DocumentsDate added
The Sustainability of Medicare
Hugh Mackenzie and Michael Rachlis
Canadian Federation of Nurses Unions
The facts do not support the contention that Medicare costs are increasing uncontrollably or unexpectedly. The alleged Medicare cost crisis does not exist. Medicare costs have indeed been increasing, however modestly, because of the changing age structure of our population and the failure to control certain cost drivers. However, the main problem remains the failure to fulfill Medicare’s original vision for a transformed delivery system. By contrast, many of the changes suggested are likely to create a crisis of sustainability where none previously existed. Proposed changes often include a shift in emphasis towards both private finance – through user charges, utilization taxes, restricted public insurance coverage and increased reliance on private insurance – and private, for-profit delivery within the publicly financed system. Our investigation suggests that rather than reduce costs, many of these measures would actually drive health care costs higher. More private financing would make our system less equitable than it is now. Moving away from our single-payer system would make Medicare less efficient by increasing administrative costs and making it more difficult to manage and control the very cost increases about which Medicare’s critics are so concerned.
Health Care in Canada: Organization, Financing, and Access
Morris L. Barer & Robert G. Evans
Centre for Health Services and Policy Research & The University of British Columbia
The Canadian health care system took its modern form between 1968 and 1971, and its fundamental principles and basic structural features of organization and finance have remained the same since that time. The system has evolved over the past three decades, and has adapted more or less successfully both to significant changes in the external environment and to the changing needs and possibilities of health care services themselves. But it remains easily recognizable as the same system that was established more than thirty years ago.
Public Solutions to Health Care Wait Lists
Michael M. Rachlis
Canadian Centre for Policy Alternatives, 2005
Waits for care are the biggest political issue facing Canadian health care. Both citizens and providers are concerned that too many waits are too long and put some patients at risk. In June 2005, the Supreme Court added to the sense of crisis by striking down a Quebec ban on private insurance for Medicare-covered services: the Chaoulli decision. Despite the narrow scope of the decision, the verdict was widely seen as a repudiation of Medicare. Across Canada, the operators of private clinics and their supporters have seized upon the Chaoulli decision. They are aggressively developing for-profit clinics to sell services to the public sector and any individual who has the cash to jump the public waiting lists. Some advocates for more for-profit delivery claim that wait-lists would be solved if the public system contracted out its services to for-profit providers. This paper takes a different approach, arguing that, before going private, Canadians would do well to consider public sector solutions.
