Cities have to spend this money, taken from local taxpayers, because Canada's medicare system is the only universal, public health care system among developed countries that does not include universal coverage of prescription drugs. It is not wrong for cities to care for their employees. But leaving these costs to the cities makes about as much sense as requiring every homeowner to maintain the roads and infrastructure surrounding their property. Here's why.
I had a vision of cultivating a practice where patients felt heard and cared for, and where I could provide full-spectrum family medicine care, including obstetrical care. My practice embraced the principles of patient-centered collaborative care. It employed the latest in 21st-century technology. I loved my work and my patients. But after five years of constant fighting with multiple private insurance companies in order to get paid, I ultimately made the heart-wrenching decision to close my practice down. The emotional stress was too great.
The dismal record of for-profit hospitals illustrates the problem with running hospitals as businesses. The for-profits have higher death rates and employ fewer clinical personnel like nurses than their non-profit counterparts. But care at for-profits actually costs more, and they spend much more on the bureaucracy, a reflection of the high cost of implementing shrewd financial strategies. Canadian hospital administrators don't have to play financial games to assure their survival.
Employers want their drug plans to be as competitive as those offered by other employers. So what happens when the norm is to cover all new drugs at any cost, even if the drugs do not provide additional therapeutic value? Well, the end result is that everyone buys "generous" plans instead of increasing employee compensation. Everyone we spoke with agrees about the need to educate employees and employers alike. And in fact, everyone agrees (even insurers) that exorbitant drug costs are a big issue for Canadians.
Better pharmacare for all Canadians will be difficult to achieve without the federal government at the table. The government of Canada could lead on this issue in a way that no single province or territory can do, by supporting the development of a single national list of drugs to be covered for all Canadians and by harnessing the purchasing power of the whole nation to get the best possible bang for our buck.
Recently, a scathing report on the United States' health care system was issued. Surprisingly, little was made of this report in Canada. This was a shocking oversight, given that our performance on this same report was abysmal. Our health care system ranked second last in the study. How did our once-vaunted health care system become such a very expensive failure?
Those opposed to market-based health care reform do their best to scare Canadians. Reality, however, is considerably different. International experience suggests that private competition is a fundamental feature of a high-performing, universal access health care system. For evidence, consider the Dutch health care system where private (and even for-profit) insurance companies, private providers, activity-based funding and cost sharing combine to provide more timely access to high (if not higher) quality care than Canada's system for similar cost.
As consumers of an amazing medical system, I see the benefits of what we have to offer. At the same time I do see the shortfalls. I often wonder if we had a system which emphasized prevention, nutrition, meditation, breathing, routine exercise, living life from a heart based existence and more -- would we have such an expensive health care system?
As in the U.S., there's much soul searching about whether the country is getting as much bang for the bucks it spends. Does the quality of care match the country's outlay? A number of studies, including the latest international comparison from The Commonwealth Fund, show that Canada and the U.S. both fall down on several dimensions of care.
If being sick doesn't kill you, the medical bills might. Imagine getting better and being bankrupted for it. Facing the prospect of financially devastating medical bills is a reality many Americans know isn't going away. But a newly announced partnership between B.C. startup FundRazr and leading US provider of healthcare information Healthline.com may just save them from financial ruin.
Canada's health expenditures as a share of the economy are, after accounting for our younger population, higher compared to every other developed nation with universal health insurance. Yet Canadians endure some of the longest delays for emergency care, primary care, specialist consultations, and elective surgery in the developed world.
New medicines are a central component of modern medical care. Unfortunately for Canadians, our federal government takes an approach that is slower than others, unnecessarily costly for taxpayers, and is ultimately of questionable benefit to Canadians. Canadian approvals for market access to new drugs take longer than similar approvals in both Europe (under the European Medicines Agency) and the U.S. (under the FDA). Specifically, the median approval time was longer in Canada than in the other jurisdictions in four of the past five years. But would faster approval of new drugs expose us to greater risk? Perhaps.
How did you end up paying for my teeth cleaning? My private health insurance plan reimburses me for dentistry and optometry, as well as prescription drugs and other health care services. But health insurance premiums aren't taxed the way the rest of income is. People without private health insurance are disadvantaged the most by the private health insurance subsidy. They have no private health insurance themselves, yet they still end up subsidizing everyone else's coverage.