tango Posted August 20, 2009 Report Posted August 20, 2009 (edited) OK, let's get it on! I don't know what I think, and I'm interested in what others think and know. This article is a good reference, and a good starter ... http://www.theglobeandmail.com/life/health...article1258137/ The celebration at the Broadway Theatre last Sunday night even featured a birthday cake. It was, after all, the 25th anniversary of the Canada Health Act. Staged by the Canadian Doctors for Medicare, it was an earnest affair. But it was also a sober reminder that, despite Canadians' jingoistic love for medicare, they know appallingly little about its legal basis and its history, never mind its strengths and weaknesses. ... Under the terms of the CHA, if a province wants federal money it has to agree to satisfy five "program criteria" (often described as guiding principles): Public administration: The provincial health insurance plan must be administered on a non-profit basis, and audited; Comprehensiveness : The provincial health-insurance plan "must insure all insured health services" provided by hospitals or physicians; Universality : All insured health services must be provided on "uniform terms and conditions;" Portability : Insured health services must be paid (at a rate set by the province) even if a patient is treated in another jurisdiction; Accessibility : The provincial health-insurance plan must provide "reasonable access" to services and provide "reasonable compensation" to medical practitioners. In addition to these five criteria, the province must provide Ottawa with some basic spending information and "give recognition" for the funding in public documents. Finally, the CHA states that if extra-billing or user charges for medically necessary services occur in a province, those amounts can be deducted from cash contributions from the federal government. Those dollar-for-dollar penalties are a heavy stick, but one that is rarely wielded. Between 1984 and 2004, a total of $8.7-million was deducted from transfers to the provinces. During that same period, public spending exceeded $1.1-trillion. Today, there are more violations of the program criteria of the Canada Health Act than ever, but there is essentially no enforcement. The federal government - under the Conservatives as well as the Liberals - has abdicated its responsibilities under the CHA. All the stuff that's currently in the law sounds good to me: I definitely do not want to have a situation where some people don't get proper health care due to poverty: I think that's the underlying principle of our system, and I do not want that to change. And frankly, I'm not enamoured with the idea of health care for profit either - just seems tacky to me. I'm also very aware that the babyboom bulge is fast approaching the golden years of health care usage, and I'm not sure our system can cope as it is. Since, as the article says, the CHA is being violated anyway, doesn't it make sense to revise it to something we can all agree on and not violate? Some private health care services are available in some places, not others. Lots of ancillary health care services operate privately - eg, Homecare. Where do we draw the line? Can we operate successfully with just private, nonprofit and public care, as I would prefer? Are there services that could be removed from public and become private nonprofit, to improve wait times while not interfering with quality and continuity of care? MRI's and specialists seem to be really sticky points these days. I'm not sure why specialist are so backlogged, as I've heard that's what doctors want to do these days as there's more money in it than family practice (thus the shortage there). I really don't know too much about it, but would like to learn what others know. I do not think that better health care should be provided to those who can pay more money. Am I deluding myself? Why do we have such doctor shortages? We don't pay politicians all that much either, and we have no shortage of them! One thing I do know: Our public system is more cost effective than the US system. Think about it: We have one (single-payer) administration, and massive though it may be, the million-company health insurance in the US has many many duplications of administration. We have economies of scale, and that works. I read some research on that comparison years ago: Our system is cheaper per capita, with 100% of us covered, than the US system is with millions still not covered at all. But many/most of us also have private extended care coverage too. sigh I just can't make sense of it all ... but I'm afraid what we have is not sustainable through the boomers. However, it should be very smooth sailing for those under 40. help ... eta- Oh wait! Perhaps the answer is already here: http://www.canada.com/health/Doctors+debat...5076/story.html After heated debate about the slippery slope of pursuing private health care, Canadian doctors voted Tuesday in Saskatoon to push governments to look more closely at allowing competition for public health dollars. As part of a plan to create a “blueprint” to transform Canada’s health-care system, the Canadian Medical Association approved a resolution Tuesday to implore governments and health authorities to “examine internal market mechanisms, which could include a role for the private sector, in the delivery of publicly-funded health care in Canada.” “Competition is not a negative thing,” said Dr. Tim Nicholas of Aurora, Ont., speaking in favour of the motion. “Competition is good.” Competition is already happening in Ontario, where hospitals are rated based on how their patients fare, he said. He said more competition will help create more access in a system that often leaves patients waiting. B.C doctor Victor Dirnfeld told delegates they shouldn’t confuse the idea of competition for public health dollars with the introduction of private care. “What I see is the fear of the dirty word ‘private,’ ” he said. “We already have extensive private involvement in the publicly-funded system. “Let’s not confuse, and let’s not contaminate, the discussion on this proposal with the fear and anger of the private system.” Now how does that work? Edited August 20, 2009 by tango Quote My Canada includes rights of Indigenous Peoples. Love it or leave it, eh! Peace.
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