Canadian approach to a Healthcare service provision

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Overall review

Canadian medicine is one of the most upscale in the world. For residents and citizens of a country who have lived on its territory for more than three months, most services are covered by insurance (but not all). In most cases, if an individual has a job in a good company, the insurance is provided by the employer. State insurance in the country is mandatory. But policy prices vary widely in each province. For example, calling an ambulance for an MHI policy in Toronto will cost $110, in Vancouver – $90, in Ontario – $45.

healthcare service

Most prescription drugs are free for people under 25 years old and over 65 years old. For the rest they cost $6-15 from the first recipe once a year – the rest is covered by insurance. Moreover, if a person gets insurance at the place of work, his entire family often takes out one policy. With an insurance cost of $45 per month (deducted from salary), the policy covers dentist services up to $ one thousand per year for cleaning and routine inspection. Complicated procedures will be partially covered by insurance (up to 80%).

Ontario Initiative

From January 1, 2018 in Ontario, prescription drugs started to be provided free of charge to children and youth under 25 years old. The Ontario Government Initiative has been praised by healthcare providers across the country. According to doctors, the illnesses of many small patients could be defeated faster if all the necessary medicines were available to them.

The question remains whether this initiative will extend to all categories of the population. Prime Minister Caitlin Wynn on Friday expressed the hope that the federal government and other provinces will follow Ontario’s example. However, administration remains silent on this subject. The Ontario Initiative was the first such step in the country. Prior to this, in Canada, free drugs were provided only to the poor and elderly, sometimes with a partial surcharge.

According to Canadahealthcaremall.com, the budget for covering free medicines for young people was $ 470 million. Medical care for younger age groups is lower in cost than for middle-aged and elderly people. The program also saved employers some insurance money. As Ontario’s health minister Eric Hoskins explained, his intention was to transfer those funds to businesses and their employees.

What is to be improved?

Medical care is excellent in Canada. There are a lot of all kinds of convenient devices to make people comfortable. If you ask the Canadian what kind of medicine he has in his country, he will find many unkind words, but he will not stint good ones either. You can read in all booklets about Canada that ‘Canadian health care is one of the few areas that the state is rightly proud of,’ and this also will not be untrue.

Officially, Canada is considered a country in which ‘free medicine’, ‘medicine is one of the most effective in the world’, ‘what Canada is rightfully proud of’, ‘is rightfully considered one of the best in the world’, in general. To confirm or refute this, we decided to turn to the Mapofmedicine.com.

In early March 2018, the Star newspaper reported that in Markham, Ontario, at least three cases of group A streptococcal infection were recorded in a maternity hospital. One woman in labor died, two others were saved. At the same time, CBC News reports that in the province of New Brunswick, an infant died after refusing hospitalization in a hospital. The girl was born healthy, but two weeks later she began to cough. The hospital said that this is a temporary condition, the consequences of a caesarean section will pass by itself. The condition of the girl nevertheless worsened, and the mother again went to the doctors. In three weeks, her parents visited five doctors, and the girl was given x-rays and tests. It turned out that she had an RS virus (respiratory syncytial virus).

At the request of the mother to hospitalize the girl in the hospital, they said that there were no places, they could not be hospitalized. The doctor suggested coming the next day, but the girl died in the evening. The ambulance summoned could no longer help her. The National Post reported a few days later that a resident of Ontario died without waiting for a place in the hospital. 72-year-old resident of London (Ontario) fell ill with pneumonia on vacation in the Dominican Republic. He had to wait two weeks for a bed to be vacated in the intensive care unit of the Ontario hospital. But it was too late. According to the same newspaper, in the same month an incident occurred with another resident of London (Ontario). The man had a heart attack when he was in the U.S. The insurance company prepared everything necessary for transporting the patient to Ontario the very next day, but there were no empty seats in the provincial hospitals.

Unfortunately, judging by these examples, we have to admit that Canada cannot be called a problem-free medicine. If the system has such failures, then it is not perfect, then something is wrong, and calling it the most effective in the world will be incorrect. Canadian health care cannot be smeared only with black paint, but you should not blindly admire it either.

Elderly Canadians also think so. According to The Commonwealth Fund’s annual International Health Policy Survey, Canadians over 65years believe that although there is a lot of good in the country’s healthcare system, on the whole, pensioners are more and more dissatisfied with its condition every year.

Canadian doctors do not agree with the assessment of Canadian medicine as “the best” and “most effective”. When asked how effective the country’s health system is, many doctors answer: “No, not at all effective.” Doctors are dissatisfied with both the system itself and the lack of funding.

Let us explain that taxes (local, state, and enterprise taxes) are the main source of financing for healthcare in Canada. Public health spending is almost entirely covered by general taxation that goes to the federal and provincial and territorial governments. Some provinces use lottery sales taxes as financing, but this is a very small fraction of the total financing. The tax system in Canada is quite complicated, worthy of a separate article, so we’ll call it rough figures – an individual deducts from 25% to 45% of the tax on his salary, some of which goes to the health fund. Private entrepreneurs pay a special tax on medicine.

Therefore, it is incorrect to say that medicine in Canada is free. By the way, Canadian taxes are one of the highest in the world. But these high taxes make it possible to cover outpatient, that is, visits to doctors, and inpatient, that is, hospital treatment, as well as caring for old people, people with disabilities and people with mental disabilities. This is a big plus of the Canadian health care system, despite the fact that Canadians themselves pay for all this, though indirectly.

That is, to a large extent, the Bismarck system operates in Canada, when the population makes mandatory contributions to the health insurance fund, and the state distributes these funds. At the same time, doctors are private entrepreneurs on a contract with the government. Canadian doctors are businessmen who provide services, but their work is required to fit into the public funding system and follow government regulations.

Considering that for a businessman his profit is most important, such government intervention naturally causes dissatisfaction with Canadian doctors. The result of the discontent is the outflow of specialists from Canada to America. This can explain the ongoing shortage of professionals, and, as a result, overcrowded emergency rooms and the situation in hospitals, such as that described at the beginning of the article. Add to this the long waiting lists for vital surgical operations, constant delays in diagnostic tests – this has become the norm in Canada. Canadians regret that they have long been proud of their healthcare system.

On the other hand, the state monopoly on medicine is difficult to reorganize, is rather clumsy, and slightly transparent, which allows politicians to use its shortcomings for their own purposes. The populist games of politicians, who make both patients and doctors hostage to their games, lead to an even greater crisis in the medical system.

In general, being called free, medicine in Canada is a service provided by the state, which, in turn, is deeply dependent on business doctors, populist politicians and the taxes of Canadians themselves. The state plays the role of a contractor who, with the money of the population, hires subcontractors that provide services to this population. And it is obvious that such a model, with all its positive assumptions, is becoming increasingly ineffective.

A pure “pay-for-health” model, when a direct business transaction is concluded between a businessman doctor and a patient (sometimes represented by a private insurance company) also exists in the Canadian healthcare system. And in fact, this does not improve the situation with medicine in the country.

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