HSS1101 - 11.1 The Canadian Health Care System

Summary

This presentation delves into the intricacies of Canada's healthcare system, contrasting it with the U.S.'s, highlighting its efficiency despite lower expenditure. It underscores the significance of Tommy Douglas, the 'father of Medicare,' and the Canada Health Act's role in shaping the system. The discussion covers the single-payer model, the five criteria for federal funding, and the ethical debates surrounding a potential two-tier system. It also touches on physician payment methods, the financial burden on the GDP, and the challenges of an aging population, emphasizing the need for a comprehensive approach to healthcare financing.

Takeaways

• 📚 The Canadian healthcare system is a publicly funded, single-payer system, often referred to as Medicare, which is considered more economically efficient compared to the United States' system.
• 🌐 Life expectancy is longer in Canada and infant mortality rates are lower, suggesting better health outcomes despite the U.S. spending more on healthcare per capita.
• 🔍 The Canada Health Act of 1984 is the foundational legislation that governs the financing and administration of healthcare, emphasizing public administration, comprehensiveness, universality, portability, and accessibility.
• 🏛️ Tommy Douglas, the premier of Saskatchewan and a federal leader of the New Democratic Party, is credited as the father of Canada's Medicare system and was voted the greatest Canadian in a CBC poll.
• 🏥 The healthcare system is primarily a provincial responsibility, with the federal government setting policies and collecting health data, reflecting the principle that 'health is a provincial matter' in Canada.
• 💼 The provinces must meet five criteria to receive federal funding for healthcare: public administration, comprehensiveness, universality, portability, and accessibility.
• 🏢 The term 'single-payer system' or 'monopsonistic system' refers to the government's role as the sole purchaser of healthcare services, which helps maintain cost control and uniformity.
• 💲 There is an ongoing debate about the potential benefits and ethical considerations of a two-tiered healthcare system in Canada, where a private, out-of-pocket system could exist alongside the public system.
• 👨‍⚕️ Doctors in Canada are paid in various ways, including fee-for-service, salary, and capitation, each with different incentives and implications for patient care and healthcare resource allocation.
• 💼 The healthcare system is a significant financial burden, costing over 10% of Canada's GDP annually, with a substantial portion dedicated to hospital care and services for the elderly.
• 🔑 The script highlights the complexity and challenges of the Canadian healthcare system, including long waiting times for non-emergency procedures, potential overuse, and the need to balance the quality and accessibility of care with its escalating costs.

Q & A

What is the Canadian healthcare system often compared to?

The Canadian healthcare system is often compared to the American healthcare system, primarily due to the close geographical proximity and the ongoing discussions about healthcare reform in the United States.

How does the Canadian healthcare system measure up in terms of life expectancy and infant mortality rates when compared to the United States?

In terms of life expectancy, Canadians have a longer life expectancy on average compared to Americans. Similarly, the infant mortality rate is lower in Canada, suggesting that Canadian healthcare expenditures may be more efficiently applied.

Who is considered the father of Medicare in Canada?

Tommy Douglas is considered the father of Medicare in Canada. He was the premier of Saskatchewan and the federal leader of the New Democratic Party, and his version of Medicare is the one used in Canada.

What is the Canada Health Act and what does it regulate?

The Canada Health Act, formally adopted in 1984, is the foundation for how the Canadian healthcare system is organized. It regulates how care is financed and administered, but does not dictate the organization at the delivery level, such as defining the number of doctors needed or which services must be funded.

What are the five criteria that provinces must satisfy to receive federal funding for healthcare?

The five criteria are: public administration of health care finances, comprehensiveness of services, universality, portability, and accessibility. These ensure that healthcare is provided on a non-profit basis by a public authority, covers all necessary services, is available to all citizens and permanent residents, can be accessed regardless of location within Canada, and is accessible without barriers based on traditional determinants of health.

What is the difference between a single-payer system and a multiple-payer system in healthcare?

A single-payer system, like Canada's, has one entity (the government) that purchases all healthcare services and disperses them to the population. In contrast, a multiple-payer system, like in the United States, has various entities such as insurance companies purchasing and disbursing healthcare services.

What is the ethical concern regarding a two-tiered healthcare system in Canada?

The ethical concern with a two-tiered system is that it could lead to a situation where those with financial resources can access healthcare more quickly or more comprehensively than those without, potentially contravening the accessibility criterion of the Canada Health Act and leading to a 'sucking of resources' from the public system into the private system.

How are doctors typically paid in the Canadian healthcare system?

Doctors in Canada are typically paid through a fee-for-service system, where they bill for every procedure they perform. Other payment methods include salary and capitation, which pay a set amount regardless of procedures or patients seen, or by the number of patients seen, respectively.

What is the role of the Royal College of Physicians and Surgeons in the Canadian healthcare system?

The Royal College of Physicians and Surgeons sets the standards for medical education, ensuring that physicians are appropriately trained in their disciplines. They also require physicians to maintain their competency throughout their careers.

What is the financial burden of the Canadian healthcare system on the country's GDP?

The Canadian healthcare system costs more than 10% of the country's gross domestic product (GDP) annually, making it a significant portion of the national budget.

How does the Canadian healthcare system address the issue of long waiting times for non-emergency procedures?

The script does not provide specific measures taken to address long waiting times for non-emergency procedures, but it does mention that there are long waiting lists for procedures like hip surgery, which are not life-threatening and thus can be delayed.