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The Canadian Flag
This series has explored the history of health care in the U.S., distortions in the current debate between reformists and supporters of the status quo, including proposals under consideration by Congress; specifically the public option. This section will look at the health care models of other countries that have attained universal coverage for their citizens.
Some countries have been more vigorous than others in addressing key problems with their universal systems, but they each provide a longer legislative history of identifying problems and engaging in aggressive and successful reforms. Their experiences offer lessons on how America might go about achieving the appropriate balance between consumers, private interests, and government oversight, while ensuring the focus is on quality care.
Read: A history of health care in the U.S.
Read: Distortions in the public debate on health care
Read: The Patients’ Choice Act
Read: The Affordable Health Choices Act
Read: The Public Option
This next three articles look at three countries with similar models that operate on a single-payer, nationalized scheme to achieve positive health outcomes. They will offer a summary on the similarities, strengths, and weaknesses of the Canadian, British, and Taiwanese health care systems, respectively.
Canada
Health care in Canada is governed by the Canada Health Act passed unanimously in 1984. They designed their health system to encourage solidarity for the health and welfare of the population; and despite horror stories propagated by special interests, most are satisfied with their care – or at least, disinterested in trading with America.
While Canada outscores the U.S. on many significant factors of health outcomes, including infant mortality, cost, affordability, portability, equity, life expectancy, and accessibility, the system has been slow to adapt to demographic changes, to expand its role in monitoring services and ensuring quality, and providing appropriate incentives to garner the desired changes.
According to the National Coalition on Health Care, there are 13 federally funded plans administered and managed by provincial/territorial authorities, which control the delivery of services and evaluate providers according to national guidelines. In order to receive full funding from the federal government, the plans must be: publicly administered, comprehensive (anything medically necessary as determined by hospitals/doctors), universal (uniform), portable (from job to job, within and outside of Canada), and accessible (no limiting financial barriers.)
Canadians fund their health care through corporate and income taxes at the federal and provincial levels and patients do not pay directly for services – like Britain, there are no deductibles or co-pays. In 2007, health care spending consumed about 10.1 percent of GDP, relative to 16 percent in the U.S. Click here for a visual chart of financial and service flows.
Primary care physicians account for 51 percent of all doctors, and most are private practitioners paid on a fee-for-service basis that is dispersed by the respective provincial health fund. Most physicians in hospital and other settings receive salary compensation; over 95% of hospitals are private nonprofit organizations.
While Canada has achieved its goal of providing equal access to all of its citizens, and managed to contain costs through uniform measures that ease administrative burdens, there are problems within the system, which analysts are exploring incremental ways to improve. Few are discussing wide-sweeping free-market reforms; the chances of a liberalized health care market in Canada are about as likely as a fully implemented single-payer market in the U.S.
Nonetheless, the combined forces of an aging populace, along with technological advances intended to extend lives, is taking a financial toll on health care budgets around the world – and Canada is no exception. Costs are rising, wait times for specialists are irritants in most cases, but potentially fatal in others. The Canadian Medical Forum found there are roughly 2.1 doctors per 1,000 patients, though physician shortages tend to be a problem largely limited to rural areas. Studies suggest a problem of under-performance, and poorly distributed resources in the Canadian system; rather than one of capacity.
The Canadian system focuses on what one source defines as “supply-driven system integration,” meaning that the government “relies on multilevel budget allocation mechanisms” to control prices.
Furthermore, while physicians are largely private, there is little incentive for them to compete with one another when their fees are predetermined, and there is no mechanism in place to ensure public accountability, or to encourage comparative provider services. Similar to Britain and Taiwan, accreditation is not mandatory, and consistent, quality care suffers as a result.
The free market has responded, and despite a law prohibiting the private delivery of for-profit care already offered by the public sector, some doctors have ignored the ban and withstood scrutiny in court for providing a valuable service that the government is currently unable to provide. Some hospital administrators are now subcontracting out certain procedures to this industry, and it seems that rather than outlaw its emergence, the government should find ways for it to complement the current system. Where it is under increasing pressure to provide high-tech solutions for an aging population, the Canadian system must be able to adapt to the needs of its citizens.
Next, I will examine the National Health Service in Britain in comparison to its Canadian and Taiwanese relatives.
Read: The British health care system
To receive notification when the next article of the series on health care reform is published, click on the “Subscribe” link below.
*If you would like to submit a health care story, with the possibility of seeing it published here, please send me an email message at jennyk1981@gmail.com.
Copyright ©2009 Jenny Kakasuleff
For more info:
National Coalition on Health Care: Health Care in Canada
Canada-Netherlands Seminar on Health Care
Debunking Canadian health care myths
Health Care Systems: The Four Basic Models
Health Care Financing Policies of Canada, the United Kingdom, and Taiwan
Comments
www.youtube.com/watch?v=q2jijuj1ysw&feature=player_embedded
www.politico.com/news/stories/0709/25165.html
BHO says "The reforms we seek would bring greater competition, choice, savings and inefficiencies to our health care system..."
For such an articulate and bright and clean and nice-looking guy, Barry READ his Mr Telep. As he does every day. It was a PLANNED speech. A REVIEWED speech. Probably a REHEARSED speech. At least once. Or does he go out with having NEVER READ the text on Mr Telep. Is he that smooth?
Steny was laughing about having read the bills.
And he said "inefficiencies".
And you all say Palin is incoherent!
speak for yourselves, if ou like the old way, go ahead and stay under that rock. I look forward to seeing the progress the President makes in the next few months.
Jenny, For one thing I disagree with any premise that the Canadian health system is superior to ours, but even giving you the benefit of the doubt there are other things to consider.
1. Canada has a much smaller population than ours and has vast natural recourses in relation to their population.
2. Canada has benefited for having a strong "Capitalist Neighbor" which brings a lot of money over the border into their economy whether it is tourism or trade.
3. Canada as well as many of the European nations lives under our military umbrella. A lot of these countries such as Germany (which is facing an evermore belligerent Russia) rely on our military protection. This allows them to reallocate Billions of dollars into their social experiments.
4. How expensive is having 16 million illegal Aliens (a middle number as estimates are between 12 and 20 million)?
Lynn says: "if ou like the old way, go ahead"
"Question: I like my current insurance coverage. Will I have to change plans?
Obama: No, you will not have to change plans. For those who have insurance now, nothing
will change under the Obama plan – except that you will pay less."
www.barackobama.com/pdf/Obama08_HealthcareFAQ.pdf
Don't be a fool.
To some of you who have trouble paying for health insurance-consider moving if you live in the 5 most populated liberal states to a conservative state such as Florida or Texas. In most cases you will have better schools, infrastructure, less crime etc. You can take the elimination of you state income taxes that will occur when you move from California where the state income tax rate is about 10% for 47,000 and higher incomes and use these proceeds to easily pay your health insurance (even if your company does not provide insurance) then have enough money to lease a new Toyota Hybrid and be a little smug.
Again, liberal government has failed to govern any state successfully (in my opinion) and we need to see through all of the smoke when it comes to this healthcare plan. I know Jenny cares about all of us and believes somehow the government will get it right this time. As I've said before-let them try this at the state level first-even a very wealthy liberal state and lets see-
Why is population relevant when we're talking about per capita spending?
Border crossing is mutually beneficial and we benefit from Canadian tourism as much as they benefit from ours. In relation to health care, our insured are crossing borders to receive free care or to purchase drugs at less cost.
Your financial argument against universal care fails - since the U.S. and private for-profit industry has consistently failed to control costs. ALL of the universal systems do it better.
Illegals could be made into legals overnight and thrust into the health insurance pooling mechanism, as well as the IRS. This argument is no reason to avoid universal health care Mark, it is pointing out a problem, throwing your hands up and saying, "it can't be solved."
"Again, liberal government has failed..."
But conservative government never let anybody down. Are you unable to think for yourself?
www.barackobama.com/pdf/Obama08_HealthcareFAQ.pdf
"Q. Will I still have choice in health plans?
A. Yes. Obama’s plan actually will increase the choices available to you. If you like the
insurance you have now, nothing will change under the Obama plan, except that you will
pay less. If you do not have insurance you can choose to enroll in the new public plan,
which will offer benefits similar to what every federal employee and member of
Congress gets..."
"SIMILAR TO WHAT EVERY MEMBER OF CONGRESS" and the President and hi family ?!!??!
Why a different plan? Are YOU BETTER than us serfs?
That would be a declaration of war!
"Jenny says: Illegals could be made into legals overnight"
Huhhh!? What an absurd statement.
You also said Medicare/Medicaid could be fixed and it would be "a simple fix.."
" Illegals could be made into legals overnight." Tell me you're not serious, what a LIBTARD!
Im not moving anywhere. To be honest i dont need all that much healthcare. Medicare does help. Anyone in the Indianapolis are that needs care for your elderly relatives or even yourself, check out this site
Its Home Healthcare Solutions.
.hh-solutions.com/
just add the http and www yourself,
Just contact Andi and tell her Brad, refered you.
I checkout that website, at ten on a saturday, and got a represenative on the phone, and a clinical manager the next day, and housecalls from both physical therapists, and a Doctor and nurse team, and the paper work for a Powerchair, without once reaching into m own pcoket.
I imagine people who live in places like Dallas, Houston, Phoenix, San Diego, Los Angelas etc. might feel a little bit different about wanting to this... " illegals could be made into legals overnight?" WHAT?
I know it's difficult to wrap your heads around "solutions;" it's so much more fun to whine and complain.
Face it Jenny, this socialist health plan is a loser and and will not pass. Too costly and too intrusive. If this is to "fix" the problem of the uninsured who DO INDEED get care, then "fix" that, don't mess with the tens of millions who are satisfied with the health insurance they pay for on their own for their own families.
Again, if the plan as proposed so far is good enough for 300,000,000 people, why then is it NOT good enough for 535 elected people and their families?
It reminds me of pre-revolution France. The elite ruling class and those who can eat cake!
It would be an act of war by 535 on 300,000,000.
"A world-renowned clinic that President Obama held up as an example of good medicine said Monday that the American people would be "losers" under the House's health care proposal, joining the growing chorus of critics the Obama administration is trying to fend off as the debate intensifies from Capitol Hill to Main Street."
EVEN after this: "President Obama continued to point to Mayo Clinic as an example of health care that delivers better outcomes at lower cost. The interview precedes a town hall meeting on health care reform being held at the White House on June 24, 2009."
If MAYO is against it, so am I.
NICE!
"Obama Admits He’s “Not Familiar” With House Bill"
“If you have health insurance, and you like it, and you have a doctor that you like, then you can keep it. Period.”
How can Obama keep making this promise if he is not familiar with the health legislation that is being written in Congress?
WHAT A SCAM! The BIG NOSE under the Socialist/Fascist tent.
During the call, a blogger from Maine said he kept running into a passage that claimed in Section 102 of the House health legislation would outlaw private insurance. He asked: “Is this true? Will people be able to keep their insurance and will insurers be able to write new policies even though H.R. 3200 is passed?” President Obama replied: “You know, I have to say that I am not familiar with the provision you are talking about.”
What does Obama care? He and HIS family are not supposed to be in the plan so what does he care?
There is no perfect system. It still remains that we have too many people without insurance. They are burdens on hospitals, doctors, ers, etc. We dont have to have a system like Canadas or any other nation. We can come up with a unique plan that serves the 3rd most populous nation in the world. We can pick and choose from various systems and add our own unique characteristics to any plan. It is high time we did it.
Jenny, I never claimed that private market would solve all of the problems or is not full of problems-It is just that government's track record on solving anything is horrible. After all of failure of big government you and other liberals crunch some numbers and you think this time you've cooked up something that will work-sorry I will pass on the kool-aide. In my career from time to time having to go and deal with any government agency or staff is a nightmare. In my personal life having to do it is excruciating and I can't imagine putting such people anywhere near healthcare (the few productive gov employees forgive me).
Making illegals legal over night-what? How about they get in line with everyone else-
The only thing Obama is doing right now is to make sure a "progressive" is not elected for the next 30 years. To try and do this now with the economy as bad as it is defies logic and will further cripple the middle class and small business.
Jenny, also why can't liberals get healthcare to work in a relatively wealthy state like Massachusetts?
Again Jenny I will start giving liberal government leaders some street cred. When they start solving the most basic of problems such as filling pot holes, having a semi-competent education system etc. until then I will remain skeptical of their ability to do anything meaningful with healthcare.
Jenny why are the Liberal states in so much worse shape than conservatively governed ones when many of the have more wealth? I just want to know what is the basic root of your philosophy is. I've lived in several locations across the country and in the more liberal areas the problems seem to be much more severe despite the fact in the liberal states or cities they have much large tax revenues and wealth.
Brad, yes you should stay where you are as you will have a better chance to get employed in Indiana as opposed to the liberal states or cities and keep more of your money-good call-
Que: When you're paying taxes to cover medical costs, you are paying into socialized medicine. Medicine is already "socialized," and anything that passes is going to be socialized as well - so get used to your socialized health care program.
Your figures are wrong. Our entire population does not believe the status quo is sufficient and most polls indicate that a significant majority are dissatisfied with health care in this country.
Unless you're in the minority who have managed to avoid HMO's, you already don't choose - your insurance company tells you who your Primary physician can be, and then they are the gatekeepers to any specialist. Nonetheless, the bill doesn't ban your private insurer from offering you the same coverage you receive now, and you're more than welcome - even w/o your employer - to continue purchasing from them. You would be an idiot to do so, but you'll have the choice to pay more for less - absolutely.
Que: The Mayo clinic does offer good care - and they're also the source of the "brain tumor" patient from Canada that conservatives have been running all over the media, so let's not pretend they are unbiased observers in the health care debate.
Mark: You're right, we don't have to copy another countrys' system. In fact, because they've been experimenting for much longer, they can offer us lessons on what works and what doesn't. There is no need to reinvent the wheel either.
You asked how the problem of illegals burdening the system could be solved, and I gave you a solution. They're here either way - so making them legal is not going to take more jobs than have already been lost - as you claim. They're already sucking up education, health, and other resources, right?
So, wouldn't making them legal, taxable citizens solve that problem? Granted, the process would take more than a day, but a simple piece of legislation could be written and passed as quickly as the stimulus.
Mark: Stop blaming the "liberal politicians" and look instead at the policy, which was signed into law by the very conservative Mitt Romney too. This "bipartisan" solution hasn't solved the problem, because it covered everyone and phased in cost control measures, rather than doing it all at once. You can't offer care to everyone for cheaper without first changing the inefficiencies, or at least addressing both problems together.
The system has not done enough to address administrative costs and internal inefficiencies.
Jenny, how IS the Massachusetts plan working out?
Do YOU believe any final plan SHOULD INCLUDE the Executive and Legislative branches of government?
For Brad, the Executive branch is the President and the Legislative branch is congress.
Asked whether he would sign any of the bills now being considered in Congress, Obama told NBC's "Today" show: "Right now, they're not where they need to be."
That says it ALL!
Que: The Massaschusetts plan is not working. I have explained why in this series - read it if you're interested in knowing.
Jenny, Do YOU believe any final plan SHOULD INCLUDE the Executive and Legislative branches of government?
Jenny says: "The Massaschusetts plan is not working."
I rest my case!
NO to Obammy healthcare. Obama ain't my mama.
No universal plan will work without stringent government oversight to address the inherent market failures of private industry over health care. Any plan that doesn't cover everyone is unacceptable. You're stumping for corporate America - arguing for the interests of the few who profit - rather than the many who are being done a disservice by the current system, including yourself.
You are arguing against your own best interests, but you don't know enough to know better. There is some good information in this series.
Yeah that's right everybody we need the LIEberals to tell us how to live, and what works best because they be edumucated. Only problem is nothing they have ever introduced has worked, just examine their track record in the last 50-60 years. Maybe they can do for healthcare what they did for our public schools.
Mark, is that your alter ego? The closeted conservative you try to hide when you claim your independence?
Health care is not a partisan issue - it is a problem for everyone in this country and rising costs are a problem around the world. Other countries have handled the challenges of health care reform better than we have. Universal health care is a common principle that even conservatives around the world agree upon. I guess you're the scrooge who feels no solidarity for his fellow Americans - it's a good thing most people are not like you.
"Jenny says: You are arguing against your own best interests, but you don't know enough to know better."
Do I sense a little superiority? Elitism?
Nah, I sense a WHOLE BOATLOAD of it!
How condescending. What the hell makes you Jenny, the only one who is right when YOU are losing this issue to more reasonable minds. From both sides of the isle.
Don't personalize it so much because it SHOWS your losing the issue and that is what you resort to.
Lets "fix" whats broken but leave the parts that ARE working for TENS of MILLIONS alone!
" A senior administration official says billions of dollars to raise fees for doctors treating Medicare patients are not covered by President Barack Obama's pledge to pay for health care legislation.
Budget Director Peter Orszag said Tuesday that's because the administration always assumed the money would be spent to prevent a cut of more than 20 percent in doctor fees.
The Congressional Budget Office said last Friday the higher payments cost $245 billion over 10 years. It said including the money in the overall bill would result in deficits totaling $239 billion.
On Friday, a few hours earlier, the president declared: "I've said that health-insurance reform cannot add to our deficit over the next decade. And I mean it."
I halfway agree with Obama. NO NEW deficits.
Then the question is how much will be too much in tax increases?
Looks like enough are reasonable enough to not take the Pelosi Reid bills. Remember them? The House and Senate heads?
Que: I'm the only person here that's armed with facts about health care - that you are either too ignorant, or too self-righteous to pay attention to. Typical conservative.
There was a recent study that showed in the face of overwhelming evidence to the contrary, conservatives will stick to their false beliefs. That doesn't make me elite, it makes conservatives mentally retarded.
I like how you conventiently leave out the CBO figure that shows the House version of the bill would not only reduce costs, but result in a $6 billion surplus.
Anyone can pick and choose the "facts" they want others to hear - at least I present both sides. Why don't you go back to searching for Obama's "real" birth certificate. You're more useful to the wing-nuts.
Keep loading it on. $6,000,000,000??
www.youtube.com/watch?v=M9_43nJVyKA&feature=player_embedded
Rep. Russ Carnahan speaking of the "surplus"?!
Just makem legal!
Easy fix!
You are much more naive than I gave you credit for.
Still resorting to ad hominem attacks too as usual. It ruins your cred.
I tried to keep it civil but your hate for opposing thoughts has gotten the best of you.
You are a BOT!
STILL have not answered the question.
Do YOU believe any final plan SHOULD INCLUDE the Executive and Legislative branches of government?
What Government run organization has had a SURPLUS for any amount of time?
Gotta love Jenny's idea of a "surplus".
The government forcibly takes other peoples hard earned cash, takes it away from their own children, puts it all in a big pile in DC and then calls it a "surplus".
Naive? I report, you decide.
$583,000,000,000 from other people.
$6,000,000,000 ONE PERCENT of the stolen funds.
The "surplus" if it materializes, is 1% of the "new revenue".
Looks like Que is laying the smackdown on poor little Obamabot Jenny!
Even the Mayo Clinic says NO to Obamacare.
Yeah the gubmint could run the health care program like they do the post office or the DMV, oh yeah great idea Obammy.
Que: You should work on your reading comprehension. And in that spirit, learn both sides of an argument. Then perhaps you will have some credibility. I've heard every talking point you lay out, and have addressed each one in my articles. You've got nothing; and you repeatedly prove that in your inability to address any of the facts I have provided.
Jenny has STILL REFUSED to answer this question:
Do YOU believe any final plan SHOULD INCLUDE the Executive and Legislative branches of government?
MY comprehension is fine, as are my analytical skills.
A TOTAL lack of leadership. What you would expect from a community organizer. Not a President.
"As the prospects for passing health reform by the time Congress leaves for its August recess look bleaker, Democratic grumbling about President Obama is growing louder. One Democratic senator tells CNN congressional Democrats are “baffled,” and another senior Democratic source tells CNN members of the president’s own party are still “frustrated” that they’re not getting more specific direction from him on health care. “We appreciate the rhetoric and his willingness to ratchet up the pressure but what most Democrats on the Hill are looking for is for the president to weigh in and make decisions on outstanding issues. Instead of sending out his people and saying the president isn’t ruling anything out, members would like a little bit of clarity on what he would support – especially on how to pay for his health reform bill,” a senior Democratic congressional source tells CNN."
www.nationaljournal.com/congressdaily/hca_20090722_6620.php
"A telling episode recounted by Senate Finance ranking member Charles Grassley reveals the Obama administration might be more worried than they are letting on that a Republican senator's comparison of the healthcare overhaul to Waterloo might be dangerously close to the truth.
Grassley said he spoke with a Democratic House member last week who shared Obama's bleak reaction during a private meeting to reports that some factions of House Democrats were lining up to stall or even take down the overhaul unless leaders made major changes.
"Let's just lay everything on the table," Grassley said. "A Democrat congressman last week told me after a conversation with the president that the president had trouble in the House of Representatives, and it wasn't going to pass if there weren't some changes made ... and the president says, 'You're going to destroy my presidency.' "
Obama sounds paranoid!
We've all seen the teleprompter bit enough times to count. All this clown has done for the last 6 months is travel the world, TALK about health care, and let his teleprompter give some televised press conferences. TALK-TALK-TALK-BLAH-BLAH-BLAH, meanwhile he has spent more money than all other past presidents in history combined, lost over 2.6 million jobs to date, hasn't made one iota of progress in Iraq or Afghanastan. I guess this clown is going to TALK for 4 years about what America needs to do?
Remember the Cheney energy issue? The lieberals demanded the list of energy people he met with to produce the Bush energy plan? Well, Obammie is up to the SAME tricks. And you progressives claim the right are the hypocrites?
Pot calling the kettle black?
" Invoking an argument used by President George W. Bush, the Obama administration has turned down a request from a watchdog group for a list of health industry executives who have visited the White House to discuss the massive healthcare overhaul.
Citizens for Responsibility and Ethics in Washington sent a letter to the Secret Service asking about visits from 18 executives representing health insurers, drug makers, doctors and other players in the debate. The group wants the material in order to gauge the influence of those executives in crafting a new healthcare policy."
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