Medical Tuesday Blog

Canadian Medicare

May 16

Written by: Del Meyer
05/16/2019 7:09 PM 

Overview

Medicare is an unofficial designation used to refer to the publicly funded, single-payer health care system of Canada. Canada does not have a unified national health care system; instead, the system consists of 13 provincial and territorial health insurance plans that provides universal health care coverage to Canadian citizens, permanent residents, and certain temporary residents. These systems are individually administered on a provincial or territorial basis, within guidelines set by the federal government. The formal terminology for the insurance system is provided by the Canada Health Act and the health insurance legislation of the individual provinces and territories.

Under the terms of the Canada Health Act, all “insured persons” are entitled to receive “insured services” without copayment. Such services are defined as medically necessary services if provided in hospital, or by ‘practitioners’ (usually physicians).[3] Approximately 70% of expenditures for health care in Canada come from public sources, with the rest paid privately (both through private insurance, and through out-of-pocket payments). The extent of public financing varies considerably across services. For example, approximately 99% of physician services, and 90% of hospital care, are paid by publicly funded sources, whereas almost all dental care is paid for privately.[4] Most physicians are self-employed private entities which enjoy coverage under each province’s respective healthcare plans. . .

Medicare is an unofficial designation used to refer to the publicly funded, single-payer health care system of Canada. Canada does not have a unified national health care system; instead, the system consists of 13 provincial and territorial health insurance plans that provides universal health care coverage to Canadian citizens, permanent residents, and certain temporary residents. These systems are individually administered on a provincial or territorial basis, within guidelines set by the federal government. The formal terminology for the insurance system is provided by the Canada Health Act and the health insurance legislation of the individual provinces and territories.
The name is a contraction of medical and care, and was used in the United States for health care programs since at least 1953.
Under the terms of the Canada Health Act, all “insured persons” are entitled to receive “insured services” without copayment. Such services are defined as medically necessary services if provided in hospital, or by ‘practitioners’ (usually physicians). Approximately 70% of expenditures for health care in Canada come from public sources, with the rest paid privately (both through private insurance, and through out-of-pocket payments). The extent of public financing varies considerably across services. For example, approximately 99% of physician services, and 90% of hospital care, are paid by publicly funded sources, whereas almost all dental care is paid for privately. Most physicians are self-employed private entities which enjoy coverage under each province’s respective healthcare plans.
Services of non-physicians working within hospitals are covered; conversely, provinces can, but are not forced to, cover services by non-physicians if provided outside hospitals. Changing the site of treatment may thus change coverage. For example, pharmaceuticals, nursing care, and physical therapy must b…

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Opinions on Canadian health care

Polling data in the last few years have consistently cited Canadian Health Care as among the most important political issues in the minds of Canadian voters. Along with peacekeeping, Canadian Health Care was found, based on a CBC poll, to be among the foremost defining characteristics of Canada.
It has increasingly become a source of controversy in Canadian politics. As a recent report from the Health Council of Canada has noted “Herein lies one of the puzzles of Canadian health care: Canadians increasingly view the health care system as unsustainable and under threat, even as their own experiences with the system are mostly positive.”

As analysts have noted, the root of the concern may be traced to successful cost control efforts in the mid-1990s, where public health expenditure per capita, in inflation-adjusted dollars, actually fell. These efforts arose from efforts by the federal government to deal with its deficit through various austerity measures, which led to cuts in their transfers to the provinces, and in turn to squeezing hospital budgets and physician reimbursements. The number of physicians being trained was reduced. The result was seen in increased wait times, particularly for elective procedures. More recently, government has been reinvesting in health care, but public confidence has been slow to recover.

A number of studies have compared Canada with other countries and concluded that each system has its own strengths and weaknesses. The World Health Organization ranked Canada in 2000 as 30th worldwide in performance. However, the basis for these rankings has been highly contentious. As Deber noted, “The measure of “overall healthsystem performance” derives from adjusting “goal attainment” for educational attainment. Although goal attainment is in theory based on five measures (level and distribution of health, level and distribution of “responsiveness” and “fairness of financial contribution”), …
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Canadian Medicare does not give timely access to healthcare, it only gives access to a waiting list.

–Canadian Supreme Court Decision 2005 SCC 35, [2005] 1 S.C.R. 791

http://scc.lexum.umontreal.ca/en/2005/2005scc35/2005scc35.html

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