The Commonwealth Fund is a non-partisan organization with a proudly advertised mission: “[promoting] a high-performing health care system that achieves better access, improved quality, and greater efficiency.” It is responsible for a highly respected, annual ranking of health care systems of 11 nations, included in which is Canada that has been consistently ranking near the bottom at the ninth and tenth positions. Canada’s universal health care system has historically been a national pride—one that has served as a unique model for the rest of the world since mid-twentieth century. Changing or eliminating the system may lead to a fundamental transformation in the national identity.

So the question begs: can Canada do better than ninth or tenth? Let’s talk about the problems.

For the sake of generalization, I will divide health care into two fields: (1) conservative medicine which focuses on controlling disorders and preventing/delaying deterioration of conditions; and (2) progressive medicine which centers attention on research-based advancements to eliminate disorders for the future.

While we accept the commercial nature of progressive medicine, we sometimes fail to recognize conservative medicine as a commodity. We often label health care as a human right, but this proves to be paradoxical by nature: If health care is a human right, no one can be paid for providing it. There are, however, expenses to medical procedures, and everyone should pay for these costs. But if no one can be paid, no one can pay.

Access to health care should instead be regarded as a human right; implying, really, that health care is a commercial good that we can indiscriminately pursue. And in Canada, we have a privileged access to universal health care—which should not be confused as free health care, because health care can never be free.

Perhaps our fundamental misunderstanding of health care has inevitably led to a heterogenous approach to the two branches of medicine with respect to commerce, thereby giving rise to the greatest weaknesses in our system: accessibility and efficiency.

As a point of reference for the aforementioned inconsistencies, consider prescription drugs provided by private pharmaceuticals, the costs of which (outside of some coverage by private plans) we must provide out of our own pockets. If medications are not included in our universal health care, it is fair to suggest that the care for our health should end at the visit with our doctor. But this is obviously absurd, and the incorrect conclusion drawn is a consequence of having a nonuniform system. You can likewise consider eye and dental care, which are also omitted from our universal health care.

Our commercial negligence of conservative medicine has further created problems, because unlike other commodities, our health care has not grown to meet the demands of its consumers. To clarify, the Canadian health care is largely unchanged from the 1960s, when medical care focused on acute conditions. But now, with the aging population and increase in chronic diseases, there is a growing demand for community-based solutions to conservative medicine. You can furthermore consider dental care, the crucial nature of which in one’s overall care for health is clearer than it was when we first established our system.

There are many other examples that can demonstrate our weaknesses in accessibility and efficiency. Some family doctors, for instance, enforce a “one issue per visit” rule, because doctors are paid per visit as opposed to having a fixed salary. This creates many issues, the most obvious of which is forcing patients to triage their own problems without having the medical knowledge to do so.

And of course, there are many steps to be taken to improve our health care system, but the first is surely adopting a commercial perspective; that is, a perspective that recognizes health care for the commodity that it is and focuses on providing a uniform service in accordance to the demands of the consumers—while, of course, emphasizing access to it as a human right.