How Is Canadian Healthcare Doing?

This guest post by William Sheffield discusses the history and current state of healthcare of our neighbors to the north:

The Canadian government takes a different approach to healthcare than its neighbor. In the U.S., the healthcare system is private - each citizen pays for his or her own medical services through insurance or out of pocket. In Canada, the physicians and hospitals are also private, however, the country employs a single payer system. Put simply, all medical services are paid for by the government.

The Birth of Canada's Health Care System

It was the shortage of doctors in the Saskatchewan province around 1946 that inspired the single payer system used by the country today. By 1972, all provinces had complementary programs.

Around 1977, the federal government found it necessary to create a single plan. Having each province design its own health care system was cumbersome. In 1984, the Canada Health Act streamlined the process further.

About the Canada Health Care System

The Canada Health Act set criteria for the system in each province but has left management in the hands of the local governments. The Act states that medical insurance must operate on a non-profit basis. Doctors and hospitals remain for-profit businesses.

Canada supplies a physician-to-population ratio much like other countries, but employs more practicing nurses than the U.S. There are significant drawbacks to this approach in both countries. The most common complaint is wait times. The Canadian government addressed this issue in 2010 by establishing Patient Wait Times Guarantees to limit the amount of time a patient could be asked to wait before being treated.

Does the Canadian Health Care System Work?

In the sense that all residents have access to medical care, the system works. In the U.S., people without insurance can be denied help in non-emergency cases. The quality is also comparable to other countries. Statistics from the journal Health Affairs scores Canada healthcare at the same level as other countries including England, Australia, and the U.S. when looking at in survival rates for cancer and wellness care.

One of the most effective benefits of the Canadian approach is the distribution of funds. The bulk of a payment goes for medical services, not to the administration. The U.S. has allowed politics to clog their healthcare facilities. Over-administration takes funding away from service providers, driving up the cost of medical care to patients.

The Drawbacks

Canada has one of the most expensive healthcare systems in the world. Other healthcare systems, especially those in under-developed regions, provide quality care for less money. That is the principle behind medical tourism--people travel to these areas for surgeries that are prohibitively expensive at home.

Even with the changes made to reduce wait times, Canadian residents still have problems getting timely access to services. Part of the reason for this is the inflexibility of the system. It is difficult for the government to stay on top of all the issues because the program is so massive.

Above all things, the health care system in Canada must remain financially viable and that makes the decision-making process primarily political. The government is deciding what it can and cannot do based on budgeting restrictions. This limits the care offered to the Canadian public and forces them to look elsewhere for service.

It is safe to say that there are good and bad aspects to the universal health care system offered in Canada. The government is attempting to improve it, but the vastness of the program makes management difficult.

William Sheffield is a freelance writer who focuses on health insurance, medical science, medical education, the medical profession and other related matters. Those looking into health insurance in Canada should consider the coverage options at Kanetix in order to obtain a desirable deal.

What Singapore Health Has to Teach the World?

Comparative healthcare is a growing area of interest for both medical and political reasons. In this guest post by Lena Paul, learn more about how healthcare operates in Singapore:

The high cost of healthcare in countries such as Australia and America has many politicians twitching. In Australia, government expenditure into health care teeters at around 9%; in America, it's just above a whopping 15%. And yet Singapore only spends about 4% and has a level of healthcare services and health in general equal to Australia and America. What gives? What could the Singapore health system have that could teach others and in doing so, help save a lot of money?

One of the big problems with the healthcare system in America and Australia is that while it's a great way to stay well, it's also growing more expensive and that means a greater burden on those who need it the most-the rapidly growing, aging population. Universal healthcare may simply become unaffordable over time and plenty of people are going to fall through the cracks.

Why are costs high? No competition! Doctors and hospitals are either overloaded with patients or they are discouraged from competing with one another which means that the prices can be higher without fear. However, this system can be tackled: change Medicare to a health saving system and allow for competition over patients without regard to their insurance status. Singapore has this system and it works insofar as spending is concerned; les than 4% of its GDP is spent on healthcare. And though the spending is less, Singapore actually rates higher in World Health Organisation rankings-6th place as opposed to America (37) and Australia (32). So how does Singapore take care of its own?

The system is a two part program. First, Singapore has a compulsory savings program (Medisave). Employees and employers contribute between 6 and 8 percent of the employee's income, split down the middle and dependent on age. These funds are used to pay for medical expenses and unlike the Australian system, people cannot run a 'negative' balance; if the medical costs are higher than what is in Medisave, the difference has to come out of the patient's wallet or through voluntary insurance such as Medishield. But accounts can also be used to pay the expenses of immediate family members. For example, if you have never needed a doctor, but your father needs regular treatments, you can pay for them in part or in full from your Medisave account. Furthermore, those who have few funds can apply for assistance through a government appointed Medifund committee.

        

It's a far from perfect system; it doesn't provide as much coverage and the poor, unemployed and chronically ill are definitely at a disadvantage. However, the Australian system (and other systems) could take the Singapore method and tweak it to provide healthcare at a lower cost than it is now. How?

Singapore Skyline (Source: Wikipedia)

The big feature to take away from the Singapore system is the ability to have a government-funded savings account system that would offer the safety net features of Medicare without any disadvantage to the poor, chronically ill and/or aged. Within this system, the government would pay a pre-determined annual amount to everyone, based on age of citizens, into a health account for each person held at the Commonwealth Health Bank. Then the account would be supplemented jointly by employer/employee contributions, say 2% of income. Then funds gathered in each account would then only be used to pay for medical services at approved prices.

Private hospitals and individual practitioners could charge more than the approved amount, but the patient would have to pay the difference from his or her own wallet or private insurance. Private insurance would also be used to cover things like sudden and catastrophic events or illnesses that would kill a health savings account such as cancer treatments.

Unlike Singapore, citizens will be allowed to run up a negative health balance to provide a safety net, but if you make above a certain threshold of money a year, a slightly higher tax rate applies until the balance is put back to normal. If you die before the negative balance is dealt with, the estate must be used to pay for it and a positive balance can be willed to someone else. And just like the Singapore system, a positive balance can be used to help another family member out.

Now, the safety net feature does mean that Australia and any other country taking on this system would still pay more, but over the long run, the percentage would drop which is always a good thing.

How does this system also benefit patients? Aside from providing affordable care to everyone, a positive health account becomes an asset which is used to reward people for taking care of their health. There would be an end to over-servicing, over-ordering of tests and general floods to doctors which would reduce pressure in waiting lists. Furthermore, there would be more competition between public and private sectors which mean the system would become more efficient.

These changes may seem radical, but with a rapidly growing and aging population and increasing pressures to pay more and more for necessary services, it's important to overhaul the system now before universal healthcare becomes a footnote in history.

Lena Paul is a medical school graduate who is an enthusiastic blogger and holds an editorial position in Prepgenie, a test prep provider that offers exam preparation courses for GAMSAT, PCAT, UKCAT and UMAT.

Education Path for Doctors Without Borders

You may have heard of Doctors Without Borders, but do you know how it started or how you can participate? Find out all about it and more in this guest post by Melissa Miller:

History

The international medical humanitarian organization was created by French doctors and journalists in 1971 in response to a blockade in the Nigerian Civil War. France was the only major country that supported the newly independent county whose residents were suffering from the blockade. The humanitarian crisis and lack of support from the outside world highlighted a need for a medical organization that would operate without political or religious restraint.

“Every year, Doctors Without Borders/ Médecins Sans Frontières (MSF) provides emergency medical care to millions of people caught in crises in more than 60 countries around the world. MSF provides assistance when catastrophic events — such as armed conflict, epidemics, malnutrition, or natural disasters — overwhelm local health systems. MSF also assists people who face discrimination or neglect from their local health systems or when populations are otherwise excluded from health care.” –Doctors Without Borders Website.

There are a variety of positions that are described as urgently needed – OBGYN’s and surgeons being the most in-demand. For general physicians, however, there are a few specialties that the organization considers highly valuable.

French

Because Doctors Without Borders is a French organization (Médecins Sans Frontières) speaking French is a major asset to applicants who hope to work with the program.

Tropical Medicine
The field of Tropical Medicine focuses on the health problems of tropical and subtropical regions. Many of these health problems were once endemic in areas of colder climates, but have been controlled or eliminated as those areas have become more developed.

Poor housing, diet, sanitation and personal hygiene cause these infections to remain endemic in tropical areas, making culture, not climate, the factor that perpetuates these diseases. Thus, the field of medicine is also known as “Geographic Medicine” or “Third World Medicine.” Tulane University in New Orleans, LA, is currently the only American school of Tropical Medicine. The school offers undergraduate degree in Public Health, and there are also various specialty fields in the Master’s and Doctoral degrees, one of which is Tropical Medicine.

Many medical schools, like West Virginia University and Johns Hopkins, also offer courses in Tropical Medicine.

HIV/AIDS Specialists
The University of California at San Francisco currently has the highest rank AIDs research institute in the country.  To become an HIV specialist as certified by the American Academy of HIV medicine, you must have completed your residency and must have clinically managed at least 20 HIV patients within 2 years. You must also “demonstrate continuous professional development” through education and re-certification. The paths to satisfying the developmental component will depend on your medical degree.


This guest post is provided by Melissa Miller. She aims to help you understand the challenges and benefits involved in earning an online associates degree, and show you a way through the often confusing process. She welcomes questions and suggestions at melissamiller831@gmail.com