Canada Looks to Fix Its Health System Without ‘Americanizing’ It

Canada's health system, which guarantees citizens "essentially free access to most doctors and hospitals," is experiencing "trouble" as costs rise, and Canadians are trying to fix the system without "Americanizing" it, the New York Times reports. The $63 billion Canadian system is funded annually by the federal and provincial governments through tax revenues and other income. Raisa Deber, professor of health policy at the University of Toronto, said the Canadian system is not a "true national health service," but rather a collection of provincial health systems that operate under the 1984 Canada Health Act. She added, "People who get care get really good care. The level of satisfaction is very high." However, when care is not delivered when needed, people complain to the media and "politics can enter the mix," she said. Deber added that provinces with conservative governments can "shortchange the system to make money available for other needs," the Times reports.

Strained System
The Canadian system, like other government-financed health systems in Great Britain, Germany and Scandinavia, recently has shown other "strains," such as "overworked, underequipped hospitals," a doctor shortage and long waits for treatment. In May, Canadian Prime Minister Jean Chretien set up a royal commission to "turn the taxpayer-financed health system inside out, expose its shortcomings and recommend what to do about them." The Commission on the Future of Health Care in Canada will poll Canadians during town meetings, through a Web site and via toll-free numbers that residents can call. In early polls, most Canadians have said that they are unwilling to adopt the American system of "free-enterprise medicine," which they say would "create two classes of care -- for the rich and for the rest." Instead, many Canadians have suggested implementing copayments or "user fees" for doctor and hospital visits. Canadians already pay for most prescription drugs, dental care and eye care. Even though many Canadians do not want to privatize their system, they "cannot help keeping one eye on the other side of the border as they rethink health care," the Times reports. Roy Romanow, commissioner of the Commission on the Future of Health Care in Canada, said that Canadians are "being influenced by what they see and hear on American television, which is usually high-tech medical breakthroughs and high public expectations" (Crossette, New York Times, 10/11).