Health care system

“To provide an effective and just health care system and to forestall societal strains caused by the aging Baby Boomers, a Canadian-style government-sponsored, one-payer universal health insurance system should be instituted”. Currently in the United States, there is a widespread healthcare crisis. Approximately 20 years ago, medicine was in its “golden age”; doctors could provide what they felt was the best possible treatment for their patients without struggling with funding issues and insurance companies.

However, as more and more patients seek medical help, and as costs continue to rise, the golden age of medicine has been left behind. Doctors and nurses can no longer assess a patient without worrying about the bottom dollar. In turn, the government of the United States must attempt to remedy this healthcare crisis by devising a new healthcare plan that better serves patients while capping the skyrocketing costs. One solution to the current healthcare crisis has been the attempt to employ a Canadian style healthcare system in the United States.

The Canadian system, entitled Medicare, has many strengths. In 1966 the federal government of Canada passed a universal medical insurance law, and by 1971 the program was fully operational throughout the country 1. The Canadian system, which has many similarities to the Medicare program of the United States, offers equal healthcare to all residents of Canada and has mostly private, non-profit hospitals. Wealthy or poor, employed or jobless, retired or under age 18, every Canadian receives the same health insurance, financed in the same way. No Canadian would even imagine that leaving, changing, retiring from, or losing a job has anything to do with health insurance…Everyone contributes through the tax structure and everyone receives benefits.

All of the citizen-required revenue for the healthcare system comes out of general taxes, while the specific amount varies from province to province. In addition to healthcare for all citizens regardless of employment standing or socioeconomic class, the program also allows patients to choose their own doctor4. In fact, patients are even allowed to see specialists without referral; however, the doctor only gets paid the higher fee if the patient has a referral slip 5.

Recent studies show that elderly Canadians get 17% more services from doctors than those in the United States. Reports also show that Canadians see physicians more often and spend more days in the hospital than patients in the United States6. These qualities of the Canadian-style healthcare system are appealing to Americans who see the major faults with the current healthcare system in the United States and want a change.

Another major benefit of the Canadian style healthcare system is the socio-economic blindness toward patients. The hospitals and physicians cannot bill private insurers for their services (this practice was banned in 19847), which virtually eliminated preferential treatment of patients who can afford private insurance to cover their costs. This has been made possible because fees are negotiated with the provincial governments and the provincial medical associations, and a global budget was decided upon so fees remain the same.

The Canadian healthcare coverage provides a comprehensive healthcare system to their entire population at a fraction of the cost of the United States. The Canadian system has lower administrative costs than the United States, lower cost per patient service, and lower physician fees and prescription drug prices8. In Canada, seven percent of patients surveyed said they have experienced problems paying medical bills, as compared to 21 percent of patients in the United States9. More patient coverage as well as lower costs are factors leading many in the United States to question if we should adopt a Canadian style healthcare system.

The Canadian system not only provides all citizens with healthcare, but costs of healthcare are much less in Canada. This is accomplished by virtually no time spent on billing and administrative costs. In 1998, Canada spent 9.5% of their total GDP on healthcare costs, while the United States spent 13.6%10. The United States spends the most per capita on health when compared to Germany, the United Kingdom, Canada and Japan. The United States spends an average of $4178 per capita compared to Canada’s $2132 annually per capita11.

Unfortunately, the Canadian system is not without faults. New technology, as well as procedures that require new technology (such as cardiac surgery and MRI scans) are not performed at the majority of hospitals12. Not only are the high tech procedures not as widely available, but there is often a waiting list for elective procedures that require specialization13. This could be due to the fact that 55% of Canadian physicians are general practitioners (GPs), and not specialists14. This is a major point of criticism for the Canadian system, as patients (especially in the United States) do not feel they should have to wait for a surgery to be performed, especially if they have the monetary funds to pay for the procedure themselves. The healthcare system in Canada is now also removing some nonessential procedures from the coverage list15.

However, studies show that for lifesaving surgeries (such as a bone marrow transplantation for patients with leukemia) patients in Canada do not have to wait longer than patients in the United States16. In addition to these downfalls, in order to keep costs low, new and cutting edge prescription drugs are often not offered to patients, which is an outrage to many Canadians who feel they have a right to new prescription drugs.

To save funds, Canadian health officials delay the introduction of new and more expensive drugs. As a result it takes considerable time for new and more expensive medications to make it into the medicine chests of Canadians. Some never do. One hundred new drugs were launched in the United States from 1997 through 1999. Only 43 made it to market in Canada in that same period. Canadians are still waiting for many of them. However, because of this regulation of prescription drugs, Canada can also manage to keep the costs reasonable so most all can afford to help pay for their medication.

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