To recover from U.S.A. health reform malaise, take a dose of Canada Health Act

I am absolutely amazed that the American health care reform is bogged down in partisan politics. It doesn’t hurt for us Canadians to be reminded of the underpinnings of our system as we watch this inertia south of us. With respect to the U.S.A., it seems to me that in the 21st century it should be recognized by all that health care is a basic human value, just as we have come to recognize freedom of speech, freedom of association, etc. It sounds like there is a lengthy and detailed bill before the legislators. Why not just agree on the principles – which should be fairly straight forward, pass that as law and then implement it, working out the details at that time.

I think that is what happened with health care in Canada. And contrary to what some Republicans and other related interest groups are saying and advertising, the Canadian health care system does work. Why does it work? Because it is based on five principles which sustain its operation, have stood the test of time, are not enshrined as values of the health care system, and mirror the values of Canadians:

First, the provincial and territorial health care plans must be publicly administered – on a non-profit basis by a public authority, which is accountable to the provincial or territorial government. Its records and accounts are publicly audited.

Second, the provincial and territorial health care plans must be comprehensive – i.e. they must cover all insured health services provided by hospitals and physicians.

Third, the provincial and territorial health care plans must be universal – i.e. all residents of a province or territory must be entitled to the insured health services provided by the provincial or territorial health care plan on uniform terms and conditions.

Fourth, the provincial and territorial health care plans must be portable – i.e. residents moving from one province or territory to another within Canada must continue to be covered for insured health services by the area they left during any waiting period (not to exceed three months) imposed by the new area of residence. After the waiting period the new area of residence assumes responsibility for health care coverage.

Fifth, the provincial and territorial health care plans must be accessible – i.e. all persons shall have reasonable access to insured hospital and medical services on uniform terms and conditions, without having to pay user charges or extra-billing and unimpeded by other means (e.g. discrimination on the basis of age, pre-existing conditions or financial circumstances). The provincial and territorial health care plans must provide reasonable compensation to physicians for all the insured health services they provide and provide payment to hospitals to cover the cost of insured health services. Reasonable access in terms of physical availability of medically necessary services means access to insured health services at the setting where the services are provided and as the services are available in that setting.

The Canadian health care system allows for reasonable access to medically necessary hospital and physician services, on the basis of funding by government. It is a national program composed of thirteen provincial and territorial health plans, all of which share certain common features and basic standards of coverage. Based on the provinces and territories fulfilling the basic principles, they receive federal cash contributions to fund their health plans. The provinces and territories are responsible for the management and delivery of the health services.

It just seems so straight forward. People should be able to receive health care without having to worry about mortgaging their homes, or losing coverage when they change jobs or they develop certain medical conditions. I would hope that reason will prevail and the U.S.A. will be able to provide health care similar to what we enjoy in Canada.