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Question by frogqueen: someone explain Canada’s healthcare system to me?
I’m curious and open to pros and cons

Best answer:

Answer by Local Celebrity
Socialized medicine: waiting for hours on end to get into the Er, shi.tty doctors, and typical governmet problem of it being extremely inefficient.

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One Response to “someone explain Canada’s healthcare system to me?”

  • heyyup:

    canada does seem to have the best healthcare policy, but if you are thinking of moving over their just for the great health benefits you should know that their is a waiting period for a new resident to be recognized as a citizen, whos medical bills will then be covered by the government

    Canadian Healthcare System Fact Sheet
    American Medical Student Association
    Prepared by Kao-Ping Chua, AMSA Jack Rutledge Fellow 2005-2006
    History
    • The Canadian healthcare system was built province-by-province. In 1947, Saskatchewan
    became the first province to institute a publicly financed healthcare plan, and other provinces
    soon followed. By 1971, a provincial-federal partnership plan providing universal healthcare
    was in place. Some provincial differences existed then, and many remain to this day [1,2].
    Organization
    • Canada is said to have a “single-payer” system, which means the government is the sole
    financer of healthcare. In actuality, there are also other “payers” – citizens pay premiums in
    some provinces, and private insurance companies do exist [1].
    • The administration of the universal healthcare plan (called “Medicare”) falls under the realm
    of Canada’s provinces and territories. The federal government provides regulation, oversight,
    and some federal “transfer payments” to provincial governments (e.g. the federal government
    gives some money to the provinces to provide healthcare) [1].
    • The Canada Health Act of 1984 set forth five criteria for federal funding for healthcare:
    1) Public administration; 2) Universality; 3) Comprehensiveness; 4) Accessibility; and 5)
    Portability (easy transfer when citizens move to new provinces). The federal government
    enforces this act by its power to withhold funding to non-complying provinces [2].
    • The public nature of the administration of Canadian healthcare contrasts with the mixed
    private and public delivery of Canadian healthcare. That is, most physicians are in the private
    sector, many working out of their own offices as with the United States [1]. There are also
    both private and public healthcare facilities in Canada [3].
    • Thus, the notion that Canada is “socialized medicine” is incorrect, since socialized
    medicine refers to a system in which the government owns the means of delivering
    healthcare (e.g. the British National Health System, in which most physicians and
    healthcare facilities are in the public sector) [3].
    • The Canadian government is unique in the world for prohibiting private health insurance that
    duplicates benefits covered by the public system. The role of the private insurance
    companies is mainly to address any gaps in coverage [1].
    Financing
    • Financing occurs predominantly through provincial taxes (including income taxes, payroll
    taxes, and sales taxes) and the federal transfer payments, which are funded by federal income
    taxes [1].
    • Alberta and British Columbia charge a small monthly healthcare premium [1].
    • Private supplemental insurance accounts for a significant portion of healthcare financing
    (28% of healthcare financing in 2002) [3].
    Eligibility and Coverage
    • Everyone is covered, regardless of income, race, sex, or any other factors [1].
    • Guaranteed benefits include all medically necessary hospital/physician services [3].
    • Provinces, the federal government, and municipal governments provide other benefits to
    seniors, low-income individuals, and other groups of people. Many Canadians obtain private
    insurance to cover dental care, outpatient prescription drugs, rehabilitation services, and other
    benefits [3].
    Physicians
    • Over half of physicians in Canada are general practitioners (GP’s) or family practitioners
    (FP’s), compared to the U.S., in which only about a third of doctors are generalists [1].
    • Canadian GP’s or FP’s serve as gatekeepers for specialist care, unlike in America, in which
    patients often go directly to a specialist without referral [1,5].
    Reimbursement mechanisms
    • Physicians are reimbursed predominantly on a fee-for-service basis by the provincial
    government; the fee schedule is negotiated between the provincial government and the
    provincial medical association [1].
    • Most hospitals receive a global budget from the government, which is negotiated on an
    annual basis. The hospital must find a way to stay within this budget from year to year [1,3].
    Choice
    • Canadian citizens enjoy free choice of their physicians and few financial barriers to care. [1].
    Physicians enjoy a great deal of autonomy over their practice patterns and where they
    practice [2]. This stands in contrast with the United States, in which managed care often
    dictates which physicians a patient can see and what services are covered.
    • On the other hand, there is not as much choice in insurance plans as there is in the United
    States; everyone contributes to the same public plan, which is available to everyone.
    Cost of care: an international perspective
    • In 2001, Canada spent $ 2,792 per capita on healthcare, whereas the U.S. spent $ 4,887 per
    capita on healthcare. That is, Canada spent about 57% of what the U.S. spent per capita [4].
    • Despite this, Canadian healthcare is expensive by world standards (in 2001, 9.3% of
    Canada’s GDP was spent on healthcare, compared with a median of 8.0% in other
    industrialized countries). Provinces pay for most health expenses [1,4].
    Problems
    • Budgetary shortfalls in the early 1980’s prompted the federal government to reduce transfer
    payments to provincial governments, which in turn decreased hospital budgets and
    reimbursements to physicians [2].
    • The current push for privatization in Canada stems from the idea that private insurance
    companies may be able to restore some of the funding to the healthcare system [2]. However,
    this idea is extremely controversial, as many are concerned that privatization will result in
    inequities in the system.
    • There are coverage gaps in the healthcare system, particularly for outpatient prescription
    drugs and home care [2].
    • There is significant tension between the federal and provincial governments over both
    financing and jurisdiction, which has resulted in several heated battles in recent years [2].
    • Waiting lists for certain elective procedures is a problem for some Canadians [1].

    Canadian Healthcare System Fact Sheet
    American Medical Student Association
    Prepared by Kao-Ping Chua, AMSA Jack Rutledge Fellow 2005-2006
    History
    • The Canadian healthcare system was built province-by-province. In 1947, Saskatchewan
    became the first province to institute a publicly financed healthcare plan, and other provinces
    soon followed. By 1971, a provincial-federal partnership plan providing universal healthcare
    was in place. Some provincial differences existed then, and many remain to this day [1,2].
    Organization
    • Canada is said to have a “single-payer” system, which means the government is the sole
    financer of healthcare. In actuality, there are also other “payers” – citizens pay premiums in
    some provinces, and private insurance companies do exist [1].
    • The administration of the universal healthcare plan (called “Medicare”) falls under the realm
    of Canada’s provinces and territories. The federal government provides regulation, oversight,
    and some federal “transfer payments” to provincial governments (e.g. the federal government
    gives some money to the provinces to provide healthcare) [1].
    • The Canada Health Act of 1984 set forth five criteria for federal funding for healthcare:
    1) Public administration; 2) Universality; 3) Comprehensiveness; 4) Accessibility; and 5)
    Portability (easy transfer when citizens move to new provinces). The federal government
    enforces this act by its power to withhold funding to non-complying provinces [2].
    • The public nature of the administration of Canadian healthcare contrasts with the mixed
    private and public delivery of Canadian healthcare. That is, most physicians are in the private
    sector, many working out of their own offices as with the United States [1]. There are also
    both private and public healthcare facilities in Canada [3].
    • Thus, the notion that Canada is “socialized medicine” is incorrect, since socialized
    medicine refers to a system in which the government owns the means of delivering
    healthcare (e.g. the British National Health System, in which most physicians and
    healthcare facilities are in the public sector) [3].
    • The Canadian government is unique in the world for prohibiting private health insurance that
    duplicates benefits covered by the public system. The role of the private insurance
    companies is mainly to address any gaps in coverage [1].
    Financing
    • Financing occurs predominantly through provincial taxes (including income taxes, payroll
    taxes, and sales taxes) and the federal transfer payments, which are funded by federal income
    taxes [1].
    • Alberta and British Columbia charge a small monthly healthcare premium [1].
    • Private supplemental insurance accounts for a significant portion of healthcare financing
    (28% of healthcare financing in 2002) [3].
    Eligibility and Coverage
    • Everyone is covered, regardless of income, race, sex, or any other factors [1].
    • Guaranteed benefits include all medically necessary hospital/physician services [3].
    • Provinces, the federal government, and municipal governments provide other benefits to
    seniors, low-income individuals, and other groups of people. Many Canadians obtain private
    insurance to cover dental care, outpatient prescription drugs, rehabilitation services, and other
    benefits [3].
    Physicians
    • Over half of physicians in Canada are general practitioners (GP’s) or family practitioners
    (FP’s), compared to the U.S., in which only about a third of doctors are generalists [1].
    • Canadian GP’s or FP’s serve as gatekeepers for specialist care, unlike in America, in which
    patients often go directly to a specialist without referral [1,5].
    Reimbursement mechanisms
    • Physicians are reimbursed predominantly on a fee-for-service basis by the provincial
    government; the fee schedule is negotiated between the provincial government and the
    provincial medical association [1].
    • Most hospitals receive a global budget from the government, which is negotiated on an
    annual basis. The hospital must find a way to stay within this budget from year to year [1,3].
    Choice
    • Canadian citizens enjoy free choice of their physicians and few financial barriers to care. [1].
    Physicians enjoy a great deal of autonomy over their practice patterns and where they
    practice [2]. This stands in contrast with the United States, in which managed care often
    dictates which physicians a patient can see and what services are covered.
    • On the other hand, there is not as much choice in insurance plans as there is in the United
    States; everyone contributes to the same public plan, which is available to everyone.
    Cost of care: an international perspective
    • In 2001, Canada spent $ 2,792 per capita on healthcare, whereas the U.S. spent $ 4,887 per
    capita on healthcare. That is, Canada spent about 57% of what the U.S. spent per capita [4].
    • Despite this, Canadian healthcare is expensive by world standards (in 2001, 9.3% of
    Canada’s GDP was spent on healthcare, compared with a median of 8.0% in other
    industrialized countries). Provinces pay for most health expenses [1,4].
    Problems
    • Budgetary shortfalls in the early 1980’s prompted the federal government to reduce transfer
    payments to provincial governments, which in turn decreased hospital budgets and
    reimbursements to physicians [2].
    • The current push for privatization in Canada stems from the idea that private insurance
    companies may be able to restore some of the funding to the healthcare system [2]. However,
    this idea is extremely controversial, as many are concerned that privatization will result in
    inequities in the system.
    • There are coverage gaps in the healthcare system, particularly for outpatient prescription
    drugs and home care [2].
    • There is significant tension between the federal and provincial governments over both
    financing and jurisdiction, which has resulted in several heated battles in recent years [2].
    • Waiting lists for certain elective procedures is a problem for some Canadians [1].
    .

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