Part 5: Comparing Canada vs. U.S. health care systems
Updated On: Nov 17 2013 12:34:34 PM CST
The Affordable Care Act is a step toward, but is by no means a single payer health care system. To get a comparison, we wanted to take a look at the Canadian system.
The Canadian system is government controlled, but not government owned. Doctors and facilities are privately operated and paid for through taxes.
The current Canadian system was established in 1984.
From birth to death, a Canadian citizen's basic health care is provided at virtually no out-of-pocket cost.
Ever wonder why prescription drugs are so much cheaper in Canada? The government buys them in bulk and passes on the savings.
CEO of Shasta Community Health Care in Redding, Dean Germano, was born in Canada and worked in health management there for more than 10 years and is very familiar with both systems.
"Peace, order and good government begin the constitution of Canada. Life, liberty and the pursuit of happiness are the first words out of our mouths in our constitution. I think that distinguishes the feel of our countries. Canadians are more prone to band together and do things differently as a collective. We tend to like individual freedoms much more," said Germano.
Here are a couple of examples of how the ACA and Canadian systems would work:
A chronic health condition
An adult with a chronic condition like cancer or diabetes would automatically be covered in Canada.
Before the ACA, in the U.S., he might have been considered uninsurable. But under the new law, he can't be denied coverage.
Mercy Northstate President Mark Korth says, "If they qualify for one of the new forms of health insurance, pre-existing conditions won't prevent them from being able to access that care. Likewise, if they have a critical condition, or have cancer of something that in the past could sometimes trigger an event where they wouldn't have as much access, there are real strong provisions in the law that protect those individuals."
Germano says it's different in Canada.
"It's more of a planned approach. They have triage nurses, they have nurse practitioners, who when I worked at a cardiac hospital in Canada, we had a nurse practitioner who knew every patient on the open heart list, and we did 30 open hearts a week. Those with urgent heart surgeries had them when they needed them. Those more elective levels were monitored and when capacity allowed, they got their surgeries."
A young invincible
Young adults are often referred to as "young Invincibles" in the health care industry, strong and healthy, who see no need for health insurance, until they have a traumatic incident, like a car crash.
Under the ACA, the hope is they'll have some kind of coverage, which should mean for better follow-up care once the emergency is over.
According to Korth, “It will really depend on how well that new system of care does in getting them to have insurance or coverage ahead of time. They'll come in knowing that they have some insurance provisions covering their care. Their out of pocket costs will be down. Their access to follow-up care will be better, and will be defined as something that's available for them."
Germano says in Canada, follow-up care is covered, "Folks would then be in that system for a period of time, with a treatment plan. Eventually they'd be set up for discharge, ideally to the home, sometimes it may be a care home, but home is the ideal place. And then they'd be tied into whatever other needs they have ... whether it be physical therapy or occupational therapy."
The bottom line
As Obamacare lurches toward being fully implemented, despite political upheaval, as of now it's the law.
As Shasta Regional Medical Center Chief Financial Officer Becky Levy says, "There's a lot that is constantly changing and evolving. So what's said today may change tomorrow. But overall I think it's good for the community. We will figure it out here at the hospital as to how it fits into our life, but regardless of how it fits into our life, you know, it is here."
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