The Canadian Health Care System - Universality of Coverage - Term Paper Example

UNIVERSALITY OF COVERAGE Introduction The principles and criteria governing health insurance plans are outlined by the Canada Health Act (CHA)1 which was developed to help territories and provinces meet their health care provision requirements. The CHA stipulates other four basic principles in addition to the universality of coverage; accessibility, comprehensiveness, portability and non-profit public administration. All these principles have on objective-to offer affordable but readily available medical services for all Canadians wherever they are in the country. This paper will deal only with the universality of coverage principle in terms of a brief description of the principle, challenges and benefits that can arise as a result of maintaining this principle. It will also look at the impacts of abandoning the principle. Finally, it will provide a case study on the same principle if maintained. Overview The national health insurance program in Canada is designed to ensure that all Canadians have equal access to medical facilities2. In the last two decades, it was recommended that instead of a single national plan to enhance the implementation, monitoring and evaluation of all health care policies, it was seen necessary to have about thirteen interlocking insurance plans for all the territorial and provincial governments. These thirteen insurance plans have common features that govern health care systems in the country i.e. the principles of Medicare system This principle-universality of coverage- advocates for provision of Medicare to all Canadians regardless of their financial status or condition i.e. without any terms and conditions whatsoever. It is possible that some people may be isolated because of their economic status in private hospitals meaning that only the rich have access to health better health care. In the past, depending on ones ability to meet medical expenses, most people opted to seek for cheaper health care services. With the introduction of the CHA Act, the principle has been able to provide some form of equality for all Canadians. This principle protects all Canadians, whether they are in their country or those traveling abroad. It helps to ensure that through hospital insurance, all people who are insured are given equal opportunities in their regions of origin. The residents of particular provinces are given the opportunity to seek medical services in all the Medicare centers within the locality. Challenges and benefits The federal government is becoming increasingly concerned about the amount of finances being dedicated to the health care sector thereby consuming a high proportion of the GDP. Some provinces in an attempt to minimize spiraling costs of health care services is applying cost-cutting measures to meet the challenges experienced at the sector3. This is because the principle cannot be implemented without enough funds keeping in mind the fact that health care services are becoming more and more expensive all over the world. The federal government has been partially meeting large health care costs for most provinces, despite the fact that it is considered the responsibility of the provincial administration to do so. The main challenge therefore is that, to ensure that this principle is upheld, huge amounts of money has been used and it has not been possible to maintain it. An example for this is the large budget shortfall that hit the country in 1996 leading to the reduction of federal influence in the financing of the health care system in the provinces. The provinces have been therefore under considerable amounts of tension and pressures to meet the requirements of universal accessibility of health services to all. Another challenge is the lack of coordination and cooperation between the individual provinces and the federal government. Every provinces or territory is governed under the same constitution from the federal government, but each of the provinces has its own policies that might be different in one way or another. This may lead to distribution disparities in terms of human resource sharing, funding etc4. However, there has been increased amounts of criticisms concerning the implementation of this principle. First of all, there is the issue of longer wait times for patients who only come to the hospital for simple check-ups. Reports have even suggested that the time taken for one to get services may take as long as one week or months due to the high number of people seeking for the services. There is also the issue of shortage of medical personnel to conduct the exercise and meet the demands of the larger population. This has hindered the success rate of the universality of coverage principle. All in all, the principle has been able to meet the ‘humanity’ requirement where despite of the criticisms, residents have been able to get medical attention The benefits of maintaining this principle have in the past few years become obvious. In fact, the United Nations had in 1999 ranked the Canadian health system the best in the world possible form a report by that rated the life expectancy of Canadians at 79.0. This means that with the introduction of this principle and others, life has changed and will continue to improve as time continues. Universality of coverage is also accompanied by economic benefits which is achieved mainly because of increased health-cost savings efficiency. It also enables people to save funds through compensated public funding. The universality of coverage enables people to spread health services equitably to all the residents. It also promotes the motivation of people to pay for their taxes which will eventually be used to finance their health care services. Analysis of the impact on health care If the universality of coverage principle is abandoned, there will be greater impacts on health care and nursing. These impacts can range from poor quality services, expensive Medicare, reduced life expectancy etc. This principle there cannot be abandoned at the moment given the fact it has factored a lot of success after its implementation. With that said, if we decide to abandon the principle, there is more to lose than to gain. The positive side of it is the fact that if it is abandoned, young entrepreneurs are able to come up and take up businesses in the sector which will lead to more jobs, increased services among others5. However, previous studies have suggested that there are various determinants of universal availability to health care services in Canada. Some of these determinants include; place, income levels, gender, education or household composition. Place specifically impacts the access of the hospitals themselves not mentioning the doctor’s offices. The universality of coverage principle is mainly tackling the issue of place and that it can be well addressed if more hospitals are built to improve coverage. More and more people will also be locked out of the system if the principle is abandoned at this stage. The most notable impact that can probably occur is the social discrimination factor where the poor in the society will be denied access to proper health care services. Social order within the society will also be disrupted if this principle is abandoned because of the fact that more people will be reorganized under some specific social setting. It is then possible that specific hospitals will be left for specific people. In the process people who need frequent medical attention will be denied that opportunity to become healthier and stable. The government lives to lose confidence of many Canadians if this principle is abandoned in one way or another. In the past, when government commitment on health care was low, the confidence of the people had been shaken and was considered to lead to negative political implications6. Certain dire consequences which is a reverse of what has already been achieved may come back in that many foreign interests would gain from the abandonment of the system. More and more international health care organizations including some domestic ones will take opportunity and charge expensively for their services. The poor members of the Canadian community will find it difficult to meet their daily health care needs. Recommendations There is growing concern among health experts that there is need for primary commitment from the federal government to meet financial challenges. This may come in terms of increased funding for the provinces and other territorial governments as it has been noticed that the greatest impediment to the universal coverage of health care services to all Canadians has been the availability of funds. These funds will be used for build more hospitals to reduce ‘wait times’ experienced at the current health centers. They will also be used for recruiting additional professional staff to serve the huge population of residents taking advantage of the principle of universality. Another recommendation is the need for proper leadership at the provincial level. It is not possible to achieve universal coverage when the authorities at the lower levels don’t have the capacity to ensure that all insurers are served at the hospitals equally. The government must also come up to ensure that practicing nurses, doctors and physicians practice their guidelines and offer equal services to all without extensive terms and conditions. It should also strengthen its support to specific associations that ensure better implementation of all the principles with a view to ensuring that not only the accessibility factor is factored in but also the quality factor for health care services to all Canadians. Conclusion The universality principle has been a success in Canada since its introduction and the Canadian public is looking forward to their leaders to not only maintain the system but also take it a step further and improve it. Since members of the public pay taxes for the implementation of this principle, they need assurance that it will be available when they need it7. Various reports have concluded that Canadians are not willing-not at this moment- to abandon the system that has served them better. Despite the fact that universal coverage is a simple idea, some parts of Canada have not been covered and experts are calling on the government to use the powers within its organs to extend the Medicare coverage further to make it more nationalistic. The principle has been known to fit directly to Canadian lifestyle, values and culture hence is a positive tool for promoting national unity and cooperation among the Canadian people. Reference European Observatory on Health Care Systems (2002): Funding Health Care: Options for Europe. Policy Brief No. 4 Copenhagen: The Observatory Evans, R. G., & Morris L. B., and Theodore R. M. (1994): Why Are Some People Healthy and Others Not? The Determinants of Health of Populations New York: Aldine de Grunter Hayes, M. V., and James R. D. (1998): Population Health in Canada: A Systematic Review. Canadian Policy Research Networks Study No. H01. Ottawa: The Networks International Monetary Fund Canada (February 2003): Selected Issues. IMF Country Report No. 03/34. Washington, DC: IMF Klatt, I. (September 2000): Understanding the Canadian Health Care System. American Journal of Financial Service Professionals Kraker, D. (2001): The Canadian Cure. The New Rules Minneapolis, MN: Institute for Local Self-Reliance, spring Madore, O. (2003): The Canada Health Act: Overview and Options. Rev. Ed. Ottawa: Parliamentary Research Branch, Library of Parliament Taylor, M G. (1987): Health Insurance and Canadian Public Policy: The Seven Decisions that Created the Canadian Health Insurance System and Their Outcomes. 2 ed. Canadian Public Administration Series Montréal: McGill-Queen’s University Press World Health Organization (1999): Health Care Systems in Transition: Canada. Preliminary Version Copenhagen: WHO Regional Office for Europe Appendix Case study Martin is a middle aged man married with two children in Ontario. He also lives with his grandmother and step sister. Martins suffers from Pneumonia and needs to have frequent medical attention in order to keep him health. His wife is a housewife while he himself works with a security firm. The total income for the family including his salary per month is $ 200. 1. Maintaining the principle If the universality of coverage principle is maintained, Martins is able to channel most of the family income to other issues like education. He may be required to pay a small percentage of his income to any hospital within Ontario and get the services he requires. His energy will also be redirected to development projects not only for the nation but also for himself and his family. 2. Abandoning the principle Without the principle, Martins is not able to seek frequent medical attention for the disease he is suffering from given the fact that the income will not be able to meet the medical expenses of the whole family. He will be forced to seek cheaper services may be even in the U. S where health care services may be cheaper. Read More