The Australian and Canadian Health Care Systems - Essay Example

The Australian and Canadian Health Care Systems are comparable in many of the key measures of successful national health care systems, that is in the areas of Accessibility, Equity and Efficiency: translated into a practical level these terms describe how easily a person in a country can get health care service, how easy it is for all people in that country to get health care regardless of income or education or age, and how economically , quickly and effectively that health care is delivered. After first outlining the structures of the Australian and Canadian Health Systems, the comparison of these systems in terms of their relative Accessibility, Equity and Efficiency can effectively be made by taking a case scenario of the medical treatment of Garcia Lopez, a 20 year old student training for a trade certificate, working casually at an income below taxable levels and living with first generation, financially limited Spanish, immigrant parents. If Garcia were to suffer an Achilles tendon rupture in a soccer injury and require hospitalization and 6 months of post-operative physiotherapy care what would be the the level of treatment he would receive in the aforementioned variables in the Australian and Canadian Health Care systems ? To further complicate the issue how would Garcia's experience compare to another young man who received a similar injury but differed in the sense that he had two middle income professional parents who supported him. In answering this question an greater understanding of these two fine health care systems can be achieved. There are many similarities between the Canadian and Australian Health Care systems. Both are Commonwealth countries that were once colonies of Great Britain which now have Federal Democracies that provide a universal health care system that is available to all citizens regardless of ability to pay for the services. Both systems of public health care are called Medicare and the funding for these systems is taken from tax revenues. The difference, and to some observers of developments in Canada this may be temporary, is that Australia has a parallel system of private health care that Canada due to legislative limits has only flirted with . In Australia the government is composed of a Federal Government that oversees 6 state and 2 territorial governments. In Australia the the universal public system is funded by a public system levy that is imposed on all whether or not they are in the private system or not. The taxes that finance the the public system are collected by the Federal Government and allocated to state and territorial governments to administer. While the public system is freely available to all the government has instituted tax incentives for joining the private system before the age of 30 and penalties for those that do not . This has resulted in up to almost half of the population now registered in the private system. The private system is run through up to 40 different Insurance Plans while the public system is a non rationed system that is run through the state and territorial governments with capitation occurring in some areas. The doctors in Australia are mostly private operations that are funded publicly by the public system and by private insurance plans in the private system. Doctors in Australia have the option to extra bill and this is a common occurrence in specialist offices. Extra billing can also occur in public settings but up to 85 % can be re compensated through the Medicare plan. In cases where patients income levels fall below a certain level a 100 % re compensation can be had through Medicare. Patients in the private health care plans have access to the private and public systems and have the privilege of choosing their own doctors and in general have less waiting for services as well as access to some secondary care such as physiotherapy which is not covered in the public system. Patients in the public system are entitled to hospital care in state hospitals but they cannot have a choice of their physician unless they opt into the private care at extra cost which is option that everyone is entitled. Medications under Medicare are issued under the Pharmaceutical Benefits scheme which subsidizes generic medicines on the basis of income. Under this plan brand name drugs or newer medications must be paid for out of pocket. The Australian Medicare system was the victory of a battle of political views that culminated in the Universal program being implemented. Wall describes it well : “ In 1983 a Lab our government under Bob Hawke took office on the basis that it could rebuild the welfare state after eight years of attrition under Conservative governments. To this end, Medibank was restored in the form of a universal health insurance scheme known as Medicare” (Wall, 1996, p. 26) Canada is is a Federal government system that heads 10 provinces and two territories. The Canadian Medicare System like the Australian Medicare System was a victory of liberal politics led by the innovation of the province of Saskatchewan in 1962 which introduced a freely available public health care system. The country followed suit in 1965 with a a free accessible Universal Health Care system under a 50-50 sharing plan between the Federal and Provincial tax revenues. This sharing plan was reduced to a much lower burden on the federal government when it was replaced by the Federal Transfer Fund Program. In 1984 the landmark Canada Health Care Act tried to entrench the original spirit of the Universal Health care plan by spelling out the four conditions of the act, that is Universality , Accessibility, Portability and Public Administration. Universal referred to all residents being allowed into the plan; Accessibility, to no barriers or bills to receiving treatment; Portability to equal access to care throughout the country for all individuals and public Administration was to underline the non- profit nature of the organization. In Canada like in Australia Doctors are private operators that are paid through the public system in a fee for service system that now sees capitation in effect. Although the Canadian system is characterized by egalitarianism it is limited by rationing of services and a paucity of readily available high technology compared to what is seen just across the border in the United States. Although the single tier system appeared to have been entrenched in law the spiraling costs of health care have raised debate about the emergence of a parallel private system of health care much like Australia. In the case of Garcia the 20 year old second generation child of poor immigrant parents who was introduced as having suffered a Achilles tendon rupture requiring hospitalization and 6 months of physiotherapy, in the Australian Health Care System he would have easy access to health care as a beneficiary of the Medicare System. And since his surgery would not be deemed to be elective he would receive reasonably prompt surgical intervention. Few would argue that he would receive treatment as quickly in the public system as the private. This not completely equitable to the treatment that a similar young man with the same injury who as a child of prosperous parents would recieve under the private care system however it might be spurious to claim that Garcia would not receive as competent surgical care since there is no evidence on the record of this being the case. In Australia where physicians may extra bill this may present Garcia with some challenges since he makes less than the taxable income in his part time job. Garcia would not be able to see the doctor of his choice since this is a privilege of the private system to which the young man of prosperous parents would have. Following surgery the 6 months of physiotherapy would present Garcia with a financial challenge since the public system does not cover the user fees of physiotherapy. To some degree these services are covered in the private system for our other young man, so he would have some access to physiotherapy under his parent's private plan. The efficiency of the private plan would definitely be higher under the private plan as the public system is characterized by longer wait times for services. Any medications that Garcia would need would have to fall under the Pharmaceutical Benefits Scheme otherwise he would have to pay extra into the system. Under the Canadian system Garcia would receive emergent surgery because the nature of the problem but there would still be a wait involved since it is not a life threatening problem. Garcia's treatment options would be different from any other person because of the single tier system. The accessibility would be maximal under the Canadian System since this is laid out in the tenets of the Canada Health Care Act but since it is a rationed system Someone with more means and a desire for immediate service would have to travel to the United States for this kind of service. The equity in this system is potentially maximal because as a matter of principle it mandates no difference in treatment and no extra billing for health services. But Garcia would unfortunately incur some cost of physiotherapy in Canada because it is incompletely covered, but there would be more service than that is offered in Australia. The efficiency of the service that Canada offers as a rationed system would be of a lower level than the non-rationed Australian System so in this regard Garcia would receive more efficient care in Australia. There would not, however, be any distinctions between individuals under the Canadian Health Care plan whereas there would definitely be some in the Australian system where someone with more means and under a private plan would receive more efficient care with less waits than a recipient of Medicare. Garcia's mother and father both do not speak English and his mother suffers from low esteem. This may effect Garcia's treatment in perhaps the Australian system more because the complexities of navigating between the parallel systems would require some work on the part of the recipient. Since Garcia may also have some aspect of low esteem he too would have to work to overcome that handicap to take full advantage of the benefits of the Australian System. This is recognized as a deficiency in the equity of the Australian system especially as it pertains to the Aboriginal population which is woefully under serviced. The immigrant population has normal health profile unlike the dismal health statistics of the Aboriginal peoples, but there may be provisos here as Lumby argues that the good health of immigrants may be due to factors other than the benefits of the Australian Health Care System: “ It has been shown that, in general, immigrants have better health than the Australian-born population when they arrive (their original health status may have something to do with entry criteria) “ (Lumby, 2001, p. 82) In Canada in a single tier system with full accessibility Garcia's immigrant status and potential lack of confidence would play less of a role in him receiving care but language and cultural barriers remain a challenge to overcome in all western health care systems with immigrant populations. Canada has a single tier universal system but there is a sense that this system is untenable unless some other form of financing is devised, and there is sense that it will be moving toward a system like Australia and for that reason the comparison of these country's health systems is a useful exercise, both for observes and perhaps for health care policy makers in Canada. Australia is also facing financial challenge but it has done well comparing favorably with other country's across the developed world in terms of percent of GDP spent on health care. Some would argue this has not been without cost as Lumby states, “There is a feeling prevailing among patients that individualized care is disappearing” (Lumby, 2001, p. 63) In all this has been an illuminating exercise in showing how two county's with a similar makeup and form of government have carried out a Health Care System for their respective population in terms of Equity, Accessibility and Efficiency. References Busse, R et al (2002) Health Care Systems in 8 Countries: trends and challenges http://www.hm-treasury.gov.uk/media/70855/observatory_report.pdf . Irvine,B.(2002 ) Background Briefing: The Canadian Health Care System http://www.civitas.org.uk/pdf/Canada.pdf. Lumby, J. (2001). Who Cares? The Changing Health Care System. Crows Nest, N.S.W.: Allen & Unwin. Retrieved March 28, 2006, from Questia database: http://www.questia.com/PM.qst?a=o&d=101441547 Wall, A. (Ed.). (1996). Health Care Systems in Liberal Democracies. New York: Routledge. Retrieved March 28, 2006, from Questia database: http://www.questia.com/PM.qst?a=o&d=103072164 Read More