Comparison of American and Canadian Health Care System - Assignment Example

Comparison of American and Canadian health care system al Affiliation The health care systems of both America and Canada have always gone through mutual reviews and have adopted and amended the system in accordance to the comparison process. The objective of this essay is to critically analyze the healthcare systems of both the countries and to make conclusions on the possible amendments in the American health care system which can be adopted from the Canadian system. The researches done on this aspect would be reviewed as a methodology towards this effort. A number of literatures are available which deal in detail the banes and boons of both the systems. These had however, concluded with varied opinions on the efficacy of both the system. In general it can be said that when the public sector oriented Canadian system is adorned for its public access and affordability, completely privatized American system is renowned for its quality and precision. Comparison of American and Canadian health care system The governments within Canada both provincial and national, ensures that its citizens get health care assistance globally through insurance schemes. The non-liberalized policy of the Canadian government on this aspect is corroborated as private insurance companies are not given permission to have business in the services which benefit the public heath cause (Madore, 1992). This would mean that the public agencies would be dealing with the reimbursement for doctors and health care facilities. The general scenario is that the public do not pay for the health services but do hold the right to choose the facilities. Most of the hospitals are privately owned non profit organizations funded by the government in different levels. In totality the government of Canada ensures that the public sector rules the medical industry. Budget allocations are specially made for this cause (Madore, 1992). In comparison to these the key difference in the American health care system is that it is highly liberalized and privatized. The patients as in the case of Canadian system receive health services free of cost. The difference lies in the fact that the reimbursement of the cost is predominantly done by private companies. However, these companies work in association with employer made arrangements and other public systems (Madore, 1992). American citizens contribute towards their insurance as arranged by their employers. The process of outsourcing insurance from private agencies by the employees is also in practice. In some cases the employees handle the insurance options by themselves. Some of the examples for third party insurances options in America are Health Maintenance Organizations (HMOs) and Preferred Provider Organizations (PPOs). The limitations in such programs are that it leaves the public with lesser options in terms of choice for health care facilities and doctors. (David, 1990,p.18). On the other side the country’s heath care system gives the unemployed or self employed employees the option of getting access to private insurers personally. However, the country has options of public insurance so as to make it available to the financially needy population. Medicare is one of the examples for this which has elderly people and disabled ones as its beneficiaries (Madore, 1992). The beneficiaries are supported for the cost they incur on hospital and other health care services. Another similar insurance service, Medicaid caters economically lower class of people. The government supports the program with financial aid while incorporating strict guidelines of implementation. The beneficiary eligibility, the support level, reimbursement criteria and others of the sort is governed by the American government (Madore, 1992). The government also has tailor-made programs catering specific target groups like pregnant women, aborigines, deprived class, patients of specific diseases etc (Madore, 1992). The comparison of the healthcare system in both the countries is being done in this essay under the following categories. Public access The peculiarity in the Canadian health care system is the universal access it provides to its beneficiaries. All the citizens of this country are eligible for the health care services uniformly with reference to the terms and conditions set by the government. The health care system can be accessed by any eligible Canadian citizen from any part of the world. Moving out of the province also does not affect the access to health care programs (Madore, 1992). The heath care system in the United States has not got a uniform nature. The benefit of the program primarily depends on the kind of the medical policy. This would mean that this system to an extent would depend on the buying capacity of the customer. The larger you spend on the insurance premiums, so would be the umbrella of the coverage (Madore, 1992). This policy thus cannot be said as completely social. On careful analysis of the statistics on American health care scenario, it can be found that this system causes huge variations in the access to health care. When some of the citizens hold comprehensive insurance schemes few other do not hold any insurance schemes. The extend of the variation is corroborated by the statistics on health care access to American citizens which revealed that in 1991, 62% of the citizens were covered by private heath insurance, 25 % by public sector plans and interestingly 14% had no insurance coverage (Madore, 1992). This variation makes the process of policy formulations pertaining to different aspects of health care also difficult for the government. This complexity adds when it comes to critical and general policy issues in health care. Cost of heath care The most interesting fact in Canadian health acre is that cost becomes no barrier to health care access. This fact should be read together by the policy of the Canadian government to have its citizen’s uniform access to the heath care system. This would mean that all the people of Canada would get free medical treatment (Madore, 1992). In other terms the cost of the health care for the whole Canadian population regardless of the class of population would be met by the insurance system existing within the nation. Canada Health Act has made it mandatory that no user fee must be charged against any public insured services, except in the case of extended care for chronic illness (Madore, 1992). Very strict rules have been imposed by the government so as to prevent any such cost from incurring. These include substantial reduction in the aids provided to the insurance agencies in case any such user fees. Thus it is ensured that no Canadian citizen is deprived of medical care due to cost of the service. It is only for the non critical health care services like dental care that the Canadians have to pay for (Madore, 1992). As the case in United States goes, the health care system highly depends on the financial setup of the citizens and the access is limited accordingly. This limitation is made serious by the increased cost of medical insurance. Other matters of concerns are the low availability of public heath care programs and the high end user charges. In this context the quality of medical care highly depend on the buying capacity of the individual. The public oriented programs like Medicare and Medicaid however has limited opportunities and does not include the common man under its eligibility conditions. The presence of an uninsured population makes the situation more complex as they have bear the whole medical cost by them selves which actually terns to be much costly (Madore, 1992). Coverage policy The Canadian government has also maintained uniformity in the services covered under the insurance programs. The Canada Health Act has made it mandatory that all medically necessary hospital services must be covered by the health insurance plans (Madore, 1992).Interestingly, the list of services listed in the coverage also includes certain dental surgeries. In this context the medical policy of the Canadian government can be described as highly pro-citizen one. The provincial governments are given rights to amend the list of services under the coverage in accordance to the existing situations. In general they may include additional services which are not covered by the guidelines of the Canadian government. The extent of cost of the services in terms of money has not been limited. Thus the people are ensured to get full coverage with no regard to the cost of the health service (Madore, 1992). Contrary from the Canadian system, the extent of the coverage is hugely diverse in the United States. As per the health care system, the coverage policies are decided by the insurance company. Thus the limits and rules depend on their company regulations. This should be read together with the fact that insurance companies being private entities would look for their profit and thus would limit the coverage deliberately. However, the government regulates the insurance being promoted by private companies. This would insist them to cover the cost of minimum health services (Madore, 1992). The coverage also ends for the employees when the leave the company. There coverage of the cost of health services for the uninsured people also poses questions in the American health care system. In general it can be concluded that the factor differentiates the American system from the Canadian one in terms of coverage policy is the lack of uniformity and the resultants of increased privatization of the insurance sector. Regulatory policies The regulatory agencies for the health care system in Canada are completely public sector based. These agencies are of non profit nature controlled by the provincial governments. It is the provincial governments that decide the general policies pertaining to the cost of health care systems. These include the financial support for the health care facilities, cost for different medical services etc. Even the government has control over the maintenance and creation of medical facilities within the hospitals. It won’t be wrong to state that the Canadian government actually regulates and bears the cost of all health care activities within the country (Madore, 1992). The administration of the health care systems in the United States is carried out by a variety of agencies differing with the situations. It includes insurance companies, employers and also the governmental bodies. This diversity even makes it happen that the cost reimbursed for the same medical cause would vary in different cases. The limitations of this multi-payer have been confirmed by Baron (2008) .In totality there is no general agency which regulates the whole system. Conclusion While considering the facts evolved in the comparison of the American health care system with that of the Canadian system, it can be observed that the American version is generally lacking a public oriented approach. This very fact avers that though not copied to the fullest, the American system ideally should take lessons from the Canadian health care system. It is true that both the systems have limitations and benefits of their own. However, the key factors which differentiated the Canadian system were the public oriented approach, governmental intervention and public holding. This system makes an integration of cost, access and quality. On the other side the quality of American health care has always maintained its value. Kotlikoff (2009, p.29-36) has seriously criticized the existing health care system in USA and has suggested an entirely new ten point medical security system. Thrall (2004, 34-38) has urged the need for a shared vision for the medical system well followed by the private insurance companies, medical facilities and governmental agencies. The challenge before the American government in improving the heath care system would be bring in developments in cost, access and administrative control while maintaining the quality. References David, W. Conklin, (1990), Why Canada’s System is Better and Cheaper, Policy Options, May 1990, p. 18. Madore Odette (1992), The Canadian and American Health Care Systems, Retrieved February 24, 2009, from http://dsp-psd.tpsgc.gc.ca/Collection- R/LoPBdP/BP/bp300- e.htm Baron David (2008), Problems with the American Health Care System, Retrieved February 24, 2009, from http://dbaron.org/views/health.html Kotlikoff, Laurence J, (2009) ,Fixing health care before it fixes us. The Urologic clinics of North America 36(1):29-36 Thrall, Terese Hudson, (2004), How ready are we for reform? Without a shared vision, getting there will be difficult, Hospitals & health networks, 78(4):34-38, Read More