The
Basics of Canadian Health Care
September 15, 2017
11:48 AM
How many
of you out there really understand our nation's health care system? Like what's
really going on behind the scenes? Why
are there rumours out there that wait times in the United States are far
shorter than those in Canada? Or that Canadians near the border
"flock" to the United States for their health care?
Today,
I'm going to explain to you exactly how our health care system works, how it
compares to the United States', and why these rumours are false.
Our
publicly funded health care system is called Medicare. This provides free essential health care
services to all Canadian citizens, which means that residents don't have to pay
out-of-pocket to go to the emergency room, for example. Medicare is regulated at the provincial
level, which is why different provinces and territories have different health
cards. You can think of our system as
actually being 13 different insurance plans (one for each province and
territory) all united under one umbrella.
It is
each province and territory's responsibility to manage the delivery and
organization of these essential health care services for their residents. It is the federal government's responsibility
to establish and maintain national standards through the Canada Health Act, to
provide funding for each province and territory, to support the delivery of the
services and to offer general health-related support.
As
mentioned before, the Canada Health Act is an act that sets the standards for
the provincial health care systems to follow.
It was established in 1984, and assures that things such as public
administration, accessibility and portability standards are met. It requires that provincial and territorial
plans:
·
Operate on a non-profit basis and be run through
public authority
·
Assure all medically necessary services are
covered and provided for, specifically by hospitals, physicians and hospital
dentists
·
Assure all residents of their province are
covered
·
Assure residents are covered if they travel
within Canada, and that they have limited coverage outside of the country
·
Are funded by the federal government through the
Canada Health Transfer, and earn additional funding elsewhere (ex. hospital
foundations)
The
federal government is also responsible for providing health care services to
specific populations, such as Indigenous peoples living on reserves, members of
the Canadian Forces and some refugees.
In
addition to essential primary care, provincial governments can provide
additional coverage to certain groups, such as to the elderly and to
children. For example, people under the
age of 25 in Ontario can now get free prescription medication. Additional coverage for non-essential
services, such as physiotherapy, can be paid for out-of-pocket or through a
private health insurance plan, such as UHIP here at the university.
How does
this compare to the U.S? Well, Canada
runs on a publicly funded, privately delivered system. The United States, meanwhile, operates on a
privately funded, privately delivered system.
The same essential services that would be free in Canada you would have
to pay for in the U.S. (unless you are over the age of 65 and qualify for
Medicaid). At first, you might think
that privately funded system saves the American government lots of money, but
the data proves otherwise. In 2013,
Canadian health-care spending only accounted for 10.7% of the GDP, whereas it
accounted for 17.1% of the GDP in the United States. This is why so many American presidential
candidates, such as Bernie Sanders, have endorsed the Canadian single-payer
health care.
While
most people seem to love our system, there are those who are concerned with things
such as quality of health care and wait times.
People tend to believe that because essential services aren't paid for
out of pocket that there is no competition between health care providers, and
that you can get poor health care just because they are not incentivized to be
ahead of the competition. They believe
that if people had to spend their own money that they would choose the finest
hospital, and that this inspires hospitals to be at the top of their game,
rather than no spending your own money and going to the closest hospital.
This is
TOTALLY untrue! The regulations and
standards set out by the Canadian Health Act are so specific that you're
guaranteed to get the same treatment at every single hospital or doctor's
office you visit. It's also worth noting
very few people travel across the border for health care. In most cases, it's people who live near a
border to the United States and where it would be faster for them to go to an
American hospital rather than a Canadian one.
Realistically, having the CHA (Canadian Health Act) regulate these
standards across the province is a better setup than if it were to be
competition based - if you are having a heart attack, you're not going to go
search for which hospital has the cheapest rates and the best reputation. You're going to call 911 and go to the
nearest hospital. Here in Canada, you
can be assured that you'd get the same care no matter where you are.
Another
common myth about our health care system is that we have incredibly long wait
times. Yes, for some non-life-threatening
cases, wait times might be a bit longer than usual. However, there are standards in place where
those who are currently in danger get admitted and are given priority. The reason not everyone can be admitted right
away is because of the government's need to limit resources. This is a way for them to save LOTS of money
on health care, and it prevents exhaustion of the health care services. Think of an emergency room nurse having to
treat many patients in one night. They
are on their feet for 12 hours, and would rather get more quality interactions
with fewer patients during these hours than be overwhelmed by many patients at
once - many of whom, let's face it, aren't in danger of losing their
lives.
So, our
system might not be the perfect setup, but it accomplishes what we need, and
assures that nobody who is a Canadian citizen is denied access to health
care. I hope you have learned a little
bit more about our government's role in health care, and that this helps you to
understand a bit about what goes on behind the scenes.
Jacob
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