Based on the health systems of other developed countries, for-profit hospitals and insurers are compatible with universal health care, according to a new study from the Fraser Institute.

The study, released Tuesday, compared the universal health-care systems of Australia, France, Germany, the Netherlands, Sweden and Switzerland, and looked at the presence of for-profit hospitals and for-profit health-care insurers in each of these countries.

Compared to Canada, each of these nations spends a comparable proportion of their GDP on health. As well, according to the study, they each provide similar or superior access to care and quality of care.

The study found that for-profit health-care insurers and for-profit hospitals are found in all six countries. This is in contrast to Canada, where similar for-profit insurance is not allowed, and where only a small number of private, for-profit hospitals exist.

Bacchus Barua, a senior economist with the right-leaning Fraser Institute and co-author of the study, says that the study shows that for-profit insurers and for-profit hospitals can and do exist in countries that have a universal health-care system.

"Contrary to the way they are often perceived in Canada, for-profit hospitals and insurers are a part of high-performing universal health-care systems in other countries," he said in a statement.

For-profit insurance

When it comes to for-profit health-care insurance, there was a grab-bag of options among the six nations, the study found.

In the Netherlands, residents must purchase universal health insurance for core health-care services from a private insurer, including for-profit companies;

In Germany, for-profit companies compete to offer a private substitute for public health-care insurance;

In Australia and Sweden, for-profit companies offer a private option alongside the public option;

In France and Switzerland, the companies play a complementary or supporting role;

In Switzerland, for-profit companies may compete to offer a primary health-care insurance package on a not-for-profit basis.

For-profit hospitals

For-profit hospitals help to deliver a variety of medical treatments and care in all of the six countries, the study found.

In Australia and Sweden, universally accessible services are generally provided in public hospitals. However, the governments of both nations also have contracts with for-profit hospitals for the provision of the same services. In Sweden, this also includes acute care.

In the Netherlands, in-patient hospital care is provided by independent not-for-profit private corporations. Meanwhile, independent treatment centres that provide same-day non-emergency care can operate for profit.

In Germany, France, and Switzerland, universally accessible hospital care is delivered by both public and private not-for-profit hospitals, as well as private for-profit hospitals.

All of the countries have a number of private for-profit hospitals that exist alongside public not-for-profit hospitals. The study found the following:

In 2012, approximately 42 per cent of the 3,229 hospitals in Germany were for-profit institutions;

More than half of the hospitals in Switzerland operate on a for-profit basis;

About 40 per cent of the hospitals in France are for-profit care centres;

In Sweden, three out of 83 hospitals are for-profit, including a large acute-care facility.

The study authors argue that data on access to care and health outcomes suggests Canada's health-care system is in need of reform. However, "faulty perceptions" and "unfounded beliefs" continue to persist in Canada, related to how other countries deliver and finance health care, the study says.

The study points to two polls that show that many Canadians believe for-profit health-care delivery is incompatible with universal health care.

In 2013, a poll commissioned for the Fraser Institute found that Canadians believe strongly that private for-profit health care is incompatible with Medicare.

And according to a 2012 Ipsos Reid poll, when presented with the choice of a not-for-profit and for-profit model of health care, 80 per cent of Canadians preferred a not-for-profit model. However, 53 per cent preferred a mixed model when this third option was presented.

The study says those results suggest that Canadians are open to the idea of a mixed model.

Nadeem Esmail, Fraser Institute senior fellow and study co-author, said many developed countries have a mixed model, and are still able to deliver high-quality care, that is superior to Canada's "in timeliness, accessibility, and outcomes despite similar or lower health expenditures."