Canadians' Views about Health System Performance

摘要: The 2004 First Ministers' Accord on Health Care Renewal set the framework for Canadians' experience of medicare a decade. It involved generous financial settlement provinces and included actions designed to address contemporary problems long waits select list elective procedures diagnostic imaging examinations. fiscal political environment 2014 re-negotiations is very different from that decade ago. Although federal government committed during 2011 election campaign continue current levels indexation transfers provinces, (Conservative) probably less sympathetic expanding promise than Liberal or NDP would be. As approaches, many organizations are advancing their proposals change. But how much change do Canadians want? And concerns same as they were ago? The Commonwealth Fund has conducted an International Policy survey healthcare systems annually in Australia, Canada, New Zealand, United Kingdom States since 1998, France, Germany, Italy, Netherlands, Norway, Sweden Switzerland more recently. surveys initially sampled consumer views, but later also provider views. These present opportunity track views have changed critical issues, such system perceived necessary dimensions satisfaction with healthcare. This paper uses published results 13 years consecutive 1998 2010 (“the surveys”) assess these issues Canadian context. compares those respondents three other countries: Canada's nearest neighbour, America; Kingdom, country almost polar opposite health design funding; positioned midway between design. The countries quite expenditure proportion funded private sources (see Figure ​Figure11). FIGURE 1. Per capita expenditure, selected countries, by source finance, 2008 (adjusted $US purchasing power parity) The outlier all comparative analyses (Anderson et al. 2003) only one four without universal coverage. As shown ​Figure1,1, it substantially greater spending per capita. Australia spend roughly comparable amounts, Canada about 20%–25% two countries. role funding (including insurance out-of-pocket payments) significantly across Just over half (54%) comes sources, contrast just under one-third (30%) (32%) one-fifth (18%). Public sector consistent (Canada's 5% 20% Australia's). The scope public financing differs among In provides coverage, free at point service, hospital physician services (“insured services” Act). Other pharmaceuticals) variable coverage country, groups being subsidized provinces. well pharmaceuticals, although there mandated co-payments pharmaceuticals fees not regulated, so patients may face costs services. which based fee-for-service services, national service incorporates somewhat broader beyond countries. The multiple arrangements population segments: Medicare, covering access elderly; Medicaid, varies state, poor; service–type veterans; employer-based insurance. A significant percentage left uncovered: this group object recent reforms States, will come into force onward. The absence consequent create barriers uninsured marginally insured (American College Physicians 2008). contrast, lower level associated time (Siciliani Hurst 2005). Both explored surveys.