Public and Private Healthcare Facilities in Canada - Term Paper Example

?Running Head: Public and Private Healthcare Public and Private Healthcare Facilities in Canada This paper discusses about the issues prevalent in Canada regarding Public and Private Healthcare. It is believed that the current healthcare system of Canada is proving to be inefficient in catering to the healthcare needs of all Canadian citizens. In addition to recognizing the problem, this paper will also elaborate the changes that need to be implemented for overcoming the shortcomings of this system. The overall efficiency of the healthcare system can be improved. The Canadian healthcare system will also be contrasted with other countries like United States. This paper will also talk about how the proposed changes should be implemented. This paper contains a brief summary of the past, present and possible future of the Canadian healthcare system. Public and Private Healthcare Facilities in Canada Basic Healthcare providence is an essential for all countries worldwide. A healthy nation is considered to be a happy nation. All over the world, countries and their governments make efforts to make their healthcare systems efficient and comprehensive, providing coverage for everyone. This has given birth to several forms of healthcare systems. The two basic categories of healthcare providers split under the categories of Public Healthcare Providers and Private Healthcare Providers. The basic Healthcare system in Canada developed in three stages; Hospital Services and Diagnostics Act (1957), Medical Care Act (1966) and the Canada Health Act (1984). The Hospital Services and Diagnostics Act of 1957 ensured that provincial healthcare plans covered hospital care. The Medical Care Act of 1966 ensured that the provincial public insurance programs included the physician fees. Lastly, the Canada Health Act of 1984, which is the decisive factor of today’s Canadian Healthcare System, stated that all Canadian citizens should have continued access to quality healthcare without financial and other barriers, which will be critical in maintaining their health and well-being (Laupacis & Born, 2011). All these acts were centered on Public Healthcare providence. The issue of Public and Private healthcare system arises due to several reasons that require a prior understanding of the two systems. The Public Healthcare system is provincially governed endorsed under the Canadian Health Act of 1984, providing basic healthcare facilities to all eligible individuals who possess a provincial healthcare insurance program. These facilities are essentially publicly funded through taxes and insurance programs with no last minute payments being made. These facilities are also publicly delivered, which implies they are provided by government funded entities. However, all other non-basic healthcare facilities like ambulance services, private rooms etc fall under the category of Private facilities which are paid for out-of-pocket unless they are integrated into the insurance the patient has purchased. Such services are not necessarily deemed essential for ensuring the basic health of patients, and are usually covered by private insurance programs or extended provincial insurance programs. Hence these services may or may not be funded publicly, however, the patient is expected to pay either in the form of on-spot cash payments or advance private insurance payments. It is often quoted that about 75% of healthcare services delivered privately are funded publicly. (Schumacher) Under the Canadian constitution, the federal government is primarily responsible for taxation and collection of funds, while the provincial government is responsible for healthcare providence. This leads to skirmishes between the two levels of governance. However, according to the Canada Health Act, it was established that provincial governments will be entitled to a complete federal contribution for their healthcare if they fulfilled certain requirements. These included the provincial government’s ability to provide all medically necessary services, public administration over the medical assistance providers strictly on non-profit basis, universality and portability of the insurance coverage for all individuals, accessibility of insured services by all and the absence of additional charges by the patients. The provinces were liable for penalties if they could not comply with these requirements (Steinbrook, 2006). The Private Healthcare trend started in 2006 when the first private emergency clinic was launched in Vancouver by the name of “The Urgent Care Center”, which quickly became a subject of immense controversy. Those availing the services of this emergency clinic were expected to make payments on the spot, which is in clear contradiction with the Canada Health Act. Even so, people are continually being attracted to the new privatized healthcare provision system for its efficiency. The Public Healthcare system has long waiting lists, with strict first come first serve basis and no discrimination, which deprives the rich and affording individuals from purchasing quick medical facilities. Several patients have died or endured obnoxiously long periods of pain for this reason (Daily News Central, 2005). The constitutional laws forbid people to purchase medical treatments privately, hence worsening the situation of several patients. Masses are rebelling against this law which forbids private healthcare solutions even if the patients are ready to pay. Recently, Quebec ban of private healthcare facilities was removed by the Supreme Court due to patients’ complains regarding scarcity of publicly provided facilities. A litigation filed by a hip-replacement patient forced to wait around a year for his surgery and his doctor, obtained this ruling for the province. Critics believe this is the stepping stone for a complete privatization of the Canadian healthcare system since all of the nine other provinces of Canada will begin filing litigation cases against abysmal timeliness of public healthcare systems, thereby constitutionalizing the removal of the ban on private healthcare (Daily News Central, 2005). This poses a threat regarding medical practitioners choosing between public and private practice. Personal gains and the profitability level will allegedly coax numerous doctors to opt for private practice, hence streaming out of the public sector. The public sector will thereby face a deficiency of professional and expert staff. However, some people believe it will provide medical practitioners with an option to take part of their practice privately, hence releasing their binding on government fee schedule (CBC News, 2006). This view anticipates that medical practitioners would rather divide their time between the two systems instead of completely migrating from public sector to private sector. As authorities and critics continue to deliberate on the issues of Public and Private Healthcare systems, the facts remain unchanged and cannot be ignored. The Private Healthcare system more often comes in conflict with the Canadian Health Act of 1984, which attempts to remove the financial barriers in providing medical assistance to all. In fact the Private System is in complete contradiction with the Canadian Health Act, which is considered as a law for all healthcare providers, as it requires private insurance or out-of-pocket payments on the spot. The provincial insurance programs and public healthcare providers have huge masses queued up and immensely long waiting lines, hindering timely providence of medical facilities to all patients. Also, the public healthcare system lacks efficiency in providing consistent facilities with respect to machinery and staff availability. Complains have often been received regarding long waiting times followed by non-functional machines. Even though 70% of all healthcare provided in Canada is publicly funded, a 30% share is held by Private Healthcare system (Makarenko, 2010). The Private healthcare provides services like cosmetics surgery, dentist services, optics services or other such operations not deemed as life-saving and hence not covered by public funding. Several laboratories and MRI, CT scan machineries are already operating privately, which justifies the 30% share of Private healthcare providence. Doctors also claim that lengthy procedures for receiving medical treatments have inflicted several patients with physical and psychological pain. Untimely medical assistance hinders quality living of most patients, becoming the leading cause of psychological sufferings (Daily News Central, 2005). One of the largest private hospitals of Canada is operating in Ontario since 1945 by the name of “Shouldice Hospital”, which still remains private (CBC News, 2006). As the Health Acts were enacted after this facility was launched, the laws were not enforced upon it. Hence it is wrong to say that Canada’s healthcare is entirely funded by the provincial governments. Several Private Medical care facilities are increasingly being launched, continually strengthening a two-tier system of healthcare providence (Steinbrook, 2006). The two-tier system would enforce a status difference regarding healthcare providence with the rich approaching the Private Healthcare facilities and the poor waiting in lines for their turn to be medically scrutinized. On the contrary, it is also believed that such privatization would help ensure that adequate medical facilities are provided to all without having to wait in never-ending queues. Moreover, some people maintain that providing the affording with alternative options will not necessarily mean the formation of a two-tier healthcare providence system and would merely lessen the load of the Public Healthcare System. Yet another opinion states that Medicare facilities are not commodities to be provided and priced according to the market demand. “It is a fundamental misconception to imagine that sick patients can or should behave like ordinary consumers in commercial transactions… Healthcare is totally different from most goods and services… and that is why sick people need the professional and altruistic services of physicians and other providers” (Relman). Another disagreement stems from the nature of working of the Medical facilities. Some medical facilities are being operated on for-profit basis whereas some as operated on non-profit basis. In non-profit operations, the insurer only seeks to collect premiums and necessary fees to cover the costs incurred due to medical procedures. However, in for-profit operations, the insurer operates like a business whereby the intention includes generating profits besides recovering the costs. It is believed that these are also decisive factors in deciding the quality of the healthcare services provided. Generalization occurs where Private Healthcare providers generally operate on for-profit basis and the Public Healthcare is operated for non-profit basis. However, this generalization is not universally applicable. Several private healthcare providers operate on non-profit basis as well. A substantial portion of healthcare is already being provided by for-profit operators, like laboratories etc. It allows patients to gain quicker access to these services by paying for them directly or by private insurance (Makarenko, 2010). In 2009, Canada is reported to have spent a total of $71billion on providing healthcare facilities both publicly and privately, which amounts to $4363 per capita. Most of other European countries’ spending on healthcare is approximately same or slightly higher. However, United States spending on healthcare surpasses Canadian expenditure considerably. In 2009, United States spending on healthcare was $7960 per capita, amounting to $2.33 trillion in total (Laupacis & Born). National Employment Statistics of 2009 depict that 11.6% of total Canadian national employment was in the healthcare sector, making it the second largest employment industry of Canada (Makarenko). Canada’s current healthcare system ranks at 30th in the world whereas French healthcare system, which allows private healthcare to compliment its universal system, ranks at first (Daily News Central, 2005). Reservations are being made to employ a mixed private and public healthcare system. Such systems are experimentally implemented in the provinces of Alberta, British Columbia and Quebec. Such a system aims to infuse both public and private healthcare systems to compliment the shortcomings of both and hence attain maximum benefits (Steinbrook, 2006). In 2006, Quebec announced a methodology for ensuring citizens loyalty toward the public healthcare system. According to this methodology, the patients were given a time frame for receiving their relevant medical operations once it had been devised. If the public healthcare system was unable to provide for the operation, the patient was to receive his/her treatment from an affiliated private clinic for another preset timed duration. Beyond this duration, the patient was allowed to receive private healthcare services from the same province or even beyond national and international borders (within Canada or outside Canada). This would allegedly control public spending on healthcare services (Steinbrook, 2006). Changes are severely in demand for rectifying the healthcare system of Canada to ensure the motives of Canada Health Act are objectively achieved. Masses are clearly not entirely satisfied with the current system of public healthcare providence. Critics continue to deliberate about the ways of increasing or the factors that decrease the overall efficiency of the healthcare system. Common agreements have still not been achieved. Considering the deficiencies of Public Healthcare System, it seems inevitable that Canada has to allow a substantial part of the entire medical practice in the country to be taken to the private sector. Dependence on Public healthcare system has proved to be detrimental for Canadian citizens. Several affording citizens have resorted to receiving medical assistance from other countries like United States etc. due to the convenience of Private Medical practice in those regions (Daily News Central, 2005). This clearly shows people’s preference for Private Practitioners despite of their charges. Canada needs to improve its Public Healthcare System drastically. Proper staffing and machinery maintenance should be ensured in all hospitals across the country. People forced to endure pain should be provided for with adequate facilities. Also, the long waiting queues need to be sorted out on priority basis to ensure that timely medical aid is provided to all. Patients requiring immediate treatments should be provided for, without having to wait in lines. Several factors of the current system brings the public healthcare providence in contradiction with the Canada Health Act itself, which was in fact enacted to safeguard every individual’s (whether a citizen or an immigrant) right to basic health services. These factors need to be eliminated. Private Practice should be constitutionally allowed in the country. However, there should be certain rules devised for supervising their operations. The Canada Health Act should be considered as the leading light for formulating these guidelines for Private Healthcare System. The ban on private medical care should be officially lifted by Court rulings so people can opt for convenient medical solutions. It needs to be ensured that a two-tier healthcare system is not allowed to form. Along with the establishment of Private Healthcare Providers, the Public Healthcare System also needs to be made efficient and effective. The burden of medical assistance seekers should be equally divided among the two sectors instead of focusing on one and neglecting the other. The government should specifically be focused on improving all aspects of Public Healthcare system. Also, laws regarding surgical practice need to be tightened. Currently, almost any doctor in Canada can call him/herself a cosmetic surgeon and start operating – even if that person was not a surgeon before (CBC News, 2006). Laws for such medical practice need to be revised and made adequate to keep the unprofessional out of operations to ensure the safety of the masses. The proposal of more privately run and privately funded medical assistance providers is the only debate currently in controversy. The Public Healthcare system is rarely questioned despite of its ineffectiveness of providing appropriate and timely universal healthcare services to all. However, the government concern on this issue is if more privately funded medical facilities centers are opened, it will lead numerous physicians and healthcare workers to opt out of the public funding system, eroding this system and damaging it (Sehgal & Tong, 2009). Efforts need to be made in ensuring this does not happen. Public Healthcare system needs to reserve comparable incentives for health workers in order to achieve a balance between the two systems. The innumerable issues regarding the healthcare system all eventually stem down on whether Private Healthcare Providers are a viable solution of these problems or whether it will worsen these issues. Discussions and critical analysis is being done of all possible solutions and alterations to the current system of healthcare providence. However, agreements need to be reached regarding what and how the changes should be implemented in the country. The most effective way of devising and implementing changes can be done on governmental level. A committee needs to be formed with widespread representations from all provinces regarding public and private healthcare systems. This committee should be allowed to argue about all possible relevant problems and solutions to reach a common point of agreement. All contents of discussion should be available for public information. Mutually agreed conditions should then be experimentally and constitutionally implemented. Further deliberations, if necessary, should also occur. All possible ventures of Public and Private Healthcare System’s mutual existence should be explored. This methodology can also be practiced on provincial level. Representative of Public healthcare system and private healthcare system should meet and devise strategies to ensure maximum overall efficiency of the healthcare system, provincially and country-wise. Solutions can only be devised through discussions and peaceful arguments. The best can only be achieved by bringing together the masterminds and allowing them to discuss the matters. The crux of the whole paper is that the healthcare system of Canada is inefficient, lacking in several areas. The governance of the healthcare system needs to devise viable solutions to overcome the issues. Private healthcare system, in my opinion, is a viable solution for the problems currently posed by the Public healthcare system. It effectively compliments all the shortcomings of the Public healthcare system, from time-effectiveness to quality service provision. However, the Private Healthcare System should not be allowed to thrive unconditionally. There should be set guidelines for the operations of the Private Healthcare system in accordance with the government’s policies regarding healthcare. Masses should also be taken into confidence regarding these matters. People should be allowed to participate directly in the decision regarding constitutionalizing of Private Healthcare. Ultimately, everything revolves around the citizens; their health, their convenience and their accessibility to healthcare solutions. References Laupacis, A, and Born, K. (2011) Public and Private Payment for Healthcare in Canada. Retrieved from http://www.healthydebate.ca/2011/07/topic/cost-of-care/publicprivate CBC News. (2006) Public vs. Private Healthcare. Retrieved from http://www.cbc.ca/news/background/healthcare/public_vs_private.html# Sehgal, C, and Tong, M. (2009) Public versus Private healthcare system in Canada!. Retrieved from http://canadianhealthcareblog.blogspot.com/2009/02/public-versus-private-healthcare-system.html Makarenko, J. (2010). Canada’s Healthcare System: An Overview of Public and Private Participation. Retrieved from http://www.mapleleafweb.com/features/canada-s-health-care-system-overview-public-and-private-participation Steinbrook, R. (2006). Private Healthcare in Canada. Retrieved from http://www.nejm.org/doi/full/10.1056/NEJMp068064 Daily News Central. (2005). Canada appears to be headed for public/private healthcare system. Retrieved from http://health.dailynewscentral.com/content/view/0001025/39/ Schumacher, A. Public versus Private healthcare system in Canada!. Retrieved from http://canadianhealthcareblog.blogspot.com/2009/02/public-versus-private-healthcare-system.html Relman, A. n.d. Public vs. Private Healthcare. CBC News. Retrieved from http://www.cbc.ca/news/background/healthcare/public_vs_private.html# Read More