A Comparison of the Health Insurance in Australia and Canada - Case Study Example

A Comparison of the Health Insurance in Australia and Canada Introduction Australia and Canada are proud of their health care schemes, including the health insurance programs (Colombo and Nicole, 2004). Heath insurance is known as a means of offering coverage for health services that are under the public health care insurance plan. The demand for a health insurance cover is associated with the need to increase the overall social welfare. Every country has unique health care insurance schemes that assist in ensuring health care accessibility, equality and choices to its citizens (Colombo and Nicole, 2004). In addition, different countries struggle with the complexity of managing as well as ensuring a sustainable, equitable health care system that can be brought about by a sound health insurance scheme. In most countries, however, there is a concern about the sustainability of the health care systems due to the unsound health insurance schemes (Colombo and Nicole, 2004). This paper will compare the health insurance between Australia and Canada. It will offer the similarities and differences of health insurance schemes between the two countries and will describe its strengths and weaknesses. Health Insurance in Australia and Canada Similarities In Australia and Canada, healthcare systems are government funded as well as private health insurance. The Medicare in the two nations is considered public funded healthcare system. Also, in both countries, there is duplicate private healthcare insurance in terms of healthcare provision (Colombo and Nicole, 2004). Duplicate private insurance covers for healthcare services that are already under the public health insurance plan. This means that patients have the chance to choose both the doctors as well as the health facilities of their choice. In addition, the two countries compare due to the use of the universal healthcare system known commonly known as Medicare (Flood et al., 2005). Furthermore, in both nations, they give their citizens the right to access high quality and safe healthcare services regardless of the financial capabilities of their citizens. Australia has a corresponding Act safeguarding the healthcare services within its boundaries the same was as Canada Health Act (Lemmens, Trudo and Archibald, 2005). Similarly, both Canada and Australia significantly value their healthcare universally. Both nations view Medicare as replicating their national attribute for every citizen. In both Australia and Canada, the benefits acquired from Medicare are on the basis of a fee schedule which is established by the Australian government (Colombo and Nicole, 2004). They cover issues benefits for: consultation fees for both doctors and specialists; eye tests conducted by optometrists; a number of surgical as well as therapeutic operations conducted by the physician and surgical operations conducted by approved dentists (Colombo and Nicole, 2004). In both nations, Medicare ensures that every citizen has the right to use free and low-cost medical as well as hospital care. At the same time, they are free to choose the private health services they desire (Lemmens, Trudo and Archibald, 2005). Medicare systems in both countries offer free treatment for public Medicare patients within a public hospital are offered free subsidised treatment by specialists such as doctors and dentists to name a few for assigned services only (Colombo and Nicolle, 2004). Also, individuals that are eligible for access to Medicare services ought to have the following qualifications: they should be citizens of their country; they should possess a permanent resident visa and they ought to follow up with applications for permanent resident visas (Colombo and Nicolle, 2004). Differences Healthcare in Australia abides by the Western traditions which involve the utilisation of both technical and scientific skills so as to prevent, examine, and treat sick individuals (Colombo and Nicole, 2004). Therefore, any person accessing the country has to be assessed for any health issues before gaining access into the country (Colombo and Nicole, 2004). The Australian Government offers aid with both medical expenditure and hospital care via a medical scheme known as Medicare. This scheme offers public access to any free public hospital care with the doctors’ fees. It ensures that every Australian citizen has free access to affordable medical, optometrical as well as hospital care (Lemmens, Trudo and Archibald, 2005). This scheme offers access to free treatment as a public patient and subsidies treatment for specified treatment only. On the other hand, Canada offers health care services which are most at times free at the point of use and most of their services are offered by private bodies (Flood, Colleen and Archibald, 2001). These health care policies are therefore directed by the Canada Health Act. In addition, Canada offers provincial based Medicare system which is cost-effective due to the simplicity of their administration (Colombo and Nicole, 2004). Since there is no need for an individual to be included in billing and reclaim, each doctor located in each province takes care of the insurance claim against the provincial insurer. In addition, they have a universal health care system that doesn’t take into consideration the coverage of prescription drugs (Flood, Colleen and Archibald, 2001). Australia permit doctors to work in both publicly funded systems, while at the same time practising in the private sector as well. This process is commonly known as “dual practise” (Flood et al., 2005). This has provided them with higher incentives working in the private sector due to higher payments. On the other hand, Canada prohibits the act of dual practice within its administration. They highly discourage such acts since their doctors have no choice but to either work in the public sector or work in the private sector entirely (Flood et al., 2005). Moreover, even though doctors wish to opt out, the legislation offers economic disincentives to prevent them from doing so. Canadian Health Insurance Strengths The country has a universal health care system that has enhanced health care accessibility to every citizen (Evans, 2005). No Canadian is left behind when it comes to the private health care system as everyone as equal access whether or not he can afford it. This means that the country has a universal health care system (Evans, 2005). The public funding scheme in Canada pays for medically necessary care. This has allowed for a large portion of the population to access the health care system. Weaknesses The access to the private health care system in the country brings about inequality as a result of duplicate private insurance scheme in the country (Buckett, 2005). In addition, Canada spends a lot of capital in the health care system compared to Australia. The health care system in the country is considered one of the most expensive and less efficient (Evans, 2005). Since the government funds the public system more than the private system, the public system tends to be overcrowded while the private facilities have a number of comfort amenities. These private facilities are often well maintained with amenities such as private wards and better tasting food among others while the public healthcare facilities are neglected (Evans, 2005). Australia Health Care Insurance Strength The mix of public and private health care insurance in Australia has led to the use of scarce capital which has promoted greater efficiency (Buckett, 2005). In the same way as Canada, Australia has a universal health care system that has enhanced accessibility of health care services including Medicare for every citizen (Buckett, 2005). In the private health insurance scheme, patients have shorter wait times since the hospitals and clinics are less busy. In addition, there is the choice of by passing patients in the line with extra pay. When it comes to the private health care system and Medicare, a patient has the freedom of choosing the healthcare facility and a doctor of his choice (Buckett, 2005). This may be an advantage for the patients who are comfortable with one specific doctor. Weaknesses The health care insurance in the country brings about inequality (Colombo and Nicole, 2004). When health insurance is privatised, both the insurance companies as well as the healthcare providers think about their welfare. If an individual is willing to pay the extra amount, he can get priority treatment (Buckett, 2005). This has enhanced the inequality sequences in the country in terms of health care provision. Moreover, there is poor coordination and organisation of the health care planning involving the insurance companies which has resulted to poor health care service deliver (Buckett, 2005). Conclusion Health care insurance schemes are very fundamental in ensuring equal accessibility, choice and equality of health care provision. Canada and Australia’s health care insurance schemes have a number of similarities. For instance, in the two countries, the health care system is both government funded and private funded by the insurance companies. There is duplicate private insurance cover that has brought about inequality and greater health care choice. The differences existing between the two schemes are several. For instance, in Australia, the Medicare covers for prescription drugs while in Canada this is not the case. Australia permits dual practice while Canada does not. In the two countries, the health care insurance scheme ensures universality and choice in terms of health facility and doctor. However, the permit to pay the extra cost for special considerations has brought about inequality. One of the strengths of the health care insurance in Australia is that, it has led to use of scarce capital as compared to Canada which utilizes huge capital in its healthcare system. References Buckett, S. J. (2005). “Living the Parallel Universe in Australia:  Public Medicare and Private Hospitals.”  Canadian Medical Association Journal, 173(7): 745-747. Colombo, F. and Nicole T. (2004).  Private Health Care Insurance in OECD Countries:  The Benefits and Costs for Individuals and Health Systems.  OECD Health Working Papers, No. 15. Evans, R.G.  (2005). “Preserving Privilege, Promoting Profit:  The Payoffs from Private Health Insurance.”  In Access to Care – Access to Justice:  The Legal Debate Over Private Health Insurance in Canada, ed. Colleen M. Flood, Kent Roach and Lorne Sossin.  University of Toronto Press, pp. 347-368. Flood, Colleen M., and Archibald T. (2001).  “The Illegality of Private Health Care in Canada.”  Canadian Medical Association Journal, Vol. 164, No. 6: 825-830. Flood, Colleen M., Stabile M. and Kontic S. (2005). Finding Health Policy Arbitrary: The Evidence on Waiting, Dying, and Two-Tier Systems. University of Toronto Press, pp. 296-320. Lemmens, Trudo, and Archibald T. (2005). The CMA’s Chaoulli Motion and the Myth of Promoting Fair Access to Health Care. University of Toronto Press, pp. 323-346. Read More