Global Health Blogs with Professor Swahn

Healthcare system we always talked about. It’s always been a hot topic for discussion and diabetes. What is health care..? Health care is the maintenance or improvement of health via the prevention, diagnosis, treatment, recovery, or curve of disease, illness, injury, and other physical and mental impairments in people. The definition looks like it’s a lot of services, to provide healthcare service there are healthcare professionals and allied fields. Every country has its system to provide health care. Talking about the health care system of developed countries, insurance usually plays an important role. On the other hand, if we talk about countries like India, the insurance concept is not very common. People usually pay in cash for their health care expenses.

      Health care reflects how the country is using its resources for the betterment of the public. It’s always not the case that the developed can only provide good healthcare.  If you see the ranking of countries according to the quality of healthcare, you will be surprised to see that Singapore, Hong Kong, Italy, and Spain are leading in terms of their healthcare system. Although they are not very rich countries, they utilize their resources in a very efficient manner. 

       Let’s talk about the healthcare system of two countries that are sharing borders. The United States of America and Canada both are developed countries, full of resources and hub of modern migrations. Most people all around the world wanted to move to the USA and Canada for a better future. Healthcare access and insurance coverages are the main topics of discussion in both countries. 

 

 

 

HEALTHCARE IN THE UNITED STATES – 

    I would like to elaborate on the American healthcare system. Healthcare in the US is individually funded. It can either through the employer which covers almost about 48.8% of the population. Then there are government-funded insurances like MEDICAID, MEDICARE, and Veterans health administration. People who are below the poverty line and poor people usually qualify for government-funded health plans. But in the U.S the employer doesn’t need to give insurance coverage, not all people get insurance from their employer. This is the main reason that 15.5% of people are without insurance, which usually includes adults and couples without children. https://www.sgu.edu/blog/medical/comparing-us-and-canadian-health-care-systems/

 

 

 

  There is a lot of competition among private insurance providers to get business by selling insurance policies to the employers in the form of benefit packages for employees. They also tried their level best to influence private customers. Along with insurance companies, the health care provider also competes for the patients. They compete through areas of specialty, quality, and cost. Those who are getting insurance privately not through employers usually have to go in-network providers only, their access to services is also limited depending on the coverage of the services. Introduction of Patient Protection and Affordable Act (ACA) in 2010 law mandates all insurances to provide coverage for basic services at least. About two-thirds of primary health care providers provide services to the populations, they also can give a referral to the specialist when it is required, but it’s usually the patient’s decision depending on whether it is in-network or not.

 

HEALTHCARE IN CANADA –

Canada, on the other hand, provides government-funded health insurance to the public. According to the Canada Health Act (CHA) in 1984. All insurance companies are government-funded and it provides full coverage health insurance to all citizens of Canada. So technically all Canadian citizens are fully under coverage. Most of the health care providers work independently in their private practice or are hired by private hospitals and private health service management organizations. As it’s a government-funded system, they get revenue through the government instead of sending claims to private insurances like in the United States.

       Canada follows the Universal health care system in which all Canadian citizens are covered under insurance however the service coverage is limited to hospital, medical practitioners, and dental work. Apart from the basic coverage, the province provides services like coverage for prescription, homecare, long-term care, vision, mental health, etc. But the dental practices are not covered by insurance, people have to get insurance separately for it or have to pay out of pocket. Approximately half of health care providers are general practitioners. They can give a referral to the specialist if needed. But specialists will get less payment if the person comes to them without a referral. Since the government is funded, the primary provider usually negotiates with the minister of the health care system for the payments. The patient has no role in the negotiation, it’s always between the government and the provider.

 

 STRENGTHS- 

1- Both the U.S and Canada are providing good quality health care to the population. There is no compromise on the quality of the health care system.

2- Both countries had advancements in their technology and highly qualified and trained health care professionals.

3- Customer protection is considered very important in both countries.

4- Both systems have competition in the health care service, as a result, there is always quality care to the public.

5- Both countries and federal agencies supervise the consumer protection and health provider competition.

 

LIMITATIONS- 

1 – In my opinion, the biggest limitation is that the U.S has a universal health care system. I like the Canadian model of healthcare more than the U.S as all citizens are covered.

2- In both countries, since the paying party is insurance or the government, more misuse can be seen, in terms of unnecessary tests, MRIs, and C.T scans to get more money. 

3- In the USA, I think people had better choose their providers depending on the insurance they have. Since patients have to pay deductible and co-payments. They are fully aware of all the expenses.

4- In the Canadian system, patients had no role in the financial issue, it’s all between the government and providers.

5- Although both countries believe in consumer protection I unnecessary tests and scans are also a kind of exploitation of the consumer.

6 – Last is Dental coverage, both countries are on the same page. There is not much difference in terms of dental services.

 

 

Cskopecce. (2019, April 09). Comparing the US and Canadian Health Care Systems: 4 Differences You Need to Know. Retrieved from https://www.sgu.edu/blog/medical/comparing-us-and-canadian-health-care-systems/

 

Piper, K. (2019, April 12). India’s poor don’t want money – they want health care. Retrieved from https://www.vox.com/future-perfect/2019/4/12/18306457/india-poor-money-health-care-cash-transfers