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Loading...The End of Universal Health Care in Canada?
Canada is in the beginning stages of a health care crisis. The federal government in Ottawa, which is controlled by Prime Minister Steven Harper’s Conservative Party, has indicated it plans to hold funding increases to the provinces’ Medicare systems in line with inflation when the current funding accord expires in three years. This will be a disaster for the provinces, and quite possibly the end of the universal health care system that Canadians take for granted.
Funding Formula Gap
Currently, the federal government contributes about 20 cents of every dollar spent by the provinces. The provinces themselves come up with the rest of the funding. Until 2013-14, Ottawa is committed to a 6% increase in its contribution every fiscal year, but they plan to drop back to the rate of inflation at 0 – 2% when the current agreement expires.
Given that health care costs are increasing at a rate of 5 – 7% every year, the provinces will have to make up the difference by raiding funding from other programs like education, or simply cutting available Medicare programs by reducing or eliminating services, adding user fees, or allowing more private health insurance companies to operate within their jurisdictions.
False Utopia
I emigrated from the Midwest United States to Western Canada nearly four years ago. Since then I am often reminded by the liberal American friends I left behind just how lucky I am to live in a country where health care is universal and free.
But it’s not that simple in the way that reality never is. While the Canadian Medicare system is in theory a single payer system with a level playing field in terms of accessibility, it’s hardly free. And not many average Canadians would say it was the best system in terms of customer service, ease of use or even access.
Never Recovered From Cuts in 1990′s
The 1990′s saw huge cuts in nurses and hospital access in an effort to reduce and cap increasing costs, and most provinces have yet to recover from either.
Staff shortages continue and most hospitals run at capacity, which means that anything short of a life-threatening emergency strands patients on waiting lists or lining the hallways of emergency rooms, waiting for a bed to open up.
Worst of all, in the eyes of Canadian citizens, the budget slashing of the 90′s left them with an embittered medical profession, which now considers patient service dead last on their list of priorities. Complaints about service are nearly always met with a rejoinder to “contact your local MP and let them know you think there should be more funding for hospitals, health care workers and doctors.” Health care professionals in my province, Alberta, see patients as a tool for promoting their grievances more than charges in their care.
Personal Experience
While I have never seen a doctor bill – nor does anyone else in Alberta – prescription drugs are not free. Only those who have private prescription plans through employers escape the full brunt of the cost for medications. In addition, eye and dental care is not covered by Medicare for anyone over the age of five, and catastrophic illnesses, like cancer, still carry the frightening potential for financial devastation if a person doesn’t have some sort of private health insurance in addition to Medicare.
Would I trade the system here for what I had? I was a public employee back in the States. My healthcare plan was worthy of envy, but by no means typical of what most Americans have. So if I had to choose between what I personally had and what I have now, I would gladly take the insurance I had as a teacher with its easy access to doctors, hospitals and services. I never waited. I didn’t queue up as they do here. I really didn’t worry.
But if I had to trade my Canadian Medicare for what passes as health insurance for most people in the United States, I would keep my Alberta Health.
I am lucky enough to have a family doctor. Many Canadians do not have a personal physician due to the doctor shortage, but this is largely the fault of the Canadian Medical Association (CMA) and not Medicare. The CMA keeps the numbers of working doctors artificially low by controlling the number of applicants allowed into medical schools and by lobbying the provinces to make it difficult for foreign-trained physicians to obtain a license to practice here. This allows them to maximize their profits as billing the provincial systems by office visits and procedures pays them piecemeal essentially. Doctors in Canada have no interest in seeing the current system continue and some openly advocate for private health insurance because it is the best thing for them financially.
I have prescription drug, eye and dental care through private insurance provided by my husband’s employer, so it is a misnomer to say that private insurance for health care isn’t available in Canada. So aside from the fact that medical services basically don’t exist outside emergency rooms and a few medi-centres on weekends and holidays, my family and I have adequate coverage and care. However, the working poor in Canada face some of the same problems they do in the U.S., as they are often forced to utilize ER’s for common complaints and can’t afford medications, eye exams or glasses and basic dental care.
What’s Next for Canadian Medicare?
The Federal government in Canada currently shows little interest in sitting down to renegotiate the funding accord with the increasingly frantic Provinces. The aging Baby Boomer population and the expense of chronically ill patients, who are living longer and in need of more services, is not a problem faced just in the United States, but Canadians are not quite ready to deal with the realities of setting limits and prioritizing, which is something they have in common with their American cousins.
What Do You Think?
Were you under the impression the Canadian Medicare system was something other than what is described above? Could the U.S. benefit from a similar system? Let’s here from you.
Read more: canadian medicare system, health policy, universal healthcare
photo credit: No Stethescopes by Mykl Roventine
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+ add your ownThe CMA is NOT the body that licenses physicians. Each province has its own College of Physicians for licensing physicians. The system is complex and intertwined though so the CMA and its provincial counterparts do influence the physician supply in other ways.
thanx for info
thanks for the info.
Frank B. is absolutely right. Encouraging physicians to rely on expensive highly-technologized testing is destroying the "art" of medicine. This is a problem common to both public and private systems. The best doctor I have seen in years was a 91 year old locum who works two afternoons a week to "stay out of my wife's hair" -- he actually still knew how to take a good history and work through a differential diagnosis.
Getting doctors to actually think of themselves as providing primary care rather than as simply quasi-bureaucrats writing referrals and test requests would be a good step in fixing health care everywhere. Fixing *access* to health care in the US is another thing entirely, as is keeping access to health care here in Canada.
Private health care simply is not better. The US has the highest rate of invasive cardiac procedures (45%) higher than the next highest country, but still has not any better heart health -- and a life expectancy lower than Canada, Australia, Sweden, etc. In a for-profit system, it is profit, not what is best for the patient, that rules. Patients in the private system are subject to many unnecessary tests and procedures because that's what makes money for the providers. A two-tier system will cost Canada more and provide worse health care -- even Canada's banking CEOs admit this!
Here's a link to two doctors explaining why it is essentail to save universal medicare in Canada: http://www.publicvalues.ca/ViewArticle.cfm?Ref=00809
Terrible. It seems like all of North America is in a downward spiral.
Health care has been rendered too expensive by the level of technology. All those "machines the go 'ping' " are VERY expensive.
The irony is that all this whiz-bang hi-tech stuff has made health care WORSE for most people.
Any public system should emphasize the low-tech stuff first, and have the high-tech stuff as a last resort.
It would actually be worse in the U.S.
Canada has a tradition, culture, and a legal code which include Crown corporations. The U.S. does not. A public health-care system in the U.S. would be manipulated ruthlessly for partisan politics. "Not going to vote for my party? Too bad for the hospitals in your area."
I have already spotted a great big red flag: The public health-insurance premiums can vary only up to a factor of two for any condition (age, medical history) aside from location. I bet the premium-disparities will follow the electoral map ... and I don't gamble. "Look, my opponent's supporters can pay for an effective campaign. Time to loot them ... I mean have them pay their fair share according to whatever bogus statistics ... for health-care."
The sad fact is that we really cannot afford our health care as it is being run. We need a more cost-effective system and that means going private, or at least significantly two-tier.
The problem with the public system is this: The guys at the top are elected for a good campaign, not promoted for good performance. They are paid to enact policies that look good to voters, not ones that are sustainable and actually beneficial. This is a problem throughout the public sector.
For example, the Quebec government got service in rural regions by setting an arbitrary quota on the number of new doctors licensed to begin practice in metropolitan areas each year. There is a shortage in Montreal but nobody can legally fix that. There are positions, even private-sector, and people who want them, but the licenses are not given. They also instituted a program where they, as the single payer, cut pay by 30% if new doctors do not spend most of their work-week in specific jobs where there are publicized shortages. Now there are shortages in primary care.
I saw a building which looked like a large hospital in Montreal, but it turned out to be the health authority's office-building, the size of a hospital. All funding increases go into the bureaucracy while cuts come from front-line care. Canadian health-care is broken due to intrinsic problems in any public system.
Here is a good article:
http://fullcomment.nationalpost.com/2010/11/13/scott-stinson-fight-goes-on-after-doctor-leaves
I'm sorry I must be missing something. In Canada we pay for the most part under $1,000. per person per year for health coverage without a 'no pre-existing illness' clause to restrict coverage. In the U.S. I understand that health coverage runs into many thousands.
Even if we did pay a little more for our coverage which is based on income level we would have just as good or better coverage including service than those in the U.S. do.
The other point which makes me shake my head in wonder is... why would any sane person say to him/herself "Gee I really want to pay $10,000. in insurance premiums instead of $1500. because I'm not going to pay for somebody else's coverage". HELLO!
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