If its virtues and deficiencies are averaged out, the Canadian system appears superior to that of the United States. The difference lies in the basic elements of each system: Whereas the U. One of the great problems of the moment is the steady increase in health expenditures, control over which is made difficult by population aging, the growing need for hospital care, and high-volume consumption of new technologies. The current decade represents a crucial juncture in which there is an immediate need to correct certain problems of the Canadian health system in order to avoid progressive deterioration in the accessibility and quality of care and to prevent further cost increases.
Toward this end various reforms have been proposed: development of health promotion and disease prevention activities to complement curative services; implementation of cost-containment measures and reduction of the government deficit; complete rationalization, integration, regionalization, and restructuring of the health services, with increased emphasis on their efficiency and effectiveness and on alternative ways of providing services; decentralization of responsibilities; and careful management of the adoption and use of technologic innovations, focusing particularly on cost-effectiveness.
Whatever the reforms adopted, the end purpose is of course the satisfaction of the needs of the population, taking advantage of every opportunity to reduce both the risk and the burden of morbidity. While any error or omission remains my sole responsibility, I wish to extend my sincere appreciation for comments and suggestions to all those who helped with the preliminary drafts of this manuscript and, particularly, to the three anonymous reviewers who provided guidance for producing this final version.
National Forum on Health. Ottawa: National Forum on Health; Ministry of Supply and Services. Choose Canada: for world class health products and services. Ottawa: Ministry of Supply and Services; Health Canada. Sutherland R, Fulton J.
Spending smarter and spending less: policies and partnerships for health care in Canada. Ottawa: The Health Group; Fulton J. Heidemann E. The Canadian health care system: cost and quality. Chernomas R, Sepehri A. World Bank. World development report investing in health. Washington, DC: World Bank; Himmelstein DM, Woolhandler S. Cost without benefit: administrative waste in U. Controlling health expenditures: the Canadian reality. Naylor D. The Canadian health care system: a model for America to emulate?
Evans R. Health care in the Canadian community. In: Bennett A, Adams O. San Francisco: Jossey-Bass; Retirement Homes. In some retirement homes you can get special licenses to do dementia care and things like that, but generally speaking, if you can direct your own care, you belong in a retirement home.
Financially, long-term care homes are usually government funded, and retirement homes are privately funded. When living in a long-term care home, there is a co-payment required to help contribute to the costs of the facilities.
These co-payment amounts are set by the government, and are to be paid directly to the long-term care facility. Another thing that the LHINs are responsible for are community support agencies. For example, there are addiction services that are publicly funded, where you can go in for free and receive treatment. There are transportation services that bring seniors to appointments; companies like TransCare receive government money just to make sure seniors can get to and from appointments safely.
There are population age differences, lifestyle differences, population density differences, and much more. For example, think about Kirkland Lake, where the closest hospital is in New Liskeard and is a 2hr drive away. Remember the Canada Health Act requires that we provide equal and universal access to healthcare. When you start looking at the different geographies within our own province, there are very unique needs.
Therefore, since the LHINs are responsible for the local planning of healthcare services, hospitals fall within their umbrella. From a clinical and medical context, there are several services that the government will fund for home and community care. These services include:. One of the biggest problems that Ontario hospitals are facing is that there are simply too many people coming!
That resource is beds. They might not have supportive housing, or their family might not want to take care of them. This creates an interesting paradigm that the hospitals and LHINs are faced with.
How do we as a province reduce the amount of ALC patients to free up beds for people requiring acute care? One weakness of global budgets is that, under the impetus to meet budget targets, providers might restrict access to services or limit the number of admissions to facilities. Since global budgets do not provide opportunities for increased revenue if patient throughput increases, healthcare providers have no incentive to shorten patient lengths of stay or to discharge patients to lower cost healthcare settings Sutherland et al.
Evidence and Perspectives on Funding Healthcare in Canada. Global Budgets The most common healthcare funding method in Canada is global budgets, where a fixed payment amount is allocated to a provider such as a health authority or a hospital to cover operating expenses for a period of time, usually one year.
However, the CHA does not specify what is medically necessary and what is not. In many cases, dental and vision health are not included with Medicare. Prescription drug coverage is also usually omitted. Because of this, roughly two-thirds of Canadians also have private health insurance to cover non-medically necessary services. Of course, Medicare does not cover treatment costs for gambling addiction, but sometimes gambling addiction can be considered as a mental disease.
In this case, treatment costs are partially covered. Yes, there can be long wait times for access to services. It should be noted, though, that these are not emergency situations.
In most cases, the appointments with the longest wait times were for specialists being recommended by a primary care provider. Yes, in most instances, the Canadian health system does allow members to choose their own medical providers.
However, if you need to see a specialist, that visit must be arranged through your primary care provider similar to a referral in the US system.
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