Comparing the U.S. and Canadian Health Care Systems
In the light of healthcare reform, the Canadian system is oftentimes mentioned as a prospective direction for U.S. However, both systems have fundamental differences, so even if the transition to Canadian way is possible, it is definitely not likely to be the fast process. So let’s find out how both systems differ from each other.
The access to healthcare services
Canadian healthcare boasts a universal access to its instruments, and Canadians are very proud of its accessibility and impressive coverage, willing to pay higher taxes for it.
In Ontario, for example, The Ministry of Health grants an individual an access to a wide array of health services after 3 months of legal residence. Visits to the doctor, laboratory and instrumental examinations, surgery, emergency care and hospitalization are covered by no means for the patient. As a rule, this also applies to nursing home care, physiotherapy and transportation of people with disabilities.
Patients choose their family doctor by availability in a particular province. To consult specialists (including internists) a referral from a local doctor is needed. In the absence of such, the specialists may examine the patient, but the fee for a consultation will be decreased.
In Canada, the number of uninsured patients is very small compared to the US. This eliminates inequities in the selection of patients by doctors or insurance institutions. Patients have full access to any doctor province, while there are no criteria of exclusivity. Referral to a specialist in Canada is not based on financial motivation and the need to provide the optimal treatment.
However, with the certain benefits, certain problems are inevitable. The increasing shortage of doctors significantly restricts access to their services. The recruitment of students in medical facilities has decreased over the past 10 years. Now the annual number of retiring physicians exceeds the number of physicians acquiring licenses. This is especially true of family physicians, since very few medical graduates are choosing this line of work because of relatively low salaries.
In many localities qualified staff is a problem, the load on the primary health care centers is constantly increasing, and patients sometimes have to travel very long distances to see their family doctor. Timeout planned visit, a specialist consultation or treatment long enough. In general across Canada, this indicator increased by 127% as for 2013 in comparison with the year of 1993. The average waiting period from the date of referral of the family doctor for a consultation with a specialist before the actual consultation is now exceeding 8.3 weeks, the longest one is the orthopaedic surgery (12.7 weeks). From recommendations and examination to treatment course start it takes a minimum of 9.2 weeks and up to 19.3 weeks in orthopedic surgery and 10.3 weeks – in certain cardiac surgery.
An independent doctor
Canadian doctors run their practices without corporate or government restrictions, i.e. decisions they made based on scientific evidence, and depending on what is needed in particular case to ensure optimal treatment. While the sovereignty of a healthcare worker in the US has blurred in recent years. Medicare and private insurance companies require prior authorization even with the most insignificant treatment approaches, and so many really efficient treatment methods are discarded.
In university hospitals and clinics, doctors can use materials of residents, supplementing them with essential documentation to treat the patient, or for educational purposes. The right to sign for consultation forms is a very liberal. Payments for medical services is fixed, eliminating the complex requirements of the jurisdiction issue (as well as higher pay for greater effort).
In the US, the requirements for medical documentation are way more complicated, which adversely affects the learning process itself. Fixed payment in Canada also reduces the risk of inspections in connection with the incorrect assessment of the services provided – a problem faced by so many US hospitals. However, if some discrepancies regarding the evaluation of financial services are found in Canada, the authoritative organs may initiate the required checks and then formally accuse the doctor of inadequate documentation.
The diagnostic procedures aren’t covered by the patient; unlike in many US cases, there is no frustration about how to convince the patient (or insurance company) that she must pass a specific examination.
However, the problem has a different nature: the long waiting to perform a specific procedure creates difficulties as for the thorough examination of the patient. Thus, to undergo magnetic resonance, computed tomography or bone densitometry test, you will have to wait for 4 months on average. Even though independent hospitals and diagnostic centers are gaining momentum since 00’s, such delays create serious obstacles for effective treatment.
Holding some diagnostic procedures prevents low compensation for them. Thus, compensation for coronary angiography is $ 107.50, a gastroscopy costs $ 90.30, a colonoscopy to splenic flexure – $ 113.10 (to the cecum – plus another $68.40), bronchoscopy (with or without biopsy) – $ 110.35, a skin biopsy – $ 14.50. Sowing of crops fungal compensated only $ 1.82, so a few of his conduct dermatologists and residents did not even learn the procedure. Regarding diagnostic mycology and microbiology are now Canadian doctors are not competent enough.
All necessary medical services are compensated, including urgent conditions. Unlike in US, patients do not receive any bills for hospital stays, with the exception of special facilities, such as a private room. Benefits for doctors or hospitals are not so obvious. Payment for the treatment is fixed regardless of the complexity of clinical cases, and very low compared with those in the United States. The low level of financial compensation in Canada prevents the excessive treatment of patients, but also contributes to a reduction in the standards of healthcare and emigration of doctors.