Access to Health Care in Canada - Research Paper Example

A Research Report on Access to Health Care in Canada OVERVIEW OF HEALTH CARE SYSTEM IN CANADA Canada is the second largest country in the world. The country has a government-funded, national health care system based on the Canadian Health Act of 1984 (Health Canada, 2012). Canada’s ten provinces and three territories run a statewide health insurance program “Medicare”, operated without any cost-sharing (Health Canada, 2012). Medicare is a national program that is composed of 13 interlocking provincial and territorial health insurance plans, all of which share common services and basic standards of coverage (Duckett&Peetoom, 2013). This publicly funded health care is run by taxes generated from Federal and provincial and territorial tax roll. These include personal as well as corporate taxes, sales taxes etc. Provinces have the power to charge a huge premium to Canadians to help in providing health care services.This does not mean that absence of a premium will limit access to necessary medical health servicesfor an individual. The basics including public health are access to a family doctor, emergency care, basic hospital treatment, sanitation, guard and treatment of infectious diseases and related education. With assured access to public hospitals and physician services, each province can decide whether to cover supplementary benefits, like dental care and drug coverage (Duckett&Peetoom, 2013). A health card is issued to every enrolled Canadian with no involvement required in billing and reclaim. Dental and vision health care, physiotherapist, massage therapies, chiropractic treatments are not covered, but insured by employers through private companies, physiotherapist, massage therapies and chiropractic treatments (Health Canada, 2012). CANADIAN HEALTHCARE POLICIES Canadian health care policy, as of 1984, is established in respect to insured health services and extended health care services, which are provided under provincial law after a full cash contribution (Fierlbeck, 2011). The principle of this law is to provide a health care system that is universally available to permanent residents, is without income barriers, has comprehensive coverage, is portable within Canada and elsewhere and is administered publicly. Currently, Canadian health policy focuses on Pandemic preparedness, immigration-caused diversities, aging, new biological advances and climate change (Fierlbeck, 2011). 1. Aboriginal health policy: Aboriginals’ lower health status is improved via provinces/territories and the Federal Government funds through Canadian health transfer (Fierlbeck, 2011). Human Resources and Social Development Canada (HRSDC) helps strengthen the ability of disabled Aboriginal people to compete in the Canadian job market and providing various health-related home care services such as case management, nursing care, in-home respite care and personal care (James&Kasoff, 2013). The National Native Alcohol and Drug Abuse Program (NNADAP), a Health Canada program beats the urgent and visible nature of alcohol and drug abuse among Aboriginals by providing over 550 prevention programs with over 700 workers (James&Kasoff, 2013). 2. Canadian forces healthcare policy: CF members are excluded from insurance coverage under the Public Service Health Care and Dental Care Plans. However,they receive the same care and publicly funded benefits and services that Canadians receive under their provincial health care plans. Preventable illnesses and casualties in garrison and on deployment are dealt with (Pierre & Pollack et al., 2007). 3. Veteran healthcare policy: Eligible veterans and other qualified clients are entitled to health care benefits under the Veterans Health Care Regulations. These range from medical, dental and surgical care, prosthetic devices and home-adapted services and supplementary benefits like travel costs for treatment and diagnosis (Pierre & Pollack et al., 2007). 4. Obesity health policy: It focuses on new nutritional labeling , annual Winter Active and SummerActive initiatives, to encourage Canadians to get involved in healthy living activities, school health programs, urban lifestyles and diabetic prevention (Pierre & Pollack et al., 2007). 5. Persons with disabilities policy: Main priority areas are improvements in transportation, housing, employment and customer services (James&Kasoff, 2013). CURRENT STRUCTURE OF CANADIAN HEALTHCARE SYSTEM Medicare, an interlocked set of ten provincial and three territorial health systems, provides broadrange of health services which include the following. 1. Primary health care services: These comprehensive services, as first point of contact with the system, include prevention and treatment of common diseases, injuries, basic emergency services, referrals to hospital or specialist care, primary mental health care, palliative and end-of-life care, health promotion, healthy child development, primary maternity care and rehabilitation services. Doctors in private practice are paid through fee-for-service payment schedules. Nurses and other health professionals are paid through salaries (Duckett&Peetoom, 2013). 2. Secondary services: These include referral to specialized care at a hospital, long-term care facility or in community and sometimes at homes. These services, however, not supported by Canada Health Act are provided and paid by provinces and territories, even though their range might be limited or in some cases paid by the individual. Palliative care focusing on those nearing death provide not just medical services but also emotional support as well as pain and symptomatic treatment, community services and bereavement counseling (Duckett&Peetoom, 2013). 3. Additional (Supplementary) services: Even though not covered under Medicare, senior citizens, residents with low income are also given health services coverage.These benefits include a. dental care b. getting prescription drugs outside hospitals c. vision care d. medical equipment and appliances and other health professional services. Those not covered under the program pay thorough private insurance plans or employee-covered private health insurances (Duckett&Peetoom, 2013). OUTCOME OF MEDICARE SYSTEM Canadians living 2 years or more than the average American are due to the healthcare system of the country. According to the Organization for Economic Corporation and Development (OECD) despite spending half as compared to US on healthcare, Medicare serves with Canadians’ increased life expectancy, every legal resident holds health insurance, highly skilled healthcare professionals, internationally recognized health institutions and provides universal coverage (Bryant, 2009). To measure health performance of Canadian system, it was evaluated with comparison to other countries on the basis of 11 health indicators. These include a. life expectancy b. premature mortality c. self-reported health status, d. mortality because of cancer, circulatory disease, respiratory disease, diabetes, musculoskeletal diseases, mental disorders, medical misadventures and infant mortality (Conferenceboard.ca, 2014). The following rankings were generated after the evaluation. Table 1.0 (Conference Board of Canada, 2012) As it is evident from Table 1.0, although Canadians boost of their healthcare system, it faces some challenges and certainly require improvement. Aging population, diversity in cultures, rising rate of chronic diseases, changing health trends, long waits, shortage of doctors and healthcare providers, and tackling environmental health issues are some of them (Bryant, 2009). 1.Reduction in wait times: In 2009, Federal Government and all provincial governments improved via 10-year plan, prioritizing on reducing wait times in 5 areas by clearing backlogs of patients requiring treatment, building capacity for regional centre of excellence; expanding ambulatory and community care programs; and developing and implementing tools to better manage wait times. These include cancer, heart, diagnostic imaging, joint replacement, cataract surgery. This was clear in 4 provinces namely British Columbia, Saskatchewan, New Brunswich and Prince Edward Island. Still lot of other provinces faced the same concern (Health Canada, 2012). 2. Shortage of doctors and other health care professionals: Provincial and territorial efforts have focused on training and hiring more health professionals and increasing immigrants. Canada had more than 75,000 doctors working last year, an increase of 4 per cent over 2011, and governments paid them $22-billion for their services, about 9 per cent more than the previous year, according to new data released Thursday by the Canadian Institute for Health Information (Health Canada, 2012). 3. Primary healthcare reforms and electronic health records: Advancements in electronic health technologies via completion of baseline electronic health records, efficient registry of patients and follow-ups led to improved access to care in remote areas, fewer drug interactions and improvements in chronic disease management. (Bryant, 2009) In 2013, the Health Council reported that the use of EMRs has more than doubled since 2006, with 57% of Canada’s primary care physicians now using electronic medical records; and – in 2012, 43% of Canadian primary care physicians routinely use e-prescribing technology, up from only 11% in 2006 (Health Canada, 2012). 4. Patient safety: This aspect which also includes avoiding medical errors or adverse reactions is an important point of concern for Canada to improve Medicare. Federal, provincial and territorial Governments along with medical professionals and organizations work to understand and treat the risks involved in delivering this health care (Health Canada, 2012). CRITICISM: The outcome of the efforts conducted by Canadian government for prompting a reformation in the overall Medicare system were regarded as disappointing in a report from Health Council of Canada, namely “Better health, better care, better value for all.”(Health Council of Canada, 2013) Emerging needs like reducing wait times for important procedures and primary health care services improvement has not sufficed as other countries have done. Home care services are not to the point for senior citizens and prescription drugs costs are still above the reach of many Canadians. This results in skipped doses and prescriptions going unfilled at the rate of 1:10. Even though life expectancy has increased a little those with chronic diseases has also increased. CONCLUSION: To enhance quality in healthcare was the most important point for First Ministers’ Accord on Health Care Renewal in 2003 and First Minister’s Meeting on Future of Medicare in 2004. After 10 years, still, access to important health services still differs greatly in many provinces and territories. Income, cultural factors and education also affect access to care like drug coverage let many low-income Canadian nationals to be without the drugs they require on regular basis. A need for better strategies in this regard is indeed indispensable for the improvement of Canada’s health care system and for this, health policies must be formulated after evaluating the drawbacks and shortcomings of current system and policy structure. References Bryant, T. (2009).An introduction to health policy. Toronto: Canadian Scholars' Press Inc. Conferenceboard.ca. (2014).Health performance | health outcomes | Canada health ranking. [online] Retrieved from: http://www.conferenceboard.ca/hcp/details/health.aspx [Accessed: 23 Jan 2014]. Duckett, S. J. &Peetoom, A. (2013).Canadian Medicare. Montreal: Mcgill-Queen's University Press. Fierlbeck, K. (2005). The development of political thought in Canada. Peterborough, Ont.: Broadview Press. Health Canada (2014).About Health Canada. [online] Retrieved from: http://www.hc-sc.gc.ca/ahc-asc/index-eng.php [Accessed: 23 Jan 2014]. Health Council Of Canada (2013). Health council canada. [online] Retrieved from: http://www.healthcouncilcanada.ca/content_bh.php?mnu=2&mnu1=48&mnu2=30&mnu3=53 [Accessed: 24 Jan 2014]. James, P. &Kasoff, M. J. (2013).Canadian studies in the new millennium. Toronto: University Of Toronto Press. Pierre, N., Pollack, N. &Fafard, P. (2007).Health policies and trends for selected target groups in Canada.CPRN Research Report. [report] Ottawa: Canadian Policy Research Networks, pp. 1-30. Table 1.0 Conference Board of Canada (2012).Canada health ranking. [online] Retrieved from: http://www.conferenceboard.ca/hcp/details/health.aspx [Accessed: 24 Jan 2014]. Read More