Canada Healthcare System - Research Paper Example

? Canada Healthcare System Canada Healthcare System Canada is the second largest country in land area in the world with the population of 30 million which is relatively smaller. Before 1971, the healthcare system of Canada had a very sharp resemblance to the healthcare system in United States. However, in 1971 the Canadian Medicare System, a system of universal health insurance, was provided by the Canadian government (Holtz 2008). Since its adaptation, the Canadian healthcare system has been under consistent and effectual progress. Many reforms and changes have been observed in accordance to the changes in the world of medicine and the society, however, the basics of the system which include the provision of health services on the basis of need rather than the ability to pay are still the same and practiced strongly. Canadian health care system can be characterized by a group of socialized health insurance plans that provide coverage to all Canadian citizens. This system is run by public funds and the administration is carried out on a provincial or territorial basis. The basic guidelines are determined and decided by the federal government (Health Canada 2009; Canadian Health Care 2007). The Canadian health care system holds a conspicuous role in comparison to the major healthcare systems of the world because of its universal medical coverage system and many a times analysts consider this system to be adapted by the United States as well. The Canadian healthcare system will be evaluated and analyzed in relevance to the Canada’s population and health status, demographic characteristics, mortality rates, availability of health services and other health data on health status, Moreover, the general description of services institutions, issues related to care, utilization of services, expenditures and political, social and cultural aspects of the Canadian healthcare system will also be highlighted. In view of the fact that, United States is one of the major and noteworthy healthcare systems, imperative features of both the healthcare systems will also be compared and analyzed in the paper. As mentioned earlier, Canada is geographically the second largest nation in the world and the largest in the continent of North America with an area of 9.9 million square kilometers. However, Canada is not a densely populated country. Two-thirds of the population resides along the southern borders and the population density of the country is 3.5 persons per kilometer. Nevertheless, the data on population density can be misleading as 80% of the nation’s population resides in the urban areas that are comparative dense. The population concentration in the metropolitan areas is 245 persons per kilometer and the rural areas of the west and the north are very sparsely populated. Being an industrial country, the population of Canada is ageing over the years. In 1985 the mean age was 31 years and by 2005 the mean age has risen to 38.5 years. By 2005 the amount of people under the age of 20 declined to 24.3%. The demographic characteristics of the socioeconomic status of the Canadian population show the median after-tax income of individuals to be $21, 400 in 2005. Canada has a relatively more equitable distribution of income as compared to United States and the United Kingdom. However, when compared to the other European countries and Scandinavian countries, the income distribution is slightly less (Johnson & Stoskopf 2010). The demographic characteristics exhibit an equal income distribution among the individuals and the mean age of the individuals also seems to be declining over the years. The data regarding the health status exhibits a change in the patterns of morbidity and mortality since the arrival of the 20th century. As is the case in other Western industrialized countries, the infectious diseases have been overcome by the chronic and lifestyle-related diseases and health conditions. Cardiovascular disease is the major and leading cause of death both in men and women in Canada. Cardiovascular causes of morbidity lead to the death of 32% men and 34% women and the studies have shown that 80% Canadian population has at least one modifiable risk factor for the cardiovascular heart disease. Hypertension, a significant risk factor for cardiovascular disease, is found in 14.9% of the adult population. The percentage of population with Diabetes has also been rising in Canada. The overall population has a prevalence rate of 5.5% in 2005with significantly higher rates in the older population. Obesity, another important risk factor both in relation to diabetes and cardiovascular disease, is also prevalent in Canada. 32.5% of the Canadian population in 2005 was estimated to be overweight. However, the signs of physical activity among the Canadians appear to be improving with a rise of 51.6% from 43% in 2005 being physically active or moderately active. Cancer is another leading cause of mortality. In 2006, 153,100 cases of cancer were diagnosed and 70,400 people died of cancer. Breast cancer and prostate cancer are the leading causes of cancer death in women and men, respectively. Lung cancer is also an important cause of mortality in both the genders; however, the rate of lung cancer cases has been increasing in women as compared to the men reflecting the changing patterns of smoking habits among the genders (Johnson & Stoskopf 2010). As evident from the demographic data and the analytic health evidence that, chronic lifestyle related health conditions are more prevalent in the Canadian population. Cardiovascular diseases affected by obesity, hypertension and diabetes and cancers such as lung, breast and prostate are among the major causes of mortality and morbidity. Canadians have enjoyed improved health status and improved life expectancy over the years because of their effective and reformed healthcare system. The improved life expectancy is an indicator of improved quality of life. Canada boasts of highest life expectancies and the lowest infant mortality rates among the industrial countries (Canadian Health Care 2007). Canadian life expectancy is among the highest among the countries belonging to the Organization for Economic Cooperation and Development. It has been observed in the last three decades that the rates of male smoking and alcohol consumption have also declined. However, female obesity has become an emerging health problem (Holtz 2008). The improving life expectancies and the reduction in smoking and alcohol consumption habits among the male genders is an indicator of a road towards improvement in aspects of quality of life and health status of the Canadian population. However, focus on female obesity and cardiovascular risk factors are a challenge for the Canadian healthcare system and the health care providers. The quality of the healthcare system can be assessed in terms of the population health standards, system efficiency and patient satisfaction measures. Infant mortality rates, life expectancy and immunization rates are some of the clinical measures used to assess the quality of a health care system. The infant mortality rate in Canada in 2005 was 5.4 infants per 1,000 live births. Infant mortality rates are higher in United States which is 6.8 infants per 1,000 live births. Life expectancy at birth in Canada is also improving; in 2005 the overall life expectancy was 78.0 years for men and 82.7 years for the women. However, disparities in infant mortality rates and life expectancy do exist in several sub-populations of Canada. Immunization rates among Canada are high with a higher percentage of children receiving immunization vaccines for rubella, measles mumps, diphtheria, pertussis, tetanus, polio and hemophilus type B. The quality of health care system is also accessed through the recipient satisfaction measures. In 2005, 84.4 % of the Canadians rated their satisfaction levels with their healthcare system as “very satisfied” or “somewhat satisfied”. A stable and unchanged result has been observed since the year 2000 (Johnson & Stoskopf 2010). The current health care system in Canada is characterized by a combined system which constitutes of various sources of funding, administration of services and delivery of healthcare services. The Canada’s health insurance program “Medicare”, mentioned before as well, was designed to ensure that all the Canadian residents will have consistent affordable access to the hospitals and physician services, on a prepaid basis. The Medicare program is the only single program the nation has and thus instead of having several different plans, a single insurance healthcare plan includes thirteen intertwining provincial and territorial health insurance plans. Medicare covers approximately services for 97% of the Canadians which include both hospital and physician services. The delivery of health care in Canada includes both public and private communications. The non-governmental entities include the services offered by the physicians and the residential care facilities. Local and provincial government operate almost whole of the hospital sector and the facilities provided. The non-profit private hospitals or religiously associated healthcare facilities or institutions make up a smaller art of the healthcare system however; they are a conspicuous part of the hospital based care. It is important to note over here that health services for the persons of the First Nation, veterans, members of armed forces and members of Royal Canadian Mounted Police are covered by the federal government and don’t fall under the Medicare framework. Furthermore, certain joint programs and federal-only programs such as dental care, residential care and pharmaceutical costs are not covered by the Medicare program. These programs are covered individually or by the private sector insurance rather than the Medicare insurance national healthcare plan (Johnson & Stoskopf 2010; Health Canada 2010). Provincial health insurance covers the health services provided to every province and a new resident to a province is obliged to apply for health coverage. A health card is issued to each resident which helps him/her avail the health services in that particular province or territory. New residents are also put on waiting lists before they get health coverage however according to the Canadian Health Act, this time period cannot exceed three months. Provinces apart from providing standard health coverage also provide additional services such as dental coverage, physiotherapy and prescription medicines. The Canada Health Act guides the provincial insurance policies to provide primary care doctors, specialists, hospitals and dental surgery to the residents of Canada. As mentioned earlier, the private sector covers the health services that are not covered by the healthcare system such as dental services and optometrists. These health insurance plans are mostly part of company employee benefit packages or the Canadians can also purchase such insurance health packages from private providers (Canadian Health Care 2007). Primary health care is the foundation and the most basic health service provided by the healthcare system. Some examples of primary health care include visits to family physicians, consultations with nurse practitioners, telephone calls to health information lines and advices from pharmacists. Primary health care physicians are a very important part of the primary health care system. Currently 30000 primary health care doctors are serving in Canada who provides basic medical services and preventive care to the general population. Currently 28000 specialists are in Canada and they provide services outside the expertise of the primary care physicians and doctors. Hospitals also form a part of primary health care and operate under both the referrals of the physicians and the emergency cases. Ambulatory services are also a part of the system for those who cannot access the hospitals (Health Canada 2004; Canadian health care 2007). The Canada Health Act defines and characterizes the standards of the hospital care provided to the residents. It is obligatory for the administration and health care professionals to meet the national criteria. Insured public hospital services defined by the Canada Health Act include standard ward accommodation, nursing services, diagnostic procedures, drug administration and use of operating rooms, anesthetic rooms and case rooms. It is the duty of the provincial and territorial governments to make sure that the principles and standards are maintained at every hospital care facility (Health Canada 2004). In the year 2003, Canada had 746 hospitals with 115, 120 operating bed. Out of these, 12 hospitals were private, six were owned by federal government and the remainder was under the local and provincial government. A decline in the acute-care hospitals has been observed from 1986 to 1995 and the closure of most of the hospitals occurred in the rural areas. In 2005 Canada had 290 hospital beds per 100,000 populations. In 2006, there were 4, 921 residential care facilities out of which 53.7 % were for older population, 1,915 were mental institutions and 290 were for the support of the public health functions (Johnson & Stoskopf 2010). Accessing healthcare in Canada initiates with the application for a provincial health card. This health card, once received by a resident is used whenever a visit is paid to the physician or health care provider. The individual’s medical information is accessed through an identification number which is mentioned on the health card. Registration with the primary care physician can be done after receiving health coverage from the provincial government. Only with showing a health card, routine visits can be made and no individual service fees have to be paid. The availability of the doctors depends on the number of doctors or physicians per person and the current demand for the medical services in Canada. Currently there is about 1 primary care doctor for every 1000 Canadians (Canadian Health Care 2007). Universal coverage is one of the basic principles of the Canadian health system. The Canadian healthcare system strives to maintain equity among the population in terms of health provision and medical care facilities. Health care insurance coverage although reduces the financial disparities among the population but it does not entirely eliminates the differences in access to health facilities. Access to care is not only affected by socioeconomic factors but also it is limited or constrained by geographical, cultural, psychological and other factors of not only the recipient but also the health care provider. The health care in Canada is funded by both the provincial and the federal governments. Financing is carried out via taxation from the personal and corporate income taxes. At federal level funds are assigned to the provinces and the territories via the Canadian Health and Social transfer. Te transfer payments include both the tax transfer and cash contributors. In 2002-2003 the funding received was more than $35 billion. The overall spending on the healthcare system in 2007 was estimated to be $160.1 billion. The expenditures exhibited an increase from the 2006 data with an increase of 6.4% (Canadian Health Care 2007; Johnson & Stoskopf 2010). Financing of the Canadian health care system has been divided into three primary sources since 1997. Medicare system, out-of-pocket-payments by individuals and private insurance are the three sources of financing in the Canadian health care system. The public sector contributes 70% of the funding while the remainder is contributed by the private sector which is not covered under Medicare (Johnson & Stoskopf 2010). The expenditures of the Medicare constitute the majority of the healthcare costs in Canada. Funding for Medicare is managed through tax revenues collected by federal and provincial governments. Physician services are managed on a fee-for-services basis and the fees schedule is negotiated on a yearly basis between the provincial government and the province’s medical association. Pharmaceuticals are paid by a combination of various methods that varies by each province. In majority of the provinces, outpatient drug costs are supplemented by the government specifically for certain population groups such as older population or low-economic groups. The payments for the residential care and long-term care facilities are provided by the both private and public sectors (Johnson & Stoskopf 2010). Various political, socioeconomic and technological factors and issues influence the healthcare system in Canada. The federal involvement in the health care is a key issue as provinces and territories are responsible for the health care administration and delivery in Canada. This funding system has led to a particular political tension between the provincial and the federal government. Under the Constitution Act of 1867, the provincial government has an official authority over the healthcare system and the welfare issues. However, in practical, federal government controls and operates the funding issues and other welfare issues regarding the health care system. Many healthcare analysts and critics object the privatization of the healthcare system. Although private sector is contributing towards the expenditures and medical care provision, however, the privatization of health system is under objection and discussion. The shortage of doctors and nurses is another key issue in the Canadian healthcare system. Many doctors and nurses leave for United States leading to an inadequacy of healthcare providers in Canada. Canadian healthcare also has a very strong impact on Canada’s economy as health care expenditures are quite high and approximately 9.5% of Canada’s gross domestic product is spent on health care. Moreover, about three-quarter of the funding comes from the public sources with only one-quarter coming from the private sector. This leads to an increasing burden on the country’s economic status (Canadian Health Care 2007). Canadian healthcare system possesses a vast system of high technology and advanced infrastructure of medical imaging and diagnostic equipment. From 1980 to 2006, 180 new CT scan units were installed in Canada which exhibited an increase of 91%. In the period between 1990 and 2006, 177 new MRI units were installed which represented an improvement of 93%. Access to the advanced imaging equipment is more common in metropolitan cities as compared to under-populated cities of Canada (Johnson & Stoskopf 2010). The health care system of Canada has exhibited a strong financial position which is sustainable enough to support the Canadian population. The expenditures and the quality measures exhibit an improvement in the health status of the population with provision of better health opportunities and facilities. However, the problem faced by the Canadian healthcare system is the access to medical care not in terms of financial access, rather in terms of geographical, demographic and other similar elements such as travel time, wait time etc. The waiting times in Canada are longer for health services and procedures as compared to other countries which signify a challenge faced by the Canadian healthcare system. Referrals, appointments with doctors, imaging procedures and surgical interventions take a longer period of time in the Canadian healthcare system. The shifting demographics which exhibit an increasing population of older people and female population direct the focus on the supply and demand of the health care facilities. United States has evolved as a leader in the provision of health care with highest health expenditures and spending. The United States healthcare system is based mainly on the private insurance which provides financial coverage for the American population. The objective of the health care system is to improve the quality and length of life for the citizens of the country. More than 70% of the population under age 65 is in private health insurance plans. Managed health care organizations are a distinguishable feature of the American health care system. In this system, fee for services is usually a negotiated capitation. Government provision is taken through Medicare and Medicaid which were founded in 1966. Medicare covers hospitalization and nursing facility charges under Part A while the Part B covers the charges for laboratory charges, physician and medical supplies. Medicaid is a safety net program which is designed for low income people, children, women, elderly and disabled who receive financial assistance from the federal or state government. United States differs from the Canadian healthcare system in terms of various aspects. Canada has a universal health care system with majorly public spending while American healthcare system has 55% of private spending as compared to the 30% Canadian private spending. United States has a higher expenditure data on healthcare provision as compared to Canada however the life expectancy and infant mortality rates are improved in Canadian healthcare system as compared to the American system (Holtz 2008; Williams 2005). Healthcare in United States differs at different grounds from the Canadian healthcare system. The Canadian system needs to focus more on the supply of physicians, nurses and other health care providers to meet the demands of the Canadian population. Access to medical and health care has to be enhanced so that the Canadian population will not have to go through extended procedures of waiting in the lines or waiting for surgical or imaging procedures. The Canadian population exhibits a high satisfactory rate for their healthcare system which reflects the accomplishment of the system in gratifying its community obligations and its fairness in providing health facilities. However, the system needs to focus on individual access to medical care and get rid of any future disparities for the preservation of a high-quality and sophisticated healthcare system. References Canadian Health Care. (2007). Canadian Health Care. Canadian-healthcare.org. Retrieved from: < http://www.canadian-healthcare.org/ > Holtz, C. (2008). Global health care: Issues and policies. Sudbury, Mass: Jones and Bartlett Publishers. Health Canada. (2009). Health Care System. Health Canada. Retrieved from: < http://www.hc-sc.gc.ca/hcs-sss/index-eng.php > Health Canada. (2004). Hospital Care. Health Canada. Retrieved from: < http://www.hc-sc.gc.ca/hcs-sss/hospital/index-eng.php > Health Canada. (2004). Primary Health Care. Health Canada. Retrieved from: < http://www.hc-sc.gc.ca/hcs-sss/prim/index-eng.php> Health Canada. (2010). Canada’s Health Care System (Medicare). Health Canada. Retrieved from: < http://www.hc-sc.gc.ca/hcs-sss/medi-assur/index-eng.php> Johnson, J A and Stoskopf, C H. (2010). Comparative health systems: global perspectives. Sudbury, Mass: Jones and Bartlett Publishers. Williams, S.J. (2005). Essentials of Health Services 3rd Edition. Delmar Thomson Learning. Read More