The Canadian Healthcare System - Essay Example

? of the of the of the Canada’s Healthcare System The Canadian healthcare system makes comprehensive coverage available to all, with relation to the medically essential physician and hospital services. The federal government of Canada has come forward with principle based leadership and financial support. This has been continuing from many years and via a number of methods. This federal initiative has been most evident in the northern territories, despite the move by these territories towards greater autonomy.1 The publicly funded Canadian healthcare system mirrors national values that incorporate access on the basis of necessity and not ability to pay, equality, fairness, and provision of healthcare without taking into consideration the place of residence. Thus, there is a sincere attempt by the Canadian healthcare system to provide every resident of Canada with reasonable access to insured essential medical services. The health outcomes essentially consist of, a life expectancy of 79 years, and a 0.56% infant mortality rate. Some of the priorities of healthcare renewal in Canada are primary healthcare reform, reduction in waiting time, improved home care, and human resource planning.2 These services are prepaid and do not involve direct charges at the point of service. However, health services should be provided on the basis of necessity and not on that of the capacity to pay for the same. The provision of healthcare in the US is exemplified by the system of private health insurance. On the other hand, the initial approach adopted in the UK towards healthcare is depicted by the National Health Service arrangement. In the case of Canada, there is a blend of these two systems, which gives rise to a national health insurance system. Canadian society protects certain core values by promoting a measure of autonomy for health professionals and health agencies, while ensuring almost equal access to healthcare by all, irrespective of their capacity to pay.3 It has been claimed by the Fraser Forum that all is not well with the healthcare system of Canada. Some of the more disturbing features of this system are the exorbitant prices being charged for generic drug, in comparison to the prices being charged in the US; significant delay in obtaining access to new drugs, which has been estimated at around 2 years, on the average; inappropriate increase in healthcare spending by the government; and programs that subsidize drugs on the basis of age, rather than economic necessity.4 In order to rectify this unwelcome situation in the healthcare system of Canada, certain measures have to be adopted. One of these measures is that of enforcing prescription drug policies that permit price competition, improve consumer access to medicines, and enhance the affordability of drugs. 5 Furthermore, there should be a circumvention or reduction in the restrictions placed on consumer choice by government planning. Although the administration of the healthcare system is vested with the provinces and territories; the federal government, in accordance with the Canada Health act is rendered responsible for ensuring that the norms of universality, accessibility, inclusiveness, portability and public administration are satisfied.6 In other words, federal funds have to be distributed uniformly between the provinces and territories, health care recipients have to be provided with comprehensive and equal treatment without any exception, and the coverage should be transferable between provinces. In the context of essential medical care, private insurance or extra billing is not permitted. Moreover, the principle of equalization is to be discontinued. Any transfer to the provinces or territories is to be on a per capita basis. 7 This will guarantee more federal funds to the more populous provinces. Furthermore, the less populated provinces are in most of the cases also poorer. Initially, it had been the objective of the Canada Health Act to employ transfer and taxation to mitigate the effects of heedless capitalism. This was hoped to be achieved by requiring the wealthier Canadians to share with the less fortunate citizens of the country. With this new policy, there has been a further breakdown in the federation’s moral character. 8 In the year 1957, the federal government of Canada enacted legislation that provided financial incentives, for introducing universal hospital insurance, to the provincial governments. Subsequently, a few major reforms were made to the health insurance system. For instance, in the year 1968, there was an inclusion of insurance for the services of physicians. Thereafter, in the year 1977, a change was made by the federal government to its cost sharing mechanism with the provinces. With this transformation, the federal government discarded its earlier commitment to defray half the cost of provincial healthcare. In effect, the provinces were left with the choice of imposing additional taxes, in order to meet healthcare costs. As a result, there was an increase in the disparity among the provinces regarding funding in this area.9 Furthermore, in the year 1984, the Canada Health Act combined the extant legislation and commenced to impose fines on provinces that permitted physicians to charge patients with fees that were in excess of the amounts stipulated in the provincial Schedule of Fees. This brought about the preclusion, in all the provinces, of extra billing. Another important development in Canadian healthcare, was that during the 1980s and 1990s, there was a transition in governmental expenditure from general hospitals to home based care and prescription drugs. Thus, Ontario witnessed a 16% increase in the expenditure related to home based care, on an annual average. 10 This change was not accompanied by any relevant revision to the Canada Health Act. The provisions of the Canada Health Act are restricted to hospital and physician services. Consequently, despite the provincial standard being that of providing publicly funded drug coverage for the elderly and the recipients of social assistance, a number of provinces resorted to user charges and combined public and private plans in the area of prescription drug coverage. 11 Moreover, variation was noticed among the provinces with regard to the domain and financing of home based care services. On account of these inconsistencies it became very difficult to reconcile with the ideal of a truly national health care system. In the 1990s there was another development, namely that with the exception of one province, all the provinces implemented a regionalized administration of healthcare. 12 This served to bring a number of acute care, long term care, and rehabilitation institutions, under the control of a single administrative entity. In addition, some of the provinces adopted population based funding procedures for health regions. In order to promote the integration of institutional and community care, home based healthcare services were frequently included in regional administrations. Despite these interventions, in some aspects, service exhibits inadequate integration. 13 For instance, even in the 9 provinces that have a regional health authority, there is no control over pharmacare budgets for physicians and outpatients. Furthermore, the largest Canadian province, namely Ontario, has not accepted regionalization. The outcome of this rejection is that acute care and long term care institutions have been rendered independent non – profit corporations that are devoid of alignment or integration incentives. 14 The Canadian healthcare system does not include copayments and other patient charges, while providing the fundamental hospital and physician services. In comparison to the system obtaining in the US, the Canadian system appears to be far superior. In fact, Canadians have an average longevity that is 2.5 years more than that of the Americans.15 Healthcare involves considerable expenditure, and the majority of the Canadian physicians do not have an accurate estimate regarding the cost of the treatment prescribed by them. This ignorance is compounded by the fact that the patients are even more in the dark, with regard to the cost of the treatment that they undergo. 16 The cost of treating chronic illnesses, such as cancer is prohibitive, and private firms and insurance companies cannot provide cancer care for profit. As the federal or provincial government bears the cost of treatment, distractions due to monetary considerations do not find a place in the interaction between patients and physicians. 17 The leaders of the physicians, a few of the analysts of health policy, newspaper columnists, and representatives of the business community have expressed misgivings regarding the aptness of healthcare that is funded publicly. One point of view, in this regard, states that the unsustainability of publicly healthcare is due to the fact that expenditure in this area constitutes an ever increasing proportion of government spending.18 In the year 1981 – 1982, the component of publicly funded healthcare in Ontario was 30% of the expenditures of the provincial government. The corresponding proportion for the year 2004 – 2005 was 45%. This has been projected to increase to 55% by the year 2025. The principal causes for this increase has been attributed to reductions in transfers from the federal government, tax cuts, and expenditure on non – health related matters. 19 Several significant challenges persist with regard to the healthcare system of Canada. For instance, the Canadian Nurses Association has shown that a third of the people of Canada suffer from at least one chronic health condition, which involves an expenditure of $900 billion annually in lost productivity and treatment. Moreover, a quarter of the Canadians are obese, and this proportion could increase to 30% by the year 2020. Furthermore, the occurrence of heart disease, stroke, Type II diabetes, cancers, and mental health problems are on the increase.20 In addition, the Canadian healthcare system is facing several crises. For instance, this country was placed at the bottom of the list of developed countries, in the context of quality care and provision of care in a timely manner, by an international survey. It is commonplace for patients in Canada to be kept waiting for hours, before being attended to in the emergency department, which invariably tends to be swarming with those requiring medical attention. This refutes the contention that the Canadians can be proud of their seemingly exemplary healthcare system.21 Furthermore, the enormous waste of funds by the Canadian healthcare system has been disclosed by a report of the Canadian Institute for Health Information. This report has revealed that tens of millions of dollars are being wasted, due to the adoption of unnecessary medical procedures. This undesirable state of affairs has been brought to the notice of the concerned authorities by healthcare planners over the years.22 It has been determined that unnecessary caesarian sections are performed across the nation, which entail expenditure that ranges from $25million to $97million, per year. It has been estimated by the Canadian Institute for Health Information that around 16,000 of such unrequired operations are conducted annually. 23 In addition, some 3,700 hysterectomies, which are not necessary, are conducted every year, and this results in the loss of $19 million. Moreover, around 3,600 arthroscopic surgeries are performed to the knee, which adopt a procedure that is now considered by many specialists to be a failure in reducing discomfort. In fact, physical and medical therapies have provided significantly better results in the treatment of such disorders. 24 There is another drawback associated with this problem, due to the localization of over doctoring. Thus, Prince Edward Island’s surgeons perform unnecessary arthroscopies to the extent of six times of the other parts of the country. Moreover, Saskatchewan surgeons perform twice the number of hysterectomies as their counterparts in Nunavut. 25 The greatest disparity is to be found with regard to caesarian section rates, which is unusually high in British Columbia. The international norm is 5% of live births, in this regard; whereas, Vancouver and Victoria have a rate of 32% for such interventions. With regard to Campbell River it is 36% and 37% in Sooke and Surrey/White Rock. It is to be clearly understood that in addition to the waste of funds, a normal birth, wherever feasible, is significantly less traumatic for the mother and child. It has been estimated that the nation would save $6.6 million every year, by discontinuing unnecessary caesarian sections. 26 The money saved on discontinuing unwarranted caesarian sections can be put to good use. For instance, the Vancouver hospitals impose a room and board fee of $29 per day upon elderly patients who are technically fit to leave the hospital. These patients continue for some time in the hospital, as they do not have anyone at home to care for them. Such charges can be eliminated by bringing down the number of unnecessary caesarian sections. 27 The balance of power, with regard to the health care system of Canada, is tilted in favor of the health providers. There have been several recommendations from various entities that the consumers of healthcare should be provided with greater power.28 One such recommendation emanated from the International Centre for Health Innovation, which referred to its white paper, “Strengthening Health Systems Through Innovation: Lessons Learned” at a conference in Toronto. Simply stated, it recommended that a transformation was to be made to the present traditional and almost exclusively prescriptive approach to healthcare. This extant approach was to be replaced by a system that made consumers the center of service delivery models. 29 In order to achieve this change, it would be necessary to modify health service environments in a manner that would create consumer choice, and enable consumers to select the providers of health services that would satisfy their personal wellness and health objectives. Moreover, the Centre for Health Innovation had made additional recommendations. Some of these recommendations were that financial incentives were to be implemented that employed insurance programs or personal health budgets. 30 The first of these dealt with enabling consumers to take decisions that would substantially influence innovation and competition among the stakeholders of the health system. Another recommendation was that the Canadian health system was to be transformed into a community based system that was concentrated on the prevention and management of chronic illness, from the present focus on dominant acute care. In addition, it had been recommended that accountability systems were to be implemented, which would render physicians and health providers responsible without any break, in the management of health and wellness of the community. 31 Moreover, it is true that the majority of the people who have utilized the Canadian healthcare system are aware of the various shortcomings with this system. There are major delays in the system, which in turn create severe problems. In addition, there have been a number of attempts to privatize some of the components of this system, under the guise of improving its efficiency and providing better access to patients. 32 As such, Canada incorporates a number of social security programs, which had been developed and introduced over the years. One of these is the health care system, and this is an interconnecting set of 10 provincial and three territorial health insurance plans. When an individual falls ill, then only that person undergoes the major discomforts and disadvantages associated with that disease. On the other hand, when the health care system, in its entirety fails to function optimally, then the entire Canadian population is adversely affected. Thus, it is essential for the Canadian policy makers to recognize this issue and take corrective measures. Works Cited "Canada Health Act." 1 April 1984. 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Some challenges facing Canada's health care system. 29 May 2011. Web. 12 October 2012. . Zaidi, Adnan Ali. "In support of Canada’s health care system: an oncologist’s perspective." Current Oncology 17.4 (2010): 2 – 3. Print. Read More