Future for Healthcare Jackie Cummings School:

Class: Professor: Date:

Abstract The paper reviews and evaluates current and future approaches to cost containment in Canada and the United States. Managed care was once seen as an effective approach to supporting health care quality while containing costs in Canada and the USA. In recent years payers started to look in other directions, since prospects for limiting expenses faded. Nowadays consumer driven health plans seem to be on the rise. The reasons for the decline of managed care, the growing popularity of the consumer driven health plans and the implications for Canada are discussed.

Future for Health Care Introduction On an international basis, the development of health care policy is increasingly being influenced by cost considerations. Advances in health science and the delivery of care continue to expand the capabilities of treatments. The ability of nations and communities to pay for this care from available resources is a major subject of debate. Today with the advanced progress of medical science and the health system capacity, the populations health care seeking behavior is much more improved. However the fact that peoples access to good health care should or should not depend on social factors such as their level of income or social status has so far aroused much concerns. The Canadian healthcare system affects each and every citizen of this country. People of every background, be it economic or cultural, rely on Canadian hospitals and healthcare professionals to care for people in times of need. One of the many reasons that Canada is rated again and again to be the best country in world to live in, is the fact that Canadian people can provide free basic healthcare to each and every citizen. But today in Canada, people are facing a healthcare crisis on many levels. The hospitals are overcrowded, many of Canada top professionals choose to practice south of the border and their aging population must be cared for. Comparison Issues One of the major differences between the U.S. and Canadian health care system is the payment system. In the United States, physicians are paid more for doing more, and the return on their time is higher if they perform a procedure than if they use their cognitive skills. Because of the fact that procedures often require hospital care, this approach

translates into higher expenditures for hospital care. In Canada, Physicians operate under a system for free schedules and overall provincial limits on health spending and they have no incentive to increase the number of procedures. In Canada patients are virtually fully insured. There are also no deductibles or co-payments. Canadian physicians are mostly reimbursed on a fee-for-service basis. There are also very little use made of the prepaid group practices that have grown so rapidly in the United States. Another major difference is the fact of the government sanctions causing Canadian physicians to limit their use of tests and procedures. The biggest difference between Canadas health care system and the United States health care system is that in Canada most of the funds for health care come from a single source. Canadas hospitals also have budgets which are set by the government causing administrators, physicians or patients to limit the amount that is to be spent. Canadians receive fewer health services than Americans, yet there is no discernable difference in the infant mortality and life expectancy statistics of the two nations. If there are no discernable differences, why are the Americans paying more for the diversity and the extra services? But, on the other hand, would Canadians want a shorter stay, and an increase in tests, and procedures, if they had the choice. Which system is actually better? The health care system that is better is the one that the specific society wants and adapts to. Both the United States and Canada operate under a system of federal government , whereby separate states, provinces, and territories are autonomous in some matters but subject to a central government in other others. However, while the U.S. health care system is a combination of private and public services, all health insurance in Canada is obtained through the government. Thus, the Canadian system is referred to as national health insurance ,

or a single-payer system. In Canada, the provinces and territories control their health insurance systems, but the federal government is able to oversee each region's system through its financial clout. In the United States, residents generally are provided health care
coverage

by their employers. The U.S. does not have the best health care system in the

world - it has the best emergency care system in the world. Advanced U.S. medical technology has not translated into better health statistics for its citizens; indeed, the U.S. ranks near the bottom in list after list of international comparisons. The ultimate conclusion of the study is that the Canadian medical system is as good as the U.S. version, at least when measured by a single metric. In other words, of the studies surveyed, some showed slightly better outcomes for the Canadian system and some showed slightly better outcomes for the U.S. approach, making it hard to draw any conclusion other than that, on balance, the two systems seem to yield only slightly different outcomes. The Canadian system is good for Canada and the American system is good for America. The systems are a function of the populationthe Canadian population believes much more in maintaining social safety nets. Canadas Future Health Care System Canadas health care system finds itself at the centre of an ongoing policy debate regarding the complex and connected issues of its funding and structure. Without change to the structure of Canadas health system, public health care expenditures will increase from 31 cents of every provincial and territorial tax dollar in 2000 to 42 cents by 2020. Commentators in the current health care debate often look to Canadas public health care systems for hints as to what their future may resemble. Canada experiences should provide insights into the future impact of proposed reforms with respect to rationing, queues,

quality, and cost of a public health care option. The overarching goal in each of Canadas provincial health plans is that every Canadian should have equal access to medically necessary physician and hospital services, on uniform terms and conditions. Health-care spending in Canada is expected to reach $183.1 billion this year 2011, up more than five per cent from last year 2010. The Canadian Institute for Health Information's annual report on national health spending forecast an increase of $241 per person, raising total expenditures to an estimated $5,452 this year 2011. The report also looked at per capita spending by age group, confirming that birth and end of life tend to be the most expensive times in terms of health care spending. An infant under the age of one costs an estimated $8,239 per person. Between age one and age 64, spending averaged less than $3,809 per person. Canada's health care system is a group of socialized health insurance plans that provides coverage to all Canadian citizens. It is publicly funded and administered on a provincial or territorial basis, within guidelines set by the federal government. Under the health care system, individual citizens are provided preventative care and medical treatments from primary care physicians as well as access to hospitals, dental surgery and additional medical services. With a few exceptions, all citizens qualify for health coverage regardless of medical history, personal income, or standard of living. Conclusion Proper healthcare is sometimes a matter of life and death. As more has been discovered about how to cure or help health problems, different countries have tried to handle healthcare by the use of different methods. For an advanced country, the United States has a fairly capitalist health care system. While through federal programs like Medicare and Medicaid, the government pays a portion of the health care bills of elderly

and impoverished people, and this adds up to tens of billions of dollars per year, most Americans deal with doctors and hospitals on their own, paying them out of their own pocket or through voluntary private medical insurance. Health care costs in the United States have greatly increased in recent years. Therefore a number of cost-containment measures have been taken, including the gathering together of doctors and other health care providers and hospitals in HMOs, Health Maintenance Organizations. In Canada, on the other hand, as in most of the most advanced countries, there is a single-payer health care scheme run by an agreement between the federal and provincial governments. Doctors, hospitals and other health care providers submit their bills to the local provincial government's health department. The provincial government pays what it thinks is appropriate. Health care providers are seldom if ever allowed to bill the public directly for health services.

Work Cited

Canadian Health Care VS. U.S. Health Care. Centre for Health and Policy Studies (CHAPS), Department of Community Health Sciences, University of Calgary, 3330 Hospital Dr NW, Calgary, AB T2N 4N1, Canada The Conference Board of Canada, 80 pages, October 2001 Detailed Findings by Pedro Antunes, Glenn Brimacombe, Jane McIntyre