Health Care Systems of U.S. and Canada - Essay Example

? Health Care Systems of U.S. and Canada Introduction Service industries can be defined as industries that obtain their income through the provision of intangible goods and services. Provision of health care is one of the services offered by health care facilities and it is of importance that this service is of high quality. Quality in this perspective can be defined as the degree to which a set of inherent characteristics that fulfill requirements (Williams & Torrens, 2008). On the other hand, service quality can be defined as the degree of superiority of a service. In relation to health, quality health care refers to doing the right thing, at the right time, to the right person with the aim of attaining best results (Harris et al, 2005). In today’s competitive world, service industries strive to provide service quality that exceeds customers’ expectation. The customer is always the deciding factor in the success of any form of business, either delivering of goods or provision of services (Eden et al, 2001). The customers’ needs have to be fulfilled, and their expectations exceeded for such service to be deemed of high quality. Service quality will determine whether a customer will be satisfied or not (Shueman et al, 2000). However, since customers are dynamic, this will lead to complications in the determinants of quality. In this research, the main focus will be on the type of service delivery offered by health care systems and a comparison of the health systems in the United States of America and those in Canada will be discussed. The performance of health care delivery system highly depends on the ability of the supportive systems to handle its operations. Service satisfaction will, therefore, only be realized when the provider is aware of what the customers’ reactions are to the provider’s behavior during the process of service provision by the health care provider. There are fourteen dimensions that can define how health care systems perform (Lighter & Fair, 2004). This includes accessibility, acceptability, care environment and amenities, competence, expenditure, efficiency, governance, equity, patient responsiveness, appropriateness, sustainability, safety and timeliness. Health system in the USA There is a worldwide perception among so many people that the best health care system in the world is one provided in the United States (SHI & SINGH, 2012). The United States being a super power has led to the generalization that they have the best type of service quality. According to a current research carried out in the US last year, 55 percent of Americans interviewed testified that U.S. patients receive a much better quality of health care than any other patient from a different country. 45 percent of the patients’ interviewed were of the opinion that United States had the best health care system in the world (Garber, 2006). Over the recent past, the government of United States has tried to implement the policy of health care for all (Lindy & Janes, 2009). This amendment has its own advantages and disadvantages. One advantage is that, patients from all walks of life would have the opportunity to receive proper health care. This will especially be of importance to the low income earners who are unable to access quality health care as a result of lack of funds. On the other hand, a high percentage of Americans are opposing this, claiming that it the quality of their own health care would decrease as a result of the provision of health care to all. Americans usually have good insurance cover; hence with this in mind, we except their patients to be provided with the best medical cover. This includes the availability of medical equipments, accessibility to the best medical procedures and lastly to original medicines. In addition to this, they have some of the best well trained medical practitioners in the world (Kovner & Jonas, 2001). With all this in mind, it is highly likely that they offer quality services during their provision of health care. According to a recent study, U.S. had the highest number of deaths, and these resulted from diseases which could be prevented or treated (WOLPER, 2011). This has lead to a negative impact of the state of the U.S. in relation to the provision of health care. In the same study, it was noted that the U.S. is not among the leading performers in relation to life expectancy. Through the health-adjusted life expectancy, the relationship between longevity and morbidity can also be established, and it was noted that the two were inversely proportional (HARRINGTON, 2007). Studies have shown that the government of United States contributes about 12% of it GDP (Field, 2007). The government intervention in health care system is a source of controversy with citizens having different opinions to their involvement. Most Americans prefer the government to assist only those in need leaving a high percentage to the private sector (Raffel & Barsukiewicz, 2002). This makes the private sector being the main stakeholder in policy making under the health delivery system. There are a number of insurance plans in existent within the U.S. these include Health Maintenance Organizations (HMOs), these plan insures and offers health services and Preferred Provider Organizations (PPOs), which only offers insurance but gives one the opportunity to choose the health care provider that bests suits an individual. This will result to the provision of good health care as once a patient is given the opportunity to choose his preferred health provider; he / she will look for the best service and hence receive quality health care. In addition to these third party insurers, commercial plans are also available. These include self insurance plans which are mainly administered by employers. Canadian health system Canada heath care system is mainly a set of socialized insurance plan that cater for all its citizens. It is funded by the tax payer’s money and administered on provincial territories with strict regulation set by the government (Caulfield & Vontigerstrom, 2002). Under the health care system, citizens are provided with basic medical treatment, optician services and access to dental services. The system provides health coverage to all citizens irrespective of income, medical history or standard of living (Machildon et al, 2005). Roles and responsibility of the Canadian health system are shared between the federal and the provincial-territorial government on a 50/50 basis. Though the health care is ‘free’ because it is publicly funded by the federal government, it is very expensive. Canada has an expensive health insurance in the Organization for Economic Co-Operation and development (OECD) (Canadian Institute for Health Information, 2006). Delivery of services in Canada is inefficient because the system is not providing accessible health care to its citizens. When compared to other OECD countries, it had the 6th highest rate on health insurance that it spent 11.4% of its GDP on health insurance (Statistics Canada & Canadian institute for health information, 2000). The expenditure is not reflected on service delivery and customers’ satisfaction compared to other OECD countries and was ranked 15 out of 20. Canada ranked 19th out of 28 for the number of practicing physicians per 1000 citizens, 12th for the number of nurses per 1000 people and last for the number of acute beds for 1000 patients. Canada was ranked 16th for the number of CT scanner it has per one million citizen and 14th for the MRI units per a million citizen (FELDSTEIN, 2011). From the above data, it is evident that the Canadian health insurance does not offer quality service to its citizens compared to the USA. The other disadvantage of the health system is the patient wait for so long before they can access the health service (Canadian institute of Actuaries, 2000). From data, the average waiting time for a patient to get a referral from a general practitioner to treatment was 17.7 weeks. The long waiting time also affects diagnostic procedure such as magnetic resonance imaging and computer tomography and they were between 2-24 weeks. The main reason for waiting according to pacific research institute was there are checks the government writes which take time to mature (McCarthy & Schafermeyer, 2007) and also, the government planners control the monetary cost by shifting the non monetary cost to the patient. The above reason will automatically consume time hence most of the patient may die, especially the ones with chronic disease like cancer. There are few medical personnel in Canada this is because of the environment they work in. This is because the government cannot pay them enough money (Fierlbeck, 2011). The doctors also work for long hours because of the increased amount of time in the waiting list. From this point, we can conclude that the federal government is not treating its customers (doctors) with respect to the ISO standards. In Canada, with reference to bill 82, enacted by the British Columbian government, the federal state tries to discourage the private sector (Heslop, 2010). In the bill, the government has disallowed citizen from paying a fee at private hospital, and to make matters worse, it fines $ 20,000 to any physician who has received money from a patient. This is a disadvantage because the government decides when and where to see a doctor and cannot give a chance to continuous improvement and competition to any organization that up holds quality. The key drivers in health care satisfaction to the citizen are the political parties and the Registered Nurse Association. The Liberal Party of Canada in their manifesto and the platform is determined to make health care is accessible to all Canadians. The party is scheduled to introduce the National Waiting Time reduction Strategy which will incorporate doctor, provinces and patient group to work together and reduce time wastage (JOHNSON & STOSKOPF, 2010). The party has also vowed in making sure that the health system can provide care to the Canadians at any time of the day without requiring long waits at the doctor’s office or an emergency room visit. The Conservative party supports the Canadian Health Accord which will expand the current system thus less waiting time. The health accord has the backing of the Registered Nurse Association. The Conservative party has also promised to increase the number of Doctors per province thus makes health services accessible to all citizens (NEUSCHLER, 2000). Major differences between health systems in USA and Canada In the United States, public health insurance is not provided to all its citizens. Its provision is dependent on the type of care and the extent of its coverage. A higher percentage of Americans are covered under private health plans, while there is small percentages that have no insurance coverage at all. This is a major disadvantage, as those who are not covered by this insurance plans have problems when trying to access health care. By contrast, in Canada there is a universal access to health care system since all its citizens are covered by the public health insurance plans. This is an advantage as anyone irrespective of their financial status, can access quality service during delivery of health care. A majority of patients in the United States receive health care at a fee and hence service delivery is dependent on the amount of money one pays. Therefore, their form of health care is limited by financial constraints. This is an advantage to the wealthy people since with the money they have in their possession, they can access the best medical care which is more readily available, whereas, for the low income earners, this is a disadvantage. This is because, they are unable to access such type of service, since they cannot afford it although over the recent past, the federal and state government has come up with ways to curb this constraint, through Medicaid. By contrast, in Canada, everyone has access to medical care regardless of their financial capability. This has been made possible by their provincial government health insurance plan. This plan covers so many medical services with the exception of cosmetic surgery, dental care and additional hospital – room amenities. Only these last three services not covered under the plan are offered at a fee. As a result, everyone is able to receive quality service in terms of medical care. Conclusion It is evident that although in both countries, health care is limited by the amount of financial resources; the cost of accessing health care in the United States is higher than in Canada. This is because whereas in the United States financial constraints are focused mainly on an individual, in Canada the constraints are applied to the whole system, hence shared collectively. This results to a more quality service in health care delivery in Canada as opposed to the one in United States. In Canada, the government should also introduce the private insurance option by amending the bill 82 which fines private sector physicians. This will allow quality health sector to those who can afford. The basis of quality service is ensuring that there is customer satisfaction because a customer is the king. The government of Canada should allow competition in its health sector. This can be achieved by including the private sector like the Drug Companies, insurance firms and private hospitals to run for the citizens’ money. If competition is allowed within the health sector, there will be quality service to the citizens hence beside the government will not spend a high percentage of GDP in the health sector. An overview of these two health care systems shows that both of them have problems and limitations. Canada has been able to achieve high standards of health care delivery to all, and it should thus maintain its status and make their health system more cost effective. On the other hand, the United States health system should be improved made more efficient, cheaper and inclusive of every citizen. These two countries should focus on putting more effort on their strengths and where possible, incorporate the desirable features from each other’s health system. References CANADIAN INSTITUTE FOR HEALTH INFORMATION. (2006). Health care in Canada. 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