There are both strengths and downfalls of the Canadian style healthcare system. The Canadian system does a superb job granting all citizens the right to healthcare while not discriminating by any factors. However, the downside of their program is the long waits for procedures and less access to cutting edge treatments and technology. But, despite some complaints from residents, overall, the Canadian system usually receives positive reviews from both policymakers and patients. As the healthcare commissioner in Canada, Roy J. Romanow, Q.
C., stated in his 2002 statement about Healthcare in Canada:I am pleased to report to Canadians that the often-overheated rhetoric about Medicare’s costs, effectiveness and viability does not stand up to scrutiny. Our health outcomes, with a few exceptions, are among the best in the world, and a strong majority of Canadians who use the system are highly satisfied with the quality and standard of care they receive. Medicare has consistently delivered affordable, timely, accessible and high quality care to the overwhelming majority of Canadians on the basis of need, not income.It has contributed to our international competitiveness, to the extraordinary standard of living we enjoy, and to the quality and productivity of our work force. This sentiment is also shared by many Canadian patients.
When asked, 80% of Canadians would not want to go to a medical system like the one provided in the United States, which shows Canadian’s satisfaction with the healthcare system overall.As many look to the north for ideas for a new healthcare program, an equal number in the United States do not feel large changes need to be made. Proponents of the United States system site Medicare and Medicaid as success stories, and believe the current health plan should remain in tact with little or no changes. The healthcare system of the United States contains three major subsystems, Medicare, Medicaid and employer-sponsored programs. Each program has its strong and weak points.
The federal government runs Medicare, which provides healthcare assistance to those over 65 years of age and people with permanent disabilities. Medicare is separated into two parts, part A and part B. Part A is mainly financed by payroll taxes, and covers inpatient hospital stays.
Part B covers physicians visits and outpatient care, as well as in-home care, (which requires a small premium and co-payment, and is voluntary). Part B of Medicare also includes preventative medicine such as mammographies and other cancer screenings20. Medicare succeeds in providing the minimal necessary assistance to the elderly residents of the United States.
Opponents and critics of Medicare cite the huge expense as a major downfall. Medicare is one of the government’s largest expenditures. In 1970, the government consumed approximately 3.75% of the federal budged, and in 1995 consumed 10.
5% of the budget. In 2000, the federal government spent 250 billion dollars on Medicare21. These costs are also predicted to rise in the future.
Critics of the program question the consistently rising costs, and wonder when they will level off. The allocation of Medicare funds is also a frequent point of debate. “Some claim that more resources should be freed up for children, others that too much public money is spent on the elderly…
Critics argue that the program inadequately meets the needs of the aged and disabled”22.Excessive rationing of healthcare for the elderly has been a rising trend in the United States. This has spurred legal battles across the country over legal responsibility of the HMOs to provide adequate care for their patients. Recently, the Supreme Court ruled that Medicare patients could sue HMOs that deny patients necessary but expensive care that they refuse to pay for23. This ruling is in response to the excessive amount of healthcare rationing that has been taking place by the HMOs.Other downfalls of the Medicare program include the lack of prescription drug coverage. Patients who are covered by Medicare do not typically have prescription drug coverage, unless a separate Medigap coverage is purchased.
As the population-percentage of the elderly continues to increase, prescription drug coverage (or at least partial prescription drug coverage) is an essential component that has been left out of the equation.It is expected that prescription drug spending will double during the next five years, with the 65-79 age group paying approximately $1,400 per year on drugs24. If this trend progresses as predicted, the elderly will not have the means to pay out of pocket for essential lifesaving drugs. In addition to the elderly, the Baby-Boomer generation accounts for an extremely large portion of the prescription drug markets. Policy makers must look toward the future elderly populations and adjust current healthcare policies so they will accommodate the needs of the elderly today, as well as the elderly population of future generations as well. Medicare must be adjusted so at least partial coverage of prescription drugs is included.
Two other large problems arise with Medicare. When Medicare was first established, it initially focused on providing for hospital expenses that are now supplemented by outpatient treatment and prescription drugs. However, adjustments for these factors have not been made (i.
e. covering a portion of prescription drugs and paying for outpatient services). In addition to this, Medicare is a government program that was imposed on a private, decentralized healthcare system, which is often cited as a source of the excessive costs, and somewhat disorganization of the program.Another subsystem of the United States healthcare system is the Medicaid program; a state/federal program that supports low-income Americans. Medicaid assists low income families with children who meet specific requirements, disabled and the elderly, children under six years old, women who are pregnant and whose family income is below 133% of the federal poverty level, and children under 19 years old who have a family income level below the poverty line.Medicaid provides the poorest people in the United States with basic health care, which is an essential component for a country such as the United States that embraces a large number of immigrants, to help people in economic hardships with basic services such as healthcare. However, the Medicaid program is often criticized for charging the most to patients who have the least. Also, many who are eligible for Medicaid and other government-funded assistance do not participate, with reduces the efficacy of the program.
The last subsystem of the United States healthcare system is the employer-sponsored branch, which is a partnership between employers (typically large and medium businesses) and their employees. The employer sponsored branch typically covers middle aged Americans who work in fairly large corporations, as small businesses often down have the means to assist their employees with a large portion of their healthcare coverage.The uninsured population who do not fall into coverage from either Medicare or Medicaid are extreme problems for the United States healthcare system.
Major problems arise in this system when the unemployed (and people who are moving from job to job) get stuck in-between jobs, and then get sick. This leaves people uninsured and needing healthcare but not having the resources to pay for it out of pocket. In the year 2000, approximately 38.7 million Americans lack private health insurance, and were not enrolled in government health care programs26.Many people gain or lose insurance for part of a year, and these gaps in coverage have an impact as well. In 1997, one-third of working-age adults reported they had some period of time in the past two years when they were uninsured, and most of these people were without health insurance for more than a year. The self-employed and the entrepreneurs also are another downfall to the healthcare system in the United States. This leaves the person to provide complete coverage for their own insurance costs, and that of their families, which is extremely expensive, and often an unreasonable goal.
“The majority of the uninsured are neither poor by official standards nor unemployed. They are accountants like Mr. Thornton, employees of small businesses, civil servants, single working mothers and those working part time or on contract.”The last group of uninsured is those who are non-poor and working. However, many are not offered insurance at work. More than eight out of ten uninsured Americans are workers and dependents of workers, and approximately 74% of uninsured are in families with at least one part time worker29. Recent studies in California show that many are not offered health insurance at work.The majority of people who fall into this group are single, white, and under the age of 40.
A staggering 81% of the uninsured in California are employed, and still do not have health insurance 30. These large populations groups of uninsured in the United States are huge gaps in the healthcare program. Studies show that “employer-sponsored health plans are paying 48 percent more out of their own pockets for care than they did three years ago.”