Universal Healthcare: Canadian Medicare

Published 2023-04-10 13:10:47
Chinook Regional Hospital in Lethbridge, Alberta - Photo by Graham Ruttan on Unsplash

Canada has a universal, decentralised health system that is called Canadian Medicare. All citizens and permanent residents can access healthcare free of charge. But like many healthcare systems worldwide, Medicare is plagued with problems that have resulted in long queues for healthcare service delivery and have even resulted in some fatalities.

Most first-world countries have some form of universal healthcare for their citizens and residents. How does the Canadian Medicare differ from other universal healthcare systems and what are the unique issues that have resulted in two-thirds of Canadians paying for private insurance?

A federal support but a different insurance for each province

The healthcare system is funded by the public from the 13 provinces and territories.

Each province or territory administers and funds its own insurance plan but receives financial aid from the federal government. Some services are not included like dental care and prescription medicines, however, certain targeted groups are more subsidised. As a consequence, each region differs with enrollment criteria and waiting periods before you can access healthcare, etc.

The Canada Health Act of 1984 provides national guidelines for various medical services, such as physician, hospital and diagnostic services. This act stipulates the points that provinces and territories have to comply with to qualify for federal support. The health insurance must be publicly administered, accessible to all, portable across provinces, universal and comprehensive.

Local governments at the provincial or territorial level are responsible for organising, delivering and financing health services in their respective areas. They fund physicians, drug programmes and are responsible for contracts with third-party health authorities to deliver healthcare in hospitals, communities, long-term care, mental health services, etc.

The federal government provides additional funding and administers health services for specific populations such as First Nations, Inuit peoples, the Canadian Armed Forces, veterans, refugees, inmates, etc.

The federal government also governs the safety and efficacy of pharmaceuticals, alternative health products, medical devices and provides funding for research, etc.

The main obstacles facing Medicare

The first line of treatment for patients is to see a primary care provider who represents the “front door” of healthcare. They screen patients, follow up with and ascertain which patients require more specialist care.

However, a recent survey showed that around 22%, which makes up millions of Canadians, are not assigned a primary care provider. This translates to many illnesses not getting caught early on and patients requiring emergency rooms, and more complicated and expensive treatment later on.

Staff shortages have been a large part of the problems facing Canada's Medicare. This is in part due to the pandemic that decimated the numbers of working medical staff across the country. Workers experienced burnout and many left their jobs in hospitals, clinics and primary care facilities.

By 2021, there were 2.46 physicians per 1,000 people, according to the Canadian Institute for Health Information. By comparison, the United States had 2.6 physicians per 1,000 people in 2018 and the United Kingdom had 5.8 in 2019 according to World Health Organization statistics.

Hospitals across the country have experienced a flood of respiratory illnesses a few months ago that left many patients with no medical help for hours while waiting in emergency rooms. This caused some high-profile deaths and exposed the urgent healthcare crisis in the country. For example, a 67-year-old woman in Nova Scotia reportedly died after a seven-hour wait to get medical attention at a local hospital's emergency department.

Additionally, there are long lists of patients waiting for diagnostic procedures and surgeries and Canada also has a rapidly-growing ageing population which was not provided for.

However, according to an Ontario-based emergency physician, Alan Drummond, the pressure could be reduced. He claims that about a whopping 20% of all daily hospital admissions are unnecessary. They are usually patients who require admission to a long-term care facility or they require the services of a caregiver in their homes. However, there are not enough home-care or long-term care resources available to take care of them and they end up being admitted to a hospital.

Increasing federal financial support

The upward trend of the annual health expenditure indicated that the growth rate for 2022 rose by 0.8%, up from the steep jump of 13.2% in 2020, the year of the pandemic. Before this pandemic period, health spending growth hikes averaged out at 4%.

Canada was projected to spend approximately C$331 billion in 2022, according to the Canadian Institute for Health Information. That translated to C$8,563 per eligible Canadian citizen or resident.

Local provincial and territorial governments have requested an increase in their funding from the federal government in the hopes of improving service delivery to their constituents.

The government responded by committing to spending C$200bn ($149bn; £124bn) in funding over 10 years to support Canada’s flailing healthcare system.

Prime Minister Justin Trudeau said at a meeting earlier this year that :

[The government is] taking action today so Canadians can continue to have trust in our public system. [...] This is a big country, built on big progressive ideas. Few are more central to who we are as Canadians than the promise of universal, publicly funded healthcare."

The newly pledged amounts are a 61% increase in the Canada Health Transfer to provinces over ten years but it still falls short of what the local governments requested from the federal government. Some premiers called the pledge “disappointing” whilst others said it was a “starting point”. Individual agreements will be negotiated with provinces to meet their particular regional problems.

The government, in addition to pledging money, also expect provinces to improve their healthcare data collection for enhanced monitoring to fix their ailing healthcare system.

How does Medicare rank with other universal healthcare?

Canada’s healthcare spending per capita still falls well below that of other first-world countries like the US, Germany and Switzerland. According to the 2017 Commonwealth Fund Report, healthcare in Canada is ranked poorly relative to other high-income countries.

According to World Bank statistics, Canada spends just over 10% of its GDP on healthcare (almost on par with the UK) compared with the US which spends over 16% but US healthcare is known as being much more expensive. In term of service and efficiency, Canada’s healthcare ranks lower than the UK but higher than the US.

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Author: KashGo
Expat Mum in the Desert and content writer for EasyExpat.com

For other discussions, advice, question, point of view, get together, etc...: please use the forum.

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