Safeguards to Improve Canadas Healthcare - Case Study Example

Undermining the Socialized Healthcare System: Safeguards to Improve Canada’s Healthcare An established healthcare system is a nation’s fingerprint that reflects government service and responsibility to provide for the well being of its citizens. Several systems have come into place to provide for this vital need. This paper discusses the issues concerning the socialized healthcare system in Canada and the measures being taken by the government to catalyze its reform. Canada is among the countries which actively seek improvements in their system of health care and has been enthusiastic in implementing reforms and evaluating performance. Other countries such as UK, USA and Australia are well under this group. However, even if the objective of efficient and high quality health care is universal for these countries, all have developed different schemes in medical care services (Arah, et al., 2003). Table 1 compares the system of health care in these four countries in terms of the funding, framework, guidelines and assessment performance. This data will be very important in the comparisons to be dealt with in the succeeding pages. In Canada, the adapted system which started in the late 1950’s, has transformed from a public and territorial hospital insurance structure to a comprehensive, compulsory system as we know today (Lemieux, 1989). This system ensures that taxes benefit taxpayers through a universal medical program and that no one is denied of medical care. Since the medical control is run by the government and funded by the taxpayers, it is but necessary that more safeguards be put in place as claims of a rusting system develops (Arnett, 1996; Cihak, 2004; Hsieh, 2007). Several issues have been batted to the socialized system of hospital care in Canada and John Goodman (2005) has summarized these into his “Five Myths of Socialized Medicine”. Table 1. Summary of national frameworks for health system performance.1 1 Arah et. al, 2003 A Right to Health Care. Goodman discusses that Canadians lose the right to health care in a universal system basically because the number of patients increase tremendously in this kind of scheme. As a result, there are very few people that get treatment and services are delayed because of waitlists and queues. He also further indicated that based on the Frasier Institute, ten times more patients in Canada are waitlisted compared to that in New Zealand. Apparently, the population in Canada is around nine times more than New Zealand’s populace, in addition to several other factors which should have been considered such as number of hospitals and the nature of health care needed and the quality of services received. Leonard Peikoff (2006) expresses the American viewpoint of this myth. In his speech entitled “Health Care is Not a Right”, he articulates that the right of one man should never impose responsibility to another to pay for his needs. Of course, moral doctrine dictates otherwise and people will always have an obligation to his fellow. This is a universal truth. Consequently, advocates of the subsidized health care believe that everyone has a right to treatment and this noble intention of free healthcare should supersede its risks. Part of the risks, not to mention dangers, of a socialized system is the long wait for treatment as the demands for healthcare become very high. However, for most kinds of health care in Canada, there is very little need for waitlists (Himmelstein and Woolhanlder, 2006). In fact, methods for a systematized queue are being put forth and ascertain that treatment gets to those who need it first. This year, the Liver Transplant Service at the Hôpital Sainte-Justine Université de Montréal at Que reports several improvements in their liver transplant methods and allocations (Martin, 2007). In addition, information networks such as the Canadian Council for Donation and Transplantation employ schemes to control the rate of tissue donation and transplant (Hollomby et al., 2007). Higher Quality. The second myth is an offshoot of the first. As a result of the bulk work for medical care personnel, Goodwin says that the quality of health services is compromised. But Himmelstein and Woolhandler (2006) have stressed how a market-driven type of healthcare system, like that of the US, reduces its quality and accessibility. If this is true, then, by all means, a people- and service-driven system is far better. Decline in quality issues are being addressed by programs that measure the efficiency and accessibility of healthcare. By keeping track of health service performance as well as current and surfacing health issues, the government becomes well aware of the pitfalls of the framework (Statistics Canada, 2001). Special programs such as the Roadmap Initiatives Indicators Framework are also instituted to focus on patient needs (Statistics Canada, 1999). The quality improvement strategy in Canada’s health services is also enhanced through the certification and accreditation of hospitals. This ensures that Canadians get quality service from any accredited hospital all through their country (Harrigan, 2000). Personnel quality is also not compromised. According to Bliss (2007), even amidst the weakening medical care, the dedication and professionalism of doctors and nurses are key attributes of the propagation of universal healthcare in Canada. In addition, Canada is also witness to an influx of healthcare human resources from other countries. The high quality of medical personnel can be further improved through government programs and competencies. These measures indicate the mendacity of a deteriorating medical practice in Canada. In fact, Canada has centers of excellence in the medical and research fields (Hollomby et al., 2007). It has kept up with recent advances in the medical technology, has pioneered in several fields and is boosting its research capabilities especially at universities. New tools that have been recently made available in Canada provide innovation and options for combating cancer and stroke. Examples of these include application of monoclonal antibodies and intensity modulated radiation therapy (IMRT), new cancer treatment systems that can accurately targets cancer cells and a breakthrough instrument (TCD) that instantly detects blood clots to reduce instances of stroke. IMRT has been made accessible at the Princess Margaret Hospital, the Sunnybrook and Women’s College Health Sciences Centre in Toronto and at the McGill University Health Centre in Montreal while TCD is available at the University of Alberta Hospital in Edmonton, the Foothills Medical Center and at St. Michael’s Hospital in Toronto (Slater, 2001). Also, performance indicators of Canada’s health system are very specific and outcome-oriented, a framework that is evaluated periodically in its priority areas (Arah et al., 2003). Costs. The next concern deals with the increasing cost of medical care and is a major drawback of the socialized system. However, the increasing cost of healthcare is a global trend and is not unique to Canada. New technologies and research aid in escalating the cost of medicine (Altman, 2006). It has been reiterated that “with great power comes great responsibility” and accessibility of healthcare is no excuse. Free healthcare is always prone to abuse (Lemiueux, 1989) and the Canadian government’s strategy is to focus on diagnostic and preventive health care rather than treatment (National Forum on Health, 1997). Thus, more efforts must be placed to promote patient responsibility. As stressed by West (1986), health consumers and providers are both members in an equal partnership that can prevent a massive outflow of medical care. Doctors also hold the responsibility of reminding their patients to practice healthier lifestyles and to promote their own health. In the long run, an improved welfare and well being of the community will drastically reduce future illnesses thereby reducing costs. Politicians in Canada also realize the need for a stronger public health institution. In addition to improvement of researches and a Population Health Strategy, they speculate that a national plan for medicine purchases would reduce drug cost because of its quantity (Kondro, 2006). Equal Access. So do Canadians really get equal access to their free care? Goodman (2005) thinks otherwise and believes that healthcare to racial and ethnic minorities are rarefied. On the contrary, in an expensive, private health care system, they will probably get none, if not very little, of the benefits of the socialized health care. As a safeguard, health care reforms in the early 90’s sought the creation of provincial legislated health regions which oversee the process of health systems (Arah et al., 2003). Survey results conducted to compare consumer reports from five countries are shown in Table 2 (Blendon et al., 2002). Percentages show that Canadians rank second to the US in terms of accessibility in seeing a doctor. Next to UK citizens, Canadians are most likely to wait for months for a surgery but gives a, relatively, high rating to their healthcare system. Table 2. Consumers reporting on access to care, waiting for care, and overall experience with health care.2 2 Blendon et al., 2002 Central to the discussion of accessibility issues in the socialized system of medical care include an analysis of the ratio of doctors attending to patients’ needs. While 44% of Canadians feel that specialists are not always available for consultation (Table 2), it should be noted that a dramatic increase in the number of doctors caring for Canadians occurred in recent years. Even with reported problems in remuneration, an increase in doctor to patient (D: P) ratio was observed. The D: P ratio in Canada in 1960 of one is to nine hundred fifty increased to a ratio of one in five hundred fifty in 1999. Despite the improving D: P ratio, however, many still claim that Canada is experiencing the onslaught of medical personnel shortages due to lack of medical incentives and options which would result in limited access of patients to physicians. Canada is also reported to be losing physicians to the US (Lemieux, 1989). Despite this mismatch, however, with territorial and provincial hospitals that provide for their medical needs, Canadians still have unlimited choice of treatments and doctors in various fields. Consequently, Canadian doctors are freer to choose practice specialties than US physicians (Himmelstein and Woolhandler, 2006). Less Red Tape. Lastly, to combat red tape and ensure the efficiency of the socialized healthcare, the Canadian government has also installed safeguard organizations that operates the framework to improve the healthcare system. Examples of these institutions include the Canadian Institute for Health Information, Statistics Canada and Health Canada (Arah, et al., 2003). Quoting Himmelstein and Woolhandler (2006), “private insurers take, on average, 13% of premium dollars for overhead and profit. Overhead/profits are even higher, about 30%, in big managed care plans like U.S. Healthcare. In contrast, overhead consumes less than 2% of funds in the fee-for-service Medicare program, and less than 1% in Canada’s program”. The single payer system employed by Canada is also believed to be efficient at cutting the administration process compared to if several private institutions are involved. In addition, compared to US doctors, Canadian physicians spend less on operating costs and employ 50% lower clerical and administrative staff, thereby, decreasing bureaucratic costs (Himmelstein and Woolhandler, 2006). Consequently, researches on waiting list registries also focus on expediting delivery of care and creating a database of information which is expected to improve the strategies in queues and reduce bureaucracy. Indeed, socialized healthcare systems may be dragged into a quagmire of politics, red tape, cultural and environment issues, as well as the values and morals of the voters. However, a system that suits a nation best should be evaluated and, most especially, improved through an assessment method to determine how efficiently it is serving the people. For Canada’s case, adversaries of the socialized health system may be doing more harm than good if a total overhaul is put in place. Statistics show that majority of residents in Quebec believe that all doctor consultations are free and 82% support socialized healthcare. Thus, majority will choose politicians and national leaders who will bolster this type of system (Lemieux, 1989). The US is contemplating on applying, in some states, currently, partially employing, on a “Medicaire” system that is based on the Canadian socialized system and it has met several oppositions (Cihak, 2004; Peikoff, 2006; Hsieh, 2007). This push originates from several premises that show how a government monopoly on health care may also be deemed successful based on standards of morality, quality, accessibility, cost and the bureaucratic process. Fairly equal to these factors are monitoring, implementation and assessment schemes that supply improvements if the system is found to be ailing or showing signs of disservice to its consumers. Currently, there are heated debates whether Canada would be allowing the private sector to provide a secondary health care scheme to penetrate its homogeneous system of medical care delivery (Esmail and Walker, 2005). This concern about “Americanizing” the Canadian medical care system is an irony to the exigent considerations by the US government to employ a “Canadian” health care system to replace what is currently “not working” for them. It is also proof that the socialized system may be adapted, or even considered, by other countries who are skeptics to format of healthcare delivery. It is obvious that the choice depends on several factors, especially in the end consumers’ preferences. And the evolution of these systems in each of the abovementioned countries is reflective of the needs of their citizens. Therefore, an effective scheme for one may not be applicable for the rest and careful considerations must be done to build and strengthen a healthy nation. References Altman, L.K. (2006). So many advances in medicine, so many yet to come. The New York Times. Retrieved August 18, 2007. http://www.nytimes.com/2006/12/26/health/26docs.html. Arah, O.A.; Klazinga, N.S.; Delnoij, D.M.J.; Tenasbroek, A.H.A.; Custers, T. (2003). 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