Canadian Healthcare Blog

Poll Results

noreply@blogger.com (Chander and Mike) — Fri, 10 Apr 2009 15:02:00 +0000

Poll results of our first two questions are out:

Our first question was "Does Canadian Healthcare system need a change?". 88% believe that Canadian healthcare system needs a selective change, only 5% believe that the system needs a complete overhaul and 5% believe that no change is required.
Second question was "What is your opinion on the public versus private healthcare in Canada?". To this question, the opinion was split with 50% believing that there should be more privately owned and funded healthcare centres while 50% believed that healthcare should remain public.

Disclaimer: the poll results are based on a very small sample and represent a section of the society who are atleast college educated and are internet savvy.

Chander

Would you trade your Canadian healthcare insurance for an American one?

noreply@blogger.com (Chander and Mike) — Mon, 23 Mar 2009 23:37:00 +0000

I hope you have all heard about Michael Moore and his movie Sicko. In this video, during a press conference, he was challenged by a Canadian in the audience regarding his (Moore's) description of average wait times in Canadian hospitals being about 20 to 40 minutes. Moore asked that person if he would trade his Canadian healthcare insurance for an American one. The answer Moore got from that person was an emphatic "NO". That says a lot about the Canadian healthcare system. It is like a value Canadians love and would never like to part with.

Having said that, there are numerous challenges the current healthcare system faces. The (disease related) healthcare outcomes are undoubtedly better in Canada than in the USA but a lot still needs to be improved. The debate continues despite the fact Moore has declared Canadian system as a model to follow. You may not agree with everything Moore says. Whatever Moore's motive, his movie Sicko raised a lot of awareness about the pitfalls of the American healthcare system and upside of the Canadian system in comparison to the American system.

Stay tuned...

Chander

Canadian Healthcare System: Frequently Asked Questions!

noreply@blogger.com (Chander and Mike) — Tue, 10 Mar 2009 14:57:00 +0000

I resume writing after a busy week of exams and other MBA related activities. Following are a few FAQs and answers, which I think are important to understand before we get into the debate:

1. What is "socialized medicine"? Is Healthcare in Canada socialized?

Definitions of socialized medicine vary, and are inconsistent. The term can refer to any system of medical care that is publicly financed, government administered, or both. Some say the literal meaning is confined to systems in which the government operates health care facilities and employs health care professionals. This narrower usage would apply to the British National Health Service hospital trusts and health systems that operate in other countries as diverse as Finland, Spain, Israel and Cuba. Some label Canada's system as "socialized medicine". To use this term to describe Canadian Healthcare system is inaccurate. The Canadian system provides public coverage for private delivery. Canadian hospitals are controlled by private boards and/or regional health authorities, rather than being part of government. The health care system in Canada is funded by a mix of public (70%) and private (30%) funding, with most services delivered by private (both for-profit and not-for-profit) providers.

2. What is the source of funding for healthcare system in Canada?

Canada's healthcare system is funded by both the federal government, and by the provincial and territorial governments. The main source of revenue is taxation, i.e., personal and corporate income taxes (in some provinces, sales tax is also used). Some provinces also charge a yearly healthcare premium based on annual income. In Ontario, for example, an individual with taxable income of C$48,500 (US$40,500) would pay a premium of C$575 (US$480) in the 2005 tax year.

3. What is the difference between single-tier and a two-tier healthcare system? Is Canadian healthcare system single-tier or two-tier?

Two-tier health care is a system in which a guaranteed public health care system exists, but where a private system operates in parallel competition. The private system provides the opportunity for patients to have more choice in choosing their doctors and benefit from generally shorter waiting times, but is known for being quite costly and reserved only for those who can afford it. Doctors in the private sector may also benefit financially as they can set their own prices. Some advanced countries in the world have two-tier primary health care to varying degrees. In Canada, publicly funded single tier system provides for medically necessary hospital and medical services. General practitioners run their clinics as private operations but are publicly funded from patients' perspective as patients are not billed for services. There is a new trend with opening of privately funded and privately delivered care for some specialist services like orthopedic services provided at Cambie surgery centre in Vancouver and with the opening of a few private cancer clinics in Ontario. Patients avail of the latter private services either due to long waiting lines for say a hip-replacement surgery or non-availability of chemotherapy services for a particular cancer medicine.

4. How does healthcare Insurance work in Canada?

Under the Canada Health Act, insured persons are eligible residents of a province or territory. A resident of a province is defined in the Act as "a person lawfully entitled to be or to remain in Canada who makes his home and is ordinarily present in the province, but does not include a tourist, a transient or a visitor to the province."

Healthcare care insurance pays for your visit to the doctor's office and your x-ray but might leave you to pay for the antibiotic drug that you are prescribed. This is the case in many provinces. It is a mixed system: you are either covered by your employer's private group insurance plan or the government plan. In all cases, there is a deductible, a user contribution and a maximum annual premium to pay. In the case of underprivileged citizens, the government pays the premium and fees.

5. How does drug reimbursement work in Canada?

Under the Canada Health Act, all necessary drug therapy administered within a Canadian hospital setting is insured and publicly funded. Outside of the hospital setting, provincial and territorial governments are responsible for the administration of their own publicly-funded prescription drug benefit programs. Most Canadians have access to insurance coverage for prescription medicines through public and/or private insurance plans. The federal, provincial and territorial governments offer varying levels of coverage, with different eligibility requirements, premiums and deductibles. The publicly-funded drug programs generally provide insurance coverage for those most in need, based on age, income, and medical condition.

Access to drugs is not uniform across various provinces. Provincial authorities make the final decisions regarding the reimbursement or denial for a new drug or new indication for an existing drug. This has led to situations where patients in a particular province had access to for example, a new cancer drug, but other provinces had not listed the drug on their formularies. Some people ironically have called it "postal-code lottery".

You can find more information on various drug coverage programs here:

Chander

Vote!

noreply@blogger.com (Chander and Mike) — Mon, 09 Mar 2009 18:36:00 +0000

It is very simple and easy to vote. Please keep voting on both these questions on the right side. This will help us to take the dialogue forward. If you would like to see some questions in polls here, please include in your comments and we would consider them for our future polls.

Chander and Mike

The debate has already started!

noreply@blogger.com (Chander and Mike) — Sun, 22 Feb 2009 21:49:00 +0000

Well, we know that the debate on public versus private Healthcare system has already begun. I found this student video which was among the winners in a competition held by The Fraser Institute. This video sets the background of our upcoming debate on public versus private health care. Take a listen:

We will also bring you an update from the upcoming debate on the topic, between Dr. Kellie Leitch and Dr. Gordon Guyatt, scheduled on March 10th at the Schulich School of Medicine and Dentistry in London, Ontario. Dr. Gordon Guyatt is a Professor of Clinical Epidemiology & Bio statistics at McMaster University in Hamilton, Ontario. He is known for his integral work on evidence-based medicine, a term that first appeared in a paper he published in 1990. Dr. Kellie Leitch is Chair of Paediatric Surgery at the Children's Hospital of Western Ontario/Schulich School of Medicine and Dentistry. She serves as Assistant Dean at the Schulich School of Medicine and Dentistry, and Co-director of the Health Sector MBA program at the Ivey School of Business, University of Western Ontario. Dr. Leitch was selected as one of Canada's Top 40 Under 40 for her work in both medicine and business.

Stay tuned!

Chander

Debate on Universal healthcare shaping up in USA!

noreply@blogger.com (Chander and Mike) — Sun, 22 Feb 2009 20:53:00 +0000

It is important to stay tuned on what happens in health care area in the (yet) biggest economy on the planet i.e. USA. USA spends about 15% of its GDP on health care and still fares poorly in comparison with other developed countries, on most health indicators. I thought some people will be keen to learn what the Nobel Laureate economist Paul Krugman has to say about universal health care. Here is an excerpt from a You Tube video. Take a listen. Also, enclosing a link for an interesting article by Mr. Krugman published in New York Times: Healthcare Now

You may also be interested in seeing how the Obama administration is leveraging social media technology to further the debate on this issue: Obama's Healthcare plan for US

We will soon get back to our debate on public versus private health care system in Canada. Stay tuned!

Chander Sehgal

Public versus Private healthcare system in Canada!

noreply@blogger.com (Chander and Mike) — Fri, 20 Feb 2009 01:59:00 +0000

The debate on public versus private health care in Canada is not new but it has never been so important. Before we dive more into the subject, a few concepts must first be clarified. Privately delivered health care must be distinguished from privately funded health care. Privately delivered health care is already prevalent in Canada. When you walk into your GP's offices, your local non-hospital lab or radiology centre, these centres are privately owned, operate on a for profit basis and thus, their services are privately delivered. Most of these services rendered however are publicly funded i.e. covered by medicare but additional "non essential services" are not.

For example, if you walk into your GP's office, a physical exam will be covered but if you would like to have a vasectomy, you will be billed for the procedure. In contrast, hospitals are government run entities and their services are publicly delivered on a not for profit basis. In fact, Dr. Albert Schumacher, former president of the Canadian Medical Association estimates that 75 per cent of health-care services are delivered privately, but funded publicly. Currently, Canadians have the option to buy supplementary insurance to cover for these non essential services which includes ambulance service, private beds and numerous services and procedures such as cosmetic surgeries, massage therapy, etc. that are not considered essential

Recently, however, we have seen the emergence of privately run centres that offer essential surgical procedures or emergency room services such as Urgent Care Center and the Cambie Surgery Centre in Vancouver. These centres differ in that their services are not only private delivered but also privately funded. At these centers, all services will be billed to the patient and currently Canadians cannot purchase insurance for most of the services offered.

The debate regarding privatization of health care is really one of privately funded health care of essential services. As you can imagine, this debate is heavily emotional and will dictate the direction of the future of the Canadian Health Care system.

There is already a significant component of private care under current system; for example drugs, cosmetic surgeries, dental services etc. Canada in 2006 spent an estimated $142 billion on health care in 2005, or $4,411 per person, according to Health Care in Canada. After taking inflation into account, this amounts to almost three times what was spent in 1975. Of that, just over $98.8 billion was spent by governments delivering public health care. An additional $43.2 billion was spent privately for additional services.

Within our publicly funded system, patients often experience long wait times even for essential services such as emergency room visits, hip or knee replacements or sometimes even radiation treatment for cancer. This is one of the reasons for thriving private surgery clinics like the Cambie Surgery Center (http://www.csc-surgery.com) in Vancouver owned and run by Dr. Brian Day former president of the Canadian Medical Association. Dr. Day along with many feel that there should be more privately run, privately funded centers to alleviate some of the backlog in the public system. On the other hand opponents against privatization will argue that since physicians must choose between the private and public system, if more privately funded centers are opened, this will lead to an exodus of physicians, health care workers and philanthropic funding out of the public system further eroding the public system.

What do you think? How much privatization is good for the Canadian system, to achieve sustainability in the long term?
Looking forward to your comments and votes on our first two poll questions.

We've attached a few articles here if you're interested in reading more about the topic and the debate. We welcome you to send any articles you have for us to post:

New England Journal of Medicine article on Canadian Healthcare
CIHR: Expert Alert, Public versus Private Healthcare debate
CBC news: Public versus Private Healthcare debate

1995 Article from canadian Medical Association Journal

The results of polls on top right side are anonymous. Please vote.

Chander Sehgal and Michael Tong

Introduction: Is the current Canadian healthcare system sustainable?

noreply@blogger.com (Chander and Mike) — Thu, 19 Feb 2009 01:50:00 +0000

Hi Friends,

We are both medical doctors by background and care deeply about all health care issues. We are currently pursuing the full time MBA program at Richard Ivey School of Business, London, Ontario and specializing in Health Care Sector.

Our Canadian Health care system is based on 5 criteria dictated by The Canada Health Act (CHA) which received Royal Assent on 1 April 1984.

Public administration: administered on a non-profit basis by a public authority, accountable to provincial government for its financial transactions.
Comprehensiveness: must ensure all services that are "medically necessary"
Universality: all residents in a province have access to public health care insurance and insured services on uniform terms and conditions.
Portability: provinces to cover insured health services provided to their citizens while they are temporarily absent from their province of residence or from Canada.
Accessibility: insured persons must have reasonable and uniform access to insured health services, free of financial or other barriers.

As Canadians, we are proud of our system despite its challenges especially when compared to our neighbours down South where half of personal bankruptcies are due to medical bills. Our system is no doubt expensive. The cost of health care in this country continues to rise at a rate far exceeding the rise in GDP. If these trends continue, it won't be long before we may have to borrow money to pay for health care costs.

The current health care system is thus unsustainable and there are many people who believe that a 6th principle of sustainability should be added. There is urgency for a public dialogue on this critical issue. Our first poll question is a very basic one. In coming weeks and months, we will bring interesting and factual stories and issues to you on Canadian health care system.

We are launching this blog as a platform to share issues and ideas related to Canadian Health care, based on your experience and knowledge. We hope that this blog will evolve as a community of people who want to share their voice and eventually make a difference to the health care. We will like to have inputs from everyone of you; your friends and families on the critical issue of health care which impacts us all. Please forward our blog to everyone who cares about health issues.

Here are a few links:

Expenditure on Healthcare in Canada-Health Canada
Health Canada's role in Canadian Healthcare system
Canada Health Act: overview and options

Chander Sehgal and Michael Tong