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Provincial governments remain incapable of providing access to care within a reasonable timeframe, yet continue to maintain their monopoly over the provision of medical care. It's time for policy makers to make the changes required for Canada to have a universal and efficient health-care system.
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B.C. law prohibits residents from accessing private insurance to pay for medically necessary treatment in B.C. These prohibitions, together with the province's rationing of health-care services, has resulted in long waiting lists. Many residents in urgent need are forced to languish, suffering irreparable harm and risking death.
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.
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A much-delayed B.C. court case challenging the ban on private health care slated to begin this fall could have widespread implications and impact all Canadians, according to a new critique. The Canadi...
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The evidence for the link between factors determined by social policy and health outcomes is crystal clear. Decades of studies have demonstrated that income and its distribution, education, employment, housing, food security and the wider environment have far greater impact than health care in influencing our health.
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Along with failing to increase affordability and access, private MRIs pose a more insidious threat to publicly-funded health care. The more Canadians believe that they have to pay out of their own pocket for necessary care, the more we will see confidence in and commitment to medicare eroded. We need strategies to improve access to diagnostic technologies that strengthen medicare rather than undermining it.
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Canada is the only country to limit the role of private health insurance exclusively to the coverage of services not insured by the public system. Canada is also alone in prohibiting doctors from practicing in both the public and the private sectors. Whereas 99 per cent of hospitals in Canada are public, in all other countries, private institutions have an important role to play in the provision of hospital services. Private, for-profit hospitals make up over one third of all hospitals in Germany (42 per cent), France (39 per cent) and Australia (36 per cent). Beyond any doubt, patients would be the first to benefit from such a pragmatic, evidence-based outcome.
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What we need is a health care system that's based on need, not ability to pay. But we also need social policies that create the conditions for good health. The evidence also shows us that lifestyle choices such as decreasing smoking, exercise and good diet increase proportionally to an individual's social and economic status.
Three years ago, on a crisp November morning, my mother fell down a long flight of stairs in her home. I didn't know at the time that her life, and mine, were also about to descend into a dark and often agonizing journey through Canada's healthcare system. By the time this second hospital was through with my mother, her demise was said to be "imminent."
Healthcare in Canada is anything but free. The average Canadian family of two parents with two children (similar to Walt's family in the drama) pays approximately $11,320 in taxes for hospital and physician care through the country's tax system, in addition to the cost of private insurance for things like dental care and outpatient prescription drugs.
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Back in ancient times I was health minister in B.C. Much has changed. No one had heard of AIDS in 1979-80. Organ transplants were rare. MRIs were just gleams in inventors' eyes.
One thing has however remained the same -- the debate over private medicine. In those days doctors were demanding the right of "balance billing," a euphemism for padding their bills. Now the doctors are mad at Vancouver's Dr. Brian Day for operating his own form of balance billing by running a clinic outside the Medical Services Plan. At this writing, Day is challenging the government to go to court and get an injunction against his clinic.
There's been a lot of talk about reforming the Canada Health Act -- specifically losing two of the five principles. What's less frequently discussed is what we risk losing if certain principles of the Canada Health Act were to be relaxed or abandoned completely. If that happens, can anyone be confident that a high quality public system can be sustained?
Given the choice between a private and a public health care system, Canadians overwhelmingly choose the latter. But insert a third option – a mixed public/private system – and the country is less cert...
Rather than go backwards to a time before medicare, we can focus on the more important business of reforming the health delivery system so that it will improve the quality of life for all Canadians, not just a privileged few.
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Let's face it: most people don't want a heart transplant or a hip replaced just because they're free. So what do user fees really discourage? They discourage the frugal and the poor from getting the care they really need.
Ottawa likes to claim credit for supporting Medicare, but is quick to note that responsibility lies with the provinces. The provinces like to assert their jurisdiction over health care but never hesitate to point to "inadequate funding" from Ottawa to explain away failures. Can we get beyond this?
Health care, which pollsters insisted was the issue of greatest concern to voters in the federal election, was summarily dismissed by our political parties with a unanimous promise made up of two simple words: "more money." But throwing ever-larger amounts of taxpayer dollars at the problem without measuring value often simply results in more waste and duplication.
The sustainability and comprehensiveness of our universal healthcare system relies on governments' collective response to a simple question: Who will pay for what?
Many worry that the Harper government will take this moment to fundamentally change the nature of health care delivery in Canada, giving more authority to the provinces but finding ways to download the fiscal responsibility at the same time.
The zombie that nirvana exists out there if we only embraced more private financing or private delivery never seems to disappear. We never seem to get around to needed health care reform.
Our fiscally unsustainable public health care system is in deep trouble. Getting the health care system we want requires a shift from a sense of entitlement to one of personal responsibility.