The Canadian healthcare system: It needs enhancement

Abstract

Although Canadian healthcare is commonly referred to as a single-payer system providing universal coverage for only hospital and physician benefits, it is argued herein that their plan actually functions as a multi-payer model; and, it provides a far lesser breadth of coverage than available among most western European countries. Of concern is that in addition to their mandated plan, only 60% of their residents are covered by private insurance for pharmaceuticals, dental care, and eye services most often paid for as a fringe benefit by their employers. In addition, based on their medical loss ratios (74% for group coverage; 38% for individual insurance), these investor-owned, private insurance plans cannot be considered as an effective approach to protect the public against these medical expenditures. An obvious solution is to mandate these benefits as enhancements to the Canada Health Act of 1985, but this alternative is currently thought to be unrealistic for both political and economic reasons. Major issues now facing the Canadian healthcare system, in terms of its routine delivery of patient care, are not the single- versus multi-payer question or the inefficiencies of their supplementary insurance, but (a) the extended patient waits for non-emergent surgical services; (b) the lack of appropriate fiscal incentives when reimbursing their hospitals; and (c) their resident physicians currently completing approved programs in general surgery and the surgical sub-specialties frequently being unable to secure appropriate medical staff appointments. Maybe the Canadian healthcare system, although providing universal hospital and physician services, is not as idyllic as perceived by many throughout the world.