70 Of Canadians Health Care Costs example essay topic

Who are the uninsured? A growing number of uninsured Americans are one of the biggest and most debated troubles we face in our health care system. The actual count of the number of uninsured gets considerable policy use and media interest and an adequate amount of attention that when national estimates of the uninsured differ, it raises doubts about our ability to design solutions or test their impact. This issue brief begins with a comparison of the total number of uninsured from three major national surveys, demonstrating that these estimates are actually more consistent than what is often perceived. In other words, who the uninsured are does not vary much across national surveys. Transversely, of all surveys according to the Keiser commission on Medicaid and the uninsured, better than half of the uninsured are in low-income families and about half are minorities.

The majority of uninsured adults are working, but their lack of education makes it more difficult for them to get jobs that offer employer-sponsored coverage. Several surveys are able to provide national health insurance coverage estimates, including how many are uninsured. Different estimates of the number of uninsured released each year are not exactly the same and that has at times created questions about how large the problem really is. Health insurance estimates from national surveys vary depending on how the questions are couched and how long a period people are asked to recall their familiarity. For instance, respondents may be asked what their insurance coverage is in the month they are being interviewed or if they have been without coverage anytime in the past year or two years.

Depending on the reference period respondents are asked to recall, national survey estimates of the uninsured have ranged as widely as 20 to 80 million. At one end, different surveys report 20 and 35 million being uninsured over the course of a full year, while as many as 80 to 85 million have been uninsured for at least part of a two year period. Who Are the Uninsured? All three surveys show that about 80% of the uninsured are adults. Adults are more likely to be uninsured than children because most low-income children qualify for either Medicaid or S-CHIP, while low-income adults under age 65 qualify for Medicaid only if they are disabled, pregnant, or have dependent children. Since many entitled children are not enrolled in these public programs-children make up 17% to 19% of all the uninsured.

Adults are disproportionately represented among the uninsured and constitute the large majority, with those 18 to 44 years old making up roughly 60% of the uninsured. Across all three surveys, more than half of the nonelderly uninsured comes from low-income families, ranging from 52% to 59% of the uninsured across the surveys. are less likely to have jobs that offer employer-sponsored coverage and are also less likely to be able to afford their share of the premium. Roughly a third of the nonelderly population comes from low-income families, but they are disproportionately represented among the uninsured because their chances of being uninsured are over three times greater than those with higher incomes. Employers are the most common source of health coverage for nonelderly Americans, but many uninsured workers either work for employers who do not offer coverage or cannot afford the coverage that they are offered. The share of the uninsured from working families is likely to grow if the percentage of firms offering health benefits continues to decrease, and employee cost-sharing increases as healthcare costs continue to skyrocket. About two-thirds of uninsured adults in all three surveys have no college education and more than one-quarter of the uninsured did not graduate from high school.

However, income disparities do not account for all of the racial and ethnic differences in health coverage. Minorities at both lower and higher income levels are more likely to be uninsured than their white counterparts. Uninsured rates are the highest among low-income Hispanics. Hispanics make up about 16% of the nonelderly population, but about 30% of the uninsured. While more than two-thirds of uninsured adults work, they are disproportionately low-income and Under-educated. Adults and minorities also comprise a disproportionate share of the uninsured.

Procedures intended to expand coverage and improve access to care can be learned by these consistencies in our largest national study and with this knowledge can focus on those with the greatest need, but the cost of these programs will effectively be absorbed by the taxpayer, and may ultimately lead to a gatekeeper- someone who specifically is charged with determining the cost of care versus the greatest need, as can be evidenced by European single payer, or "Universal" healthcare. Workers Bear the responsibility, As the cost of health insurance rises, more employers are shifting the burden to workers. The cost of medical insurance is now the most contentious sticking point in labor disputes. Hospitals Close their Doors Because they cannot afford basic services, the uninsured often end up in hospitals needing expensive treatments that they cannot afford.

The hospitals can only absorb these costs for so long before going out of business. According to the healthcare for all website, the medical system drives staggering numbers of families to financial ruin. It is now commonplace to hear stories of families, co-workers, and churches holding fundraisers and garage sales to pay for medical bills. bibliography: web web The Canadian health care system According to an online article by Wikipedia, Health care in Canada is funded and delivered through a publicly funded health care system, with most services provided by private entities. While the Canadian government calls it a "public system, it is not "socialise d medicine". Health care spending in Canada is projected to reach $160 billion, or 10.6% of GDP, in 2007. This is marginally above the average for OECD countries.

In Canada, the various levels of government pay for about 70% of Canadians' health care costs, which is slightly below the OECD average. Under the terms of the Canada Health Act, the publicly-funded insurance plans are required to pay for medically necessary care, but only if it is delivered in hospitals or by physicians. There is considerable variation across the provinces as to the extent to which such costs like outpatient drugs, physical therapy, long-term care, home care, dental care and even ambulance services are covered. Considerable attention has been focused on two issues: wait times and health human resources. There is also debate about the appropriate 'public-private mix' for both financing and delivering services. Hospitals were initially places which cared for the poor; others were cared for at home.

In Quebec, a series of charitable institutions, many set up by Catholic religious orders, provided such care. As the country grew, hospitals grew with them. They tended to be not-for-profit, and were run by municipal governments, charitable organizations, and religious denominations (both Catholic and Protestant). These organizations tended to be at arm's length from government, but, as Marchildon noted, received subsidies from provincial governments to admit and treat all patients, regardless of their ability to pay. It was not until 1946 that the first Canadian province introduced near universal health coverage. Saskatchewan had long suffered a shortage of doctors, leading to the creation of municipal doctor programs in the early twentieth century in which a town would subsidize a doctor to practice there.

Soon after, groups of communities joined to open union hospitals under a similar model. There had thus been a long history of government involvement in Saskatchewan health care, and a significant section of it was already controlled and paid for by the government. In 1957, the federal government passed the Hospital Insurance and Diagnostic Services Act to fund 50% of the cost of such programs for any provincial government that adopted them. The HIDS Act outlined five conditions, public administration, comprehensiveness, universality, portability, and accessibility. These remain the pillars of the Canada Health Act.

Medical Care Act The Saskatchewan program proved a success and the federal government of Lester B. Pearson, pressured by the New Democratic Party (NDP) who held the balance of power, introduced the Medical Care Act in 1966 that extended the HIDS Act cost-sharing to allow each province to establish a universal health care plan. It also set up the Medicare system. In 1984, the Canada Health Act was passed, which prohibited user fees and extra billing by doctors. In 1999, the prime minister and most premiers reaffirmed in the Social Union Framework Agreement that they are committed to health care that has "comprehensiveness, universality, portability, public administration and accessibility. Criticisms- Wait times One of the major gripes about the Canadian health care system is waiting times, whether for a specialist, major elective surgery, such as hip replacement, or specialized treatments, such as radiation for breast cancer. Studies by the Commonwealth Fund found that 57% of Canadians reported waiting 4 weeks or more to see a specialist; 24% of Canadians waited 4 hours or more in the emergency room.

A March 2, 2004 article in the Canadian Medical Association Journal stated, "Saskatchewan is under fire for having the longest waiting time in the country for a diagnostic MRI - a whopping 22 months". A February 28, 2006 article in The New York Times quoted Dr. Brian Day as saying, "This is a country in which dogs can get a hip replacement in under a week and in which humans can wait two to three years". In a 2007 episode of ABC News 20/20, host John Stossel cited numerous examples of Canadians who had difficulty accessing health care. According to the Fraser Institute, treatment time from initial referral by a GP through consultation with a specialist to final treatment, across all specialties and all procedures (emergency, non-urgent, and elective), averaged 17.7 weeks in 2005.

However, the Fraser Institute's report is greatly at odds with the Canadian government's own 2007 report. Although there are long waits for some non-emergency procedures (notably hip- and knee-replacement surgery, plastic surgeries, and eye surgery) and long waits for specific other procedures in specific provinces, most waits appear to be normal with respect to other health care systems. Since 2002, the Canadian government has invested $5.5 billion to address the waiting time issue. In April 2007, Canadian Prime Minister Stephen Harper announced that all ten provinces and three territories would establish patient wait times guarantees by 2010. Canadians will be guaranteed timely access to health care in at least one of the following priority areas, prioritized by each province: cancer care, hip and knee replacement, cardiac care, diagnostic imaging, cataract surgeries or primary care. [edit] Medical professional shortage Canada's shortage of medical practitioners causes problems. [27] With 2.2 doctors per thousand population, Canada is well below the OECD average of 3.0, although its 10 nurses per thousand was slightly above the OECD average of 8.6.

[28] Suggested solutions include increasing the number of training spaces for doctors in Canada, as well as streamlining the licensing process for foreign doctors already in the country. [29] Doctors in Canada make an average of $202,000 a year (2006, before expenses). [30] Alberta has the highest average salary of around $230,000, while Quebec has the lowest average annual salary at $165,000, creating interprovincial competition for doctors and contributing to local shortages. [30] In 1991, the Ontario Medical Association agreed to become a province-wide closed shop, making the OMA union a monopoly.

Critics argue that this measure has restricted the supply of doctors to guarantee its members' incomes. [31] According to a 2007 article, the Canadian medical profession is suffering from a brain drain. The article states, "One in nine trained-in-Canada doctors is practising medicine in the United States... If Canadian-educated doctors who were born in the U.S. are excluded, the number is one in 12".

[15] [edit] Restrictions on privately funded health care Main article: Canada Health Act The Canada Health Act, which sets the conditions with which provincial / territorial health insurance plans must comply if they wish to receive their full transfer payments from the federal government, does not allow charges to insured persons for insured services (defined as medically necessary care provided in hospitals or by physicians). Most provinces have responded through various prohibitions on such payments. This does not constitute a ban on privately funded care; indeed, about 30% of Canadian health expenditures come from private sources, both insurance and out-of-pocket payments. [32] The Canada Health Act does not address delivery.

Private clinics are therefore permitted, albeit subject to provincial / territorial regulations, but they cannot charge above the agreed-upon fee schedule unless they are treating non-insured persons (which may include those eligible under automobile insurance or worker's compensation, in addition to those who are not Canadian residents), or providing non-insured services. This provision has been controversial among those seeking a greater role for private funding. A February 28, 2006 article in The New York Times stated, "Accepting money from patients for operations they would otherwise receive free of charge in a public hospital is technically prohibited in this country, even in cases where patients would wait months or even years before receiving treatment... Canada remains the only industrialized country that outlaws privately financed purchases of core medical services". [33] In a June 13, 2005 editorial, the Wall St. Journal wrote, "Canada is the only nation other than Cuba and North Korea that bans private health insurance", quoting Sally Pipes, head of the conservative think tank Pacific Research Institute and author of a recent book on Canada's health-care system.

The statement is not wholly accurate, as Canada does not ban all private insurance; many Canadians have supplemental insurance. However, the editorial provides an example to illustrate its point: "When George Zeliotis of Quebec was told in 1997 that he would have to wait a year for a replacement for his painful, arthritic hip, he did what every Canadian who's been put on a waiting list does: He got mad. He got even madder when he learned it was against the law to pay for a replacement privately". In 2006, a Canadian court threatened to shut down one private clinic because it was planning to start accepting private payments from patients, According to The New York Times, although privately funded clinics are illegal in Canada, many clinics are opening anyway, because patients don't like the long waiting lists in the government system. In a 2007 interview on ABC News, Professor Regina Herz linger of Harvard Business School said, "Many clinics all across Canada are illegal for-profit...

They know they can't get the health care they need from the legal system, so they " re complicit in creating an illegal system that " ll give them what they need". Though governments have responded through wait time strategies, as mentioned above, which attempt to ensure that patients will receive high-quality, necessary services in a timely manner will continue to be debatable. The border between Canada and the United States represents a boundary line for medical tourism, in which a country's residents travel elsewhere to seek health care that is more available or affordable. Some residents of Canada travel to the United States in frustration with the limitations of their own health care system.