (61) and
  increase costs (58)
• But they also believe it would result in
  shorter waiting times (68) provide better
  access to health care (59) improve quality
  (60).

60
Private Insurance and Delivery

• 57 of Canadians believe allowing the purchase of
  private insurance for health care services
  already covered under the public health system,
  would have either no impact or a positive impact
  of the decision on the Canadian health system.
• Other groups have a wide range of opinion with 71
  of physicians, 68 of pharmacists, 46 of
  nurses and 43 of managers feeling that allowing
  private insurance purchase would have either no
  impact, or a positive impact on the system.
• 57 of the public support allowing individuals
  to pay out-of-pocket for service enhancements
  beyond a basic service level (such as upgraded
  quality prosthetic joints).

61
Views on Paying for Quicker Access
Public Doctors Pharmacists Nurses Managers
Q Do you think that Canadians should be allowed
to pay out of pocket to purchase faster access to
health services that are currently funded under
the public system?
62
Views on Paying for Quicker Access
Q Do you think that Canadians should be allowed
to pay out of pocket to purchase faster access to
health services that are currently funded under
the public system?BASE GENPOP
63
Personally Willing to Pay for Quicker Access
Public Doctors Pharmacists Nurses Managers
Q Would you personally be willing to pay out of
pocket for you or your family to purchase faster
access to health services that are currently
funded under the public system?
64
Personally Willing to Pay for Quicker Access
Q Would you personally be willing to pay out of
pocket for you or your family to purchase faster
access to health services that are currently
funded under the public system? BASE GENPOP
65
Heard of Supreme Court Ruling
Q In June 2005, the Supreme Court ruled that the
Quebec government could not prevent Quebecers
from purchasing private insurance for Health Care
services already covered under public health
insurance programs. Have you heard about this
ruling?BASE GENPOP
66
Agreement with Supreme Court Ruling
Strongly Agree
Somewhat Agree
Somewhat Disagree
Strongly Disagree
Dont Know
Q Do you strongly agree, somewhat agree,
somewhat disagree or strongly disagree with this
decision?
BASE Those who had heard of the ruling n 553
67
Impact of Private Insurance for Health Care
Services Already Covered Under Public System
You and your family The Canadian public in
general The Canadian health care system Canadian
employers who provide health care coverage for
their employees
Very Positive
Somewhat Positive
No Impact
Somewhat Negative
Very Negative
Don't Know/Refused
Q In your opinion, if Canadians were allowed to
purchase private insurance for Health Care
services already covered under the public health
system, would the impact of the decision be very
positive, somewhat positive, somewhat negative,
very negative or would it have no impact on the
following? (READ AND ROTATE)BASE GENPOP
68
Impact of Private Insurance On You and Your Family
Q In your opinion, if Canadians were allowed to
purchase private insurance for Health Care
services already covered under the public health
system, would the impact of the decision be very
positive, somewhat positive, somewhat negative,
very negative or would it have no impact on -
You and Your FamilyBASE GENPOP
69
Impact of Allowing Private Insurance on the
Canadian Public in General
Total Positive Impact47 66 61 34 39
Public Doctors Pharmacists Nurses Managers
Very Positive
Somewhat Positive
No Impact
Somewhat Negative
Very Negative
Don't Know/Refused
Q In your opinion, if Canadians were allowed to
purchase private insurance for Health Care
services already covered under the public health
system, would the impact of the decision be very
positive, somewhat positive, somewhat negative,
very negative or would it have no impact on The
Canadian public in general?
70
Impact of Allowing Private Insurance on the
Canadian Health Care System
Total Positive Impact51 63 61 36 40
Public Doctors Pharmacists Nurses Managers
Very Positive
Somewhat Positive
No Impact
Somewhat Negative
Very Negative
Don't Know/Refused
Q In your opinion, if Canadians were allowed to
purchase private insurance for health care
services already covered under the public health
system, would the impact of the decision be very
positive, somewhat positive, somewhat negative,
very negative or would it have no impact on The
Canadian health care system?
71
Impact of Private Insurance for Health Care
Services Already Covered Under Public System
TotalAgree68 61 68 59 58 60
Create a two-tier system where those who can
afford to pay will get better treatment than
those who cant Lead to a shortage of doctors and
nurses in the public system, as they leave to
work in a new privateResult in shorter
waiting timesImprove access to health care
services for everyone Result in increasing
costs of health careLead to improved quality
in health care services
Somewhat Disagree
Strongly Agree
Somewhat Agree
Strongly Disagree
Dont Know
Q Do you strongly agree, somewhat agree,
somewhat disagree or strongly disagree that such
a decision would (READ AND ROTATE)BASE GENPOP
72
Allowing Private Insurance For Health Care Would
Improve Access To Health Care Services For
Everyone
TotalAgree 59 68 68 43 39
Public Doctors Pharmacists Nurses Managers
Somewhat Disagree
Strongly Agree
Somewhat Agree
Strongly Disagree
Dont Know
Q Do you strongly agree, somewhat agree,
somewhat disagree or strongly disagree that such
a decision would Improve access to health care
services for everyone?
73
Allowing Private Insurance For Health Care Would
Create a Two-Tier System
TotalAgree 68 61 71 75 71
Public Doctors Pharmacists Nurses Managers
Somewhat Disagree
Strongly Agree
Somewhat Agree
Strongly Disagree
Dont Know
Q Do you strongly agree, somewhat agree,
somewhat disagree or strongly disagree that such
a decision would create a two-tier system where
those who can afford to pay will get better
treatment than those who cant?
74
Allowing Private Insurance For Health Care Would
Result in Increasing Costs of Health Care
TotalAgree 58 45 51 58 54
Public Doctors Pharmacists Nurses Managers
Somewhat Disagree
Strongly Agree
Somewhat Agree
Strongly Disagree
Dont Know
Q Do you strongly agree, somewhat agree,
somewhat disagree or strongly disagree that such
a decision would Result in increasing costs of
health care?
75
Allowing Private Insurance For Health Care Would
Result in Shorter Waiting Times
TotalAgree 68 72 86 70 64
Public Doctors Pharmacists Nurses Managers
Somewhat Disagree
Strongly Agree
Somewhat Agree
Strongly Disagree
Dont Know
Q Do you strongly agree, somewhat agree,
somewhat disagree or strongly disagree that such
a decision would Result in shorter waiting times?
76
Allowing Private Insurance For Health Care Would
Lead To Improved Quality in Health Care Services
TotalAgree 60 63 75 46 44
Public Doctors Pharmacists Nurses Managers
Somewhat Disagree
Strongly Agree
Somewhat Agree
Strongly Disagree
Dont Know
Q Do you strongly agree, somewhat agree,
somewhat disagree or strongly disagree that such
a decision would Lead to improved quality in
health care services?
77
Allowing Private Insurance For Health Care Would
lead to Shortages of Doctors and Nurses in Public
System
TotalAgree 61 43 63 72 60
Public Doctors Pharmacists Nurses Managers
Somewhat Disagree
Strongly Agree
Somewhat Agree
Strongly Disagree
Dont Know
Q Do you strongly agree, somewhat agree,
somewhat disagree or strongly disagree that such
a decision would Lead to a shortage of doctors
and nurses in the public system, as they leave to
work in a new private system?
78
Support for Paying Out-of-Pocket For Service
Enhancements
Q In July, Alberta proposed allowing individuals
to pay out-of-pocket for service enhancements
beyond a basic service level (such as upgraded
quality prosthetic joints). Would you like to
see this implemented in your province?BASE
GENPOP
79
Support for Paying Out-of-Pocket For Service
Enhancements
Q In July, Alberta proposed allowing individuals
to pay out-of-pocket for service enhancements
beyond a basic service level (such as upgraded
quality prosthetic joints). Would you like to
see this implemented in your province?BASE
GENPOP
80
Support for Paying Out-of-Pocket For Service
Enhancements
Q In July, Alberta proposed allowing individuals
to pay out-of-pocket for service enhancements
beyond a basic service level (such as upgraded
quality prosthetic joints). Would you like to
see this implemented in your province?BASE
GENPOP
81
Support for Private Insurance and Payment For
Non-Emergency Services Outside of the Public
System
Somewhat Disagree
Strongly Agree
Somewhat Agree
Strongly Disagree
Dont Know
Q The Alberta government recently proposed that
private insurance and payment be allowed for
services that are non-emergency outside of the
public system. Do you strongly agree, somewhat
agree, somewhat disagree or strongly disagree
with this proposal?BASE GENPOP
82
Support for Private Insurance and Payment For
Non-Emergency Services Outside of the Public
System
Somewhat Disagree
Strongly Agree
Somewhat Agree
Strongly Disagree
Dont Know
Q The Alberta government recently proposed that
private insurance and payment be allowed for
services that are non-emergency outside of the
public system. Do you strongly agree, somewhat
agree, somewhat disagree or strongly disagree
with this proposal?BASE GENPOP
83
Support for Private Insurance and Payment For
Non-Emergency Services Outside of the Public
System
Somewhat Disagree
Strongly Agree
Somewhat Agree
Strongly Disagree
Dont Know
Q The Alberta government recently proposed that
private insurance and payment be allowed for
services that are non-emergency outside of the
public system. Do you strongly agree, somewhat
agree, somewhat disagree or strongly disagree
with this proposal?BASE GENPOP
84
Canadians Views on Dealing with Health Care
Shortfalls
Total Support
Total Oppose
19 77 21 73 19 76
2005 2004 2003 2005 2004 2003 2005 2004 2003
Restricting the Range ofServices That Are
Offered Asking Patients to Pay forPart of the
Cost of Services Health Care Tax Linked to
Income
30 68 34 62 39 58
43 54 41 55 46 51
Q In order to manage health care spending more
effectively, would you strongly support, support,
oppose or strongly oppose each of the following
choices? (READ AND ROTATE)BASE GENPOP
85
Attitude Towards Working in a Privately Funded
Medical Environment
Total Enthusiastic 41 36 32 31
Total Opposed 27 12 34 22
Doctors Pharmacists Nurses Managers
Very Enthusiastic
Somewhat Enthusiastic
Neutral
Somewhat Opposed
Very Opposed
DK/Ref.
Q How would you personally feel about working in
a privately funded medical environment. Would
you be very enthusiastic, somewhat enthusiastic,
somewhat opposed, very opposed or neutral?
86
Reasons for Being Enthusiastic About Working in a
Privately Funded Medical Environment
Q Why is this? BASE Those enthusiastic about
working in a privately funded medical environment
87
Reasons for Being Neutral About Working in a
Privately Funded Medical Environment
Q Why is this? BASE Those neutral about working
in a privately funded medical environment
88
Reasons for Being Opposed To Working in a
Privately Funded Medical Environment
Q Why is this? BASE Those opposed to working in
a privately funded medical environment
89
Transforming the Health Care System/Innovation
90
Innovation and Research

• The following initiatives were all supported by a
  majority of Canadians developing more home and
  community care programs (81) implementing
  electronic patient records (61) increasing the
  use of non-physician health providers (55)
  allowing the government to contract out the
  delivery of publicly covered services to private
  clinics (55).
• All groups supported requiring health
  professionals to work in teams public (76),
  pharmacists (88), nurses (81), managers (90),
  physicians (52).
• Requiring health professionals to work in parts
  of the country where they are most needed was
  supported by 67 of the public, 56 of
  pharmacists, 50 of nurses and 56 of managers.
  Only 27 of physicians supported this option.

91
Innovation and Research

• There continues to be very strong and growing
  support for
• Increased public sector funding for health
  research - public (83) physicians (85),
  pharmacists (93), nurses (90), managers (87)
• Incentives to encourage more private sector
  investment in health research - public (85)
  physicians (86), pharmacists (90), nurses
  (85), managers (87).
• Also 84 to 90 of all groups indicate support
  for structuring regulatory and pricing systems to
  encourage research into and rapid development of
  new vaccines.

92
Increase Public Sector Funding for Health Research
Total Agree 83 81 83 85 86 82 93 88 75 9
0 82 81 87 84 80
2005 2004 2003 2005 2004 2003 2005 2004 2003 2005
2004 2003 2005 2004 2003
Public Doctors Pharmacists Nurses Managers
Q Health research can include research into
medical treatments as well as the best ways to
provide care and manage the health care system.
Would you say that you strongly agree, agree, are
neutral, disagree, or strongly disagree with the
following statements (READ AND ROTATE) There
should be increased public sector funding for
health research, such as at universities,
teaching hospitals and other not-for-profit
organizations.
93
Incentives to Encourage More Private Sector
Investment
Total Agree 85 70 76 86 79 75 90 86 78 8
5 78 69 87 75 70
2005 2004 2003 2005 2004 2003 2005 2004 2003 2005
2004 2003 2005 2004 2003
Public Doctors Pharmacists Nurses Managers
Q Health research can include research into
medical treatments as well as the best ways to
provide care and manage the health care system.
Would you say that you strongly agree, agree, are
neutral, disagree, or strongly disagree with the
following statements (READ AND ROTATE)
Incentives should be put in place to encourage
more private sector investments in health
research such as at universities, teaching
hospitals and other charitable organizations
94
Systems Should Be Put In Place To Encourage RD
Into New Vaccines
Total Agree 84 89 85 90 88
Public Doctors Pharmacists Nurses Managers
Q Health research can include research into
medical treatments as well as the best ways to
provide care and manage the health care system.
Would you say that you strongly agree, agree, are
neutral, disagree, or strongly disagree with the
following statements (READ AND ROTATE)
Regulatory and pricing systems should be
structured to encourage research into and rapid
development of new vaccines.
95
Support for Initiatives to Improve the Health
Care System
Total Support 81 61 55 55 54
Developing more home and community care
programs Implement electronic patient records to
improve integration of services and monitor
resource use Increasing the use of non-physician
health providers when a similar outcome can be
achieved at lower cost Allowing the Govt. to
contract out the delivery of publicly covered
services to private clinics Paying to promote
wellness and prevent disease
Strongly Support (9,10)
Somewhat Support (7,8)
Neutral (5,6)
Somewhat Oppose (3,4)
Strongly Oppose (1,2)
Don't Know/Refused
Q I am going to read you a list of initiatives
that may lead to a better health system.
Thinking of how effective these might be, I would
like you to tell me if you would support or
oppose the implementation of any of these, using
a 10-point scale where 1 means that you strongly
oppose and 10 means you strongly support each one
(READ AND ROTATE)BASE GENPOP
96
Support for Contracting Out Services
Total Support 55 64 64 44 58
Public Doctors Pharmacists Nurses Managers
Strongly Support (9,10)
Somewhat Support (7,8)
Neutral (5,6)
Somewhat Oppose (3,4)
Strongly Oppose (1,2)
Don't Know/Refused
Q I am going to read you an initiative that may
lead to a better health system. Thinking of how
effective it might be, I would like you to tell
me if you would support or oppose the
implementation of it using a 10-point scale where
1 means that you Strongly oppose and 10 means you
strongly support it Allowing the government to
contract out the delivery of public covered
services to private clinics, for instance having
public health insurance pay for knee surgery at a
private clinic rather than a public hospital.
97
Support for Requiring Patients to Register With
One Family Doctor
Total Support 62 40 71 67 64
Public Doctors Pharmacists Nurses Managers
Strongly Support (9,10)
Somewhat Support (7,8)
Neutral (5,6)
Somewhat Oppose (3,4)
Strongly Oppose (1,2)
Don't Know/Refused
Q And to what extent would you support or
oppose each of the following policies to increase
access to health professionals? - Requiring
patients to register with one family doctor?
98
Support For Requiring Health Professionals To
Work In Teams With Other Types of Health Care
Providers
Total Support 76 52 88 81 90
Public Doctors Pharmacists Nurses Managers
Strongly Support (9,10)
Somewhat Support (7,8)
Neutral (5,6)
Somewhat Oppose (3,4)
Strongly Oppose (1,2)
Don't Know/Refused
Q And to what extent would you support or
oppose each of the following policies to increase
access to health professionals? - Requiring
health professionals to work in teams with other
types of health care providers?
99
Support For Requiring Health Professionals To
Work In Parts of the Country Where They Are Most
Needed
Total Support 67 27 56 50 56
Public Doctors Pharmacists Nurses Managers
Strongly Support (9,10)
Somewhat Support (7,8)
Neutral (5,6)
Somewhat Oppose (3,4)
Strongly Oppose (1,2)
Don't Know/Refused
Q And to what extent would you support or
oppose each of the following policies to increase
access to health professionals? - Requiring
health professionals to work in the parts of the
country where they are most needed?
100
Barriers to Inter-Disciplinary or Integrated
Patient Care
Lack of shared information Too difficult to
communicate in real time Physical location of
health professionals Turf wars over patient
information Lack of financial incentive for
health professionals Patient confidentiality may
be compromised Too time-consuming to collaborate
Q In your opinion, how significant is the role
that each of the following potential barriers
plays in preventing inter-disciplinary or
integrated patient care? Please answer using a
scale from 1 to 10 where 1 is not at all
significant and 10 is extremely
significant(READ AND ROTATE)
101
Barriers to Inter-Disciplinary or Integrated
Patient Care Lack of Shared Information
Doctors Pharmacists Nurses Managers
Q In your opinion, how significant is the role
that each of the following potential barriers
plays in preventing inter-disciplinary or
integrated patient care? Please answer using a
scale from 1 to 10 where 1 is not at all
significant and 10 is extremely significantLack
of shared information
102
Barriers to Inter-Disciplinary or Integrated
Patient Care Too Difficult To Communicate In
Real-Time
Doctors Pharmacists Nurses Managers
Q In your opinion, how significant is the role
that each of the following potential barriers
plays in preventing inter-disciplinary or
integrated patient care? Please answer using a
scale from 1 to 10 where 1 is not at all
significant and 10 is extremely significantToo
difficult to communicate in real-time.
103
Barriers to Inter-Disciplinary or Integrated
Patient Care Physical Location of Health
Professionals
Doctors Pharmacists Nurses Managers
Q In your opinion, how significant is the role
that each of the following potential barriers
plays in preventing inter-disciplinary or
integrated patient care? Please answer using a
scale from 1 to 10 where 1 is not at all
significant and 10 is extremely
significantPhysical location of health
professionals
104
Barriers to Inter-Disciplinary or Integrated
Patient Care Turf Wars Over Patient
Information
Doctors Pharmacists Nurses Managers
Q In your opinion, how significant is the role
that each of the following potential barriers
plays in preventing inter-disciplinary or
integrated patient care? Please answer using a
scale from 1 to 10 where 1 is not at all
significant and 10 is extremely
significantTurf wars over patient information
105
Barriers to Inter-Disciplinary or Integrated
Patient Care Lack of Financial Incentive
Doctors Pharmacists Nurses Managers
Q In your opinion, how significant is the role
that each of the following potential barriers
plays in preventing inter-disciplinary or
integrated patient care? Please answer using a
scale from 1 to 10 where 1 is not at all
significant and 10 is extremely significantLack
of financial incentive for health professionals
106
Barriers to Inter-Disciplinary or Integrated
Patient Care Patient Confidentiality May Be
Compromised
Doctors Pharmacists Nurses Managers
Q In your opinion, how significant is the role
that each of the following potential barriers
plays in preventing inter-disciplinary or
integrated patient care? Please answer using a
scale from 1 to 10 where 1 is not at all
significant and 10 is extremely
significantPatient confidentiality may be
compromised.
107
Barriers to Inter-Disciplinary or Integrated
Patient Care Too Time-Consuming to Collaborate
Doctors Pharmacists Nurses Managers
Q In your opinion, how significant is the role
that each of the following potential barriers
plays in preventing inter-disciplinary or
integrated patient care? Please answer using a
scale from 1 to 10 where 1 is not at all
significant and 10 is extremely significantToo
time-consuming to collaborate
108
Key Benefit of An Integrated Electronic Health
Record for Doctors
Faster Access to Information Easier/Access to
Patient Info. Good Thing/Convenient/Efficient Impr
ove Quality of Care Improve Communication/Collabor
ation Complete Info/Records/History Avoid
Duplicatn/Double Doctoring See Medication
Hist/Abuse/Intrctions Access From Any
Location Fewer Errors Accurate/Up-To-Date
Info. Consistency/Continuity of
Care Other None/Don't Agree with it Don't
Know/Refused
Q What do you believe will be the key benefit
of an integrated electronic health record for
your practice? BASE Doctors
109
Key Benefit of An Integrated Electronic Health
Record for Pharmacists
Improve Quality of Care Easier/Access to Patient
Info. See Medication Hist/Abuse/Intrctions Complet
e Info/Records/History Faster Access to
Information Avoid Duplication/Double
Doctoring Good Thing/Convenient/Efficient Fewer
Errors Improve Communication/Collaboration Accurat
e/Up-To-Date Info. Consistency/Continuity of
Care Other None/Don't Agree with it Don't
Know/Refused
Q What do you believe will be the key benefit
of an integrated electronic health record for
your practice? BASE Pharmacists
110
Key Benefit of An Integrated Electronic Health
Record for Nurses
Faster Access to Information Improve Quality of
Care Easier/Access to Patient Info. Good
Thing/Convenient/Efficient Improve
Communication/Collaboration Complete
Info/Records/History Access From Any
Location Avoid Duplication/Double
Doctoring Accurate/Up-To-Date Info. Consistency/Co
ntinuity of Care See Medication
Hist/Abuse/Intrctions Fewer Errors Other None/Don'
t Agree with it Don't Know/Refused
Q What do you believe will be the key benefit
of an integrated electronic health record for
your practice? BASE Nurses
111
Key Benefit of An Integrated Electronic Health
Record for Managers
Faster Access to Information Improve Quality of
Care Improve Communication/Collaboration Avoid
Duplication/Double Doctoring Easier/Access to
Patient Info. Complete Info/Records/History Good
Thing/Convenient/Efficient Accurate/Up-To-Date
Info. Fewer Errors Reduction of Cost Access From
Any Location Consistency/Continuity of Care See
Medication Hist/Abuse/Interactions Other Don't
Know/Refused
Q What do you believe will be the key benefit of
an integrated electronic health record? BASE
Managers
112
Ensuring Accountability
113
Awareness of Health Council of Canada
Awareness has increased since 2004 when 27 of
the public were aware of the Health Council of
Canada
Q In 2004 the Health Council of Canada was
formed to report to Canadians on the progress of
health reforms in Canada. Have you heard of the
Health Council of Canada?
114
Experience Vs. Perceptions, and Behaviour
115
Recent Health Care Experience
Visited your family doctor Visited a hospital
emergency room Visited a walk-in clinic Been
hospitalised Had surgeryUndergone alternative
therapy treatments e.g. AcupunctureReceived
homecare Entered a long-term care facility
Q Have you personally, or a family member,
sought medical advice for a health problem in the
last 12 months in one of the following ways.
Have you or a member of your immediate family
(READ, ACCEPT ALL MENTIONS)Base GENPOP
116
Long-Term (Chronic) Illness
Q Do you or a member of your immediate family
suffer from a long-term (chronic) illness lasting
for more than 6 months?Base GENPOP
117
Volunteering Time or Financial Support
Health Care Time Support Service Time Financial
Support for Health Care Financial Support for
Other ServicesAll of the AboveNo, None
Q In the last year did you volunteer your time
or financial support to help an ill relative or
friend by providing health care services, for
example surgical wound care, or other support
services such as homemaking services?Base GENPOP
118
Most Suitable Term for Describing People Who Use
Health Care Services
Public
Doctors
Pharmacists
Nurses
Managers
Q Which of the following do you think is the
most suitable term for describing people who use
the health care service? Customer, client or
patient?
119
Health Care in Canada Survey 2005