The reality of Canada's health care system

After viewing Shona's clip, I realized the true magnitude of Canada's health care system. In Canada's attempt to cover most of their population, they had to compromise on quality of care. Shona also made a good point about the role of a consumer and how if you are paying for a good or service, you have the right to demand good quality in a timely fashion. She argues in Canada, citizens are stripped of these rights in terms of health care.

Unfortunately, with our market-based approach, we provide excellent quality in a timely fashion, but are excluding the most vulnerable. We compromised on quantity in favor of supposedly better quality (in terms of Canada that might be true). While Canada's system evidently has some serious flaws as seen in Shona's case, health care is still a right of every human and efforts need to be made to cover the vulnerable populations; who are in the most need of health care and the greatest burden on the health care system. In terms of Canada, I don't believe people should be denied care for an extended period of time, especially in a case similar to Shona's. Countries such as France and Japan are great models to which the US can look towards in order to learn how to expand coverage to include all citizens.

Private or Public?

Chile is a country where most of the population receives health insurance from the public sector where only about 35% is covered by private insurance. It seems odd that the private health care system (ISAPRES) would receive such a high percentage of the national health care budget when it does not serve a majority of the Chilean population. What is the point in putting so much effort, time, money into something that won’t be used frequently? In a country like Chile that only has a GDP per capita of about 12,000 (USD), funds need to especially be allocated more appropriately in order to help relieve any strain on their economy.

With so many people choosing to use the public sector as opposed to the private because of the high costs of co-payments, this would certainly lead to inefficient spending and wasting of resources. With less people using the private system, those that are using it and plan to will be affected negatively because co-payments will continually rise to help offset the costs of the services and resources that are not being used. If this trend does not change over time, the misallocation of resources should persuade policy makers to address the needs of the people better by making sure that they would be able to purchase private insurance before investing more funds in that system. Somehow, more economic progress would need to occur in order to even give Chileans the option to choose between using public insurance or private insurance. Until this happens I don’t think there is a viable reason to increase funds into the private health care system.

Think Twice--Canadian Reality

When I viewed the clip, it was sad to see Shona deprived of timely appointment and necessary surgery. Though Canadian health care demands no money from its citizens--supposedly, it also does not provide the quality cares that meet the patients' needs.
Patients are treated as another case but the choice is lost in this tedious process.

This is the darker side not shown in "sicko" film. It's absolutely not free, Canadians pay for it. The money got to come out from somewhere not nowhere. Shona stressed the point of "CONSUMER" mentality and its power. As a consumer, one does have certain power to demand service as well as monitor its effectiveness. As a patient buried in heavy caseload, one can be trivialized and faded into the sea of bureaucracy. How about if this happened to you or your loved ones? It must be devastating. As we favor the universal health care in this presidential election, we must also be aware of its ramification. US is the free market, if you have the money for exchange, one can get whatever the best in the market. If you are poor, you might stay in the sickness even though the treatment is available. The access becomes a moral issue. In order to "fix" the failing system, we don't have to go for the extremes for answers. More importantly, we need to be thoughtful and take into the considerations of many facets. We may not come up with a perfect system, but we certainly don't want to end up with a new dysfunctional monster. Shona's saga provides us another insight into the universal care in a highly industrialized nation. Shona is a lifelong resident in Canada and holds a strong belief that her country would rescue her from a deadly disease if she needs it. Her belief dashed to broken pieces when she encountered the harsh reality of Canadian care system. Deserve our attention while we try to overhaul our system. For better NOT for worse.

Canada, eh?

I think that Shona makes a valid point when stressing the fact that the Canadian health care system, and any national health service for that matter, is not free. These systems are paid for by the citizens of the country through taxation. In that sense, even though it is a government run system versus private, the tax payer should certainly retain the opportunity to act as a consumer and demand services in a timely fashion.

When diving into the Canadian health care system a bit deeper, it seems that about 30% is privately funded. This mostly goes to expenses not paid for by Medicare, like prescription drugs, dentistry, and optometry. The remaining 70% of health care is publicly financed, yet provisions are private. More and more, services are not being covered publicly and citizens are being forced to pay out of pocket or with secondary insurance. Oddly enough, the Canadian Health Act of 1984 does not explicitly ban private insurance for publicly insured services, but it provides financial incentives to discourage people from acquiring it (http://en.wikipedia.org/wiki/Canada_Health_Act). This would be acceptable if the publicly insured services, especially those of an urgent nature, were delivered expeditiously. Instead, Canadians are forced to endure long waiting times for not only screening procedures but, in Shona’s case, life-saving surgeries. While Canadians enjoy low out of pocket expenditures, this doesn’t matter much if they aren’t around to enjoy them.

The US lies on the opposite end of the spectrum with regards to health care consumerism. The largely private system encourages Americans to demand services to the extreme. This demand of access and excellence most certainly lends to the litigious nature of our health system. Problems arise when we have unrealistic expectations of health care providers and do not understand their limitations. Costs continue to spiral out of control as clinicians are forced to adopt astronomical insurance policies.

It seems then, that Canada and the US fall on opposite ends of the spectrum when it comes to the notion of consumerism in health care. When thinking about the faults on each end, it is clear that the best case scenario will be a more moderate move to the middle.

Healthcare "Consumers" in the U.S. and Canada

I never realized the seriousness of waiting times until I watched the video clip on Shona and her brain tumor experience. If I was in her situation I would have preferred the health care system in the U.S. because I would have more chances of surviving. In the U.S., as we all know, its all about the money...which in terms of less serious health problems may seem unfair but when it comes to the serious life-threatening illnesses, if I can afford it, I would rather pay money and survive than wait. Of course if we start talking about the issue of universal healthcare, I want everyone to have equal access to treatment...but then it made me think...if I was the one with the life-threatening condition...and I had enough money...I would probably be selfish and go with the market-based approach in the U.S. that would give me the highest quality of care according to how much money I paid..and of course with little to no wait time. But if I didnt have money or if my condition wasn't serious, I would prefer the universal health care system in Canada. So I guess there is a positive side to the health care system in the U.S. In more simple terms, as a "rich consumer" I prefer America, as a "poor consumer" I prefer Canada.

Chile

Public vs Private insurance utilization is usually a clear indicator of economic stability. The increased utilization of public resources due to the inability to pay for private insurance or manage out-of-pocket methods will undoubtedly place a heavy strain on health care resources and result in wasteful spending. A couple of ways to offset this overburden of the health system is two-fold:

- Primarily, strengthen the economic infrastructure to rebuild a self-reliant and sustainable workforce so as to promote an affinity toward purchasing private insurances (and thereby the increased likelihood of better quality care).

- Secondly, if the first approach isn't as progressive and an "above-average-use" of public resources seems impending, an alternative route to help mitigate the impact of the over-utilization of public resources would be to strengthen public health education in regard to health condition etiologies and effective best-practice steps without the overuse of medical services. In particular, outreach should be done among those that are not vulnerable so as to preserve resources for those that are most in need.

Blog Question

Canada:
Please watch the short clip below:
http://www.biggovhealth.org/testimonials/patients/shona-holmes/

Using Shona's clip and any other information that you may have, what are your perceptions of Canada's health care model? how do you think we as US citizens play into this "consumer idea" as Shona put it and which country (US or Canada) should change in that regard in terms of health services?

Chile

ISAPRES is a private health care system in Chile that received approximately 45% of the
government's national health care budget.  Twenty-five percent of beneficiaries, however,
chose to use the public sector because the copayments in private institutions are too
high.  What effect do you feel this has on resources and health care expenditures, and is
this wasteful?