Nowadays, the Canadian healthcare system is characterized by long waiting times for patients. Canada’s health sector has experienced serious financial loss addressing the problem of long wait times in healthcare facilities. The problems regarding Canada's healthcare system can be attributed majorly to socioeconomic challenges. As such, the Canadian healthcare system has undergone serious restructuring in recent years due to growing concerns about poor performance and excessive financial losses. In this case, the study hypothesizes that the current healthcare model is the leading cause of long wait times in Canadian facilities. The single-payer system is a universal healthcare framework that has been operational, but it has also been the root cause of long hospital wait times in recent years. In the single-payer system, fundamental healthcare services are provided by public and private facilities, with the overall fees being addressed by the government at the same costs. Although Canada’s single-payer system has addressed the major socioeconomic challenges, it can be argued that the model has worsened the problem of long waiting times in present-day healthcare facilities.
Background
Single-payer healthcare coverage is a framework that has brought numerous benefits to the health outcomes of Canadian residents. In essence, the model is founded on legal access to healthcare coverage from a single government insurance scheme for essential physician services (Oberlander, 2016). The insurance plan covers citizens in every Canadian province. As a result, it is possible for citizens to receive private insurance coverage for additional medical services even though those services were not accounted for by the coverage plan. Due to such a health system, the government is able to allocate funds to health providers despite the professionals originating from private organizations. The single-payer healthcare system offers numerous benefits to the healthcare sector, such as the reduction in administrative costs and complexity (Oberlander, 2016). With that said, the United States intends to emulate the single-payer system utilized by Canada since it has discerned that implementing a single-payer coverage plan comes with considerable benefits.
Delegate your assignment to our experts and they will do the rest.
Although the single-payer system has brought a large number of benefits to Canada, it is crucial to realize that the cons outweigh the pros. The coverage plan increased the waiting time for the majority of the elective medical services in the country. Consequently, services associated with orthopedics, for instance, knee surgery, hip surgery, and shoulder surgery, often delayed by more than two years (Mckee, 2019). Moreover, the single-payer system has encouraged the establishment of monopolies that hold control over hospital resources, implant budgets, surgery in operation rooms, and other revenues (Orzechowski). The rationing of crucial elective services has escalated the problem of long waiting times in public facilities. In 2017, the single-payer system compelled more than 1 million patients to wait in line to receive medical care (Pipes, 2018). The waiting time was exceedingly severe since some patients waited for 21 weeks just to gain access to medical specialists (Pipes, 2018). Evidently, the implementation of the single-payer system is detrimental to Canada’s health sector.
The problem of long waiting times for patients has been a serious bone of contention for citizens living in Canada. Canada has recorded severe increases in patient-wait times since the 1990s. For example, between 1993 and 2001, patient wait times increased by more than 70% (Mackinnon, 2017). Further studies reveal that approximately 3% of the Canadian population received delayed healthcare services in 2017 (Pipes, 2018). The implication of this challenge results in serious financial losses for hospitals and their patients. During 2017, Canada lost more than $1.9 billion to cater to the problem of long patient wait-times (Pipes, 2018). In 2013, the Organization for Economic Co-operation and Development (OECD) carried out a survey which determined that long-waiting times in healthcare facilities stem from the poor structure of Canadian health systems (Mackinnon, 2017). According to the OECD, most countries that attempt to merge public health coverage with reduced cost-sharing for patients suffer from long wait times.
The root-cause of long waiting times in Canada’s healthcare is socioeconomic challenges. The Canada Health Act was established in 1984 to ensure healthcare equity so that citizens can receive care without being impeded by financial barriers (Hajizadeh, 2017). In spite of this act, the socioeconomic challenges are worse for people with lower socioeconomic statuses. Statistics reveal that 70% of Canadian health facilities draw finances from public taxation; for that reason, most healthcare providers that receive funds and subsidies from public sources usually ration their services ( Hajizadeh, 2017) . A study carried out in 2017 revealed that socioeconomic status plays a key role in increasing patient wait times for Canadian citizens. As a result, the study disclosed that low-income individuals tend to experience longer wait times than their high-income counterparts. In addition, it was discovered that regions such as British Columbia, Saskatchewan, and Quebec recorded the lengthiest waiting times (Hajizadeh, 2017). By using wait times to ration healthcare delivery, public-funded facilities are worsening the health outcomes of patients.
Definition and Scope
The scope of this study focuses on every healthcare facility in Canada. As such, the results of this study are beneficial for nurses and health practitioners who work in private and public healthcare institutes all over Canada. The existence of the single-payer system contradicts efforts to reduce the wait times of patients in Canada. In this case, the lengthy wait time is a variable that can be ascertained by determining the number of patients who reported that they waited for more than 12 months to receive medical treatment (Hajizadeh, 2017). Therefore, the main objective is to determine the proportion of Canadian citizens who received delayed care in their respective provinces. On the whole, it is necessary to determine whether the problem of lengthy wait times affects private and public health facilities differently. The excessive wait times in Canadian hospitals is a serious conundrum for health professionals and their patients. In addition to determining the prevalence of lengthy wait times, it is also crucial to investigate whether patient wait times in hospital is increasing prior to the previous year.
Benefits and Challenges
As mentioned earlier, there are many benefits and challenges associated with the single-payer health coverage plan. When looking at the benefits, the greatest advantage of this framework is the provision of universal care to Canadian patients. The single-payer system is in adherence to the Health Act established in 1984, which is aimed at removing socioeconomic barriers to healthcare (Oberlander, 2016). In general, all Canadian citizens are given equal access to health care services regardless of their age, income, profession, and health status. In addition, the coverage is continuous such that people no longer need to change coverage plans. The coverage plan is equitable, especially with regards to primary care services like mental healthcare, health promotion, child development, maternity, and fundamental rehabilitation services (Beswick, 2017). Typically, countries that do not employ the single-payer system are forced to share medical costs between the insured and uninsured individuals (Oberlander, 2016). Thus, the single-payer system allows Canadian citizens to evade staggering bills owing to the cost-sharing nature of the health sector.
On top of that, the single-payer system allows healthcare organizations to increase the performance of administrative staff. By establishing a single government-run insurance coverage scheme, Canada gives hospitals the advantage of greatly reducing the complexity of the administrative structure resulting in a significant decrease in administrative costs (Oberlander, 2016). For nursing workers and other healthcare professionals, the simplification of administrative processes allows them to dedicate their time to healthcare delivery. The widespread implementation of the single-payer system provides more benefits than the fragmented model. For instance, the United States is a country that is often forced to enforce strict regulations when controlling the balance between state-run and private health organizations. Due to the Medicare program in the US, the country tends to experience a situation where private insurers gain more momentum than public insurers (Oberlander, 2016). Generally, the broad-spread implementation of the single-payer system has increased the performance of administrative personnel in Canadian health facilities.
In contrast, there are several challenges that emerged after Canada implemented the single-payer system. Some healthcare professionals argue that the single-payer system allowed the country to achieve the superficial benefits of the Health Act of 1984. However, there is significant evidence that claims that the single-payer system is more detrimental than beneficial. For instance, a surgeon in Toronto reported that his arthroplasty practice experienced serious challenges due to the single-payer coverage plan. On a regular basis, the patients were forced to endure through a duration of 2-years before they received surgery (Mckee, 2019). Furthermore, the problem of long waiting times is becoming worse as time progresses. In 2019, Canada was ranked last among 11 high-income nations due to excessive waiting times for elective medical services as well as specialty consultations (Mckee, 2019). In conclusion, delays in healthcare delivery have had a negative effect on the health outcomes of Canadian residents.
One of the greatest barriers in the health sector originates from Canada’s failure to integrate care. Medical fields aligned with primary and specialist care record the most serious integration problems (Beswick, 2019). According to a study undertaken in 2016, 71% of doctors in Canada claimed that they did not receive accurate patient information after undergoing specialist treatment (Mckee, 2019). As a result, it is often difficult for health professionals to coordinate cover plans and patient prescriptions. This problem hampers Canada’s ability to ensure continuity of care for certain patients. From the patient’s perspective, it appears like doctors and nurses are ignorant of their health conditions. The survey carried out in 2016 also revealed that 18% of patients claimed that their doctor was ill-informed about their patient’s medical history (Mckee, 2019). If this predicament persists, the performance of Canada’s health sector will deteriorate rapidly.
Impact and Implications
The single-payer system has affected the performance of healthcare workers when offering medical services. In essence, Canada’s healthcare sector is defined by a decentralized structure (Martin et al., 2018). In the single-payer model, doctors are basically considered independent contractors who receive funds on a fee-for-service basis. Therefore, doctors are not held accountable by health organizations in provincial and regional territories. In other words, doctors in Canada are considered members of the healthcare system since they receive funds from public sources; however, these physicians have minimal interactions with other external healthcare agencies (Martin et al., 2018). The autonomy given to physicians allows them to create independent boards that play an active role in managing the delivery of care. In conclusion, many physicians have benefited from the decentralized benefits of the single-payer coverage plan.
The introduction of the single-payer healthcare plan is oriented with augmenting service delivery for healthcare professionals. In the case of Canada, healthcare organizations utilize a three-layered framework to manage medical services (Martin et al., 2018). The first layer focuses on the provision of public services through Medicare. This strategy allows nurses and other healthcare professionals to sustain medical services through the use of public funds. Due to the first layer, hospital workers ensure that patents gain equal access to physicians and other medical specialists (Martin et al., 2018). In the second layer, healthcare workers acquire funds from a combination of public and private medical coverage. As a result, areas like Ontario allow senior citizens to receive drug coverage. Lastly, the third layer focuses on finances from private sources as well as services offered by non-physicians (Martin et al., 2018). Through the three-layered model, healthcare workers gain access to sufficient funds from various sources.
The implementation of the single-payer system has contributed to quality rationing that is both beneficial and detrimental to the health sector. With regard to the pros, quality rationing allows Canadian health care facilities to offer services at lower costs (Fox & Poirier, 2018). When medical services are rationed, health facilities gain the capability of optimizing the efficiency of health services. Evidence of this phenomenon can be discerned by comparing the number of hospital visits recorded by Canada and the United States. According to recent studies undertaken in 2018, the US recorded four physician visits per capita, whereas Canada recorded 7.5 visits per year (Fox & Poirier, 2018). When assessing the length of hospital stay, in-patients in Canada stayed in the hospital for 6.1 days, whereas in-patients from the US stayed for an average of 5.4 days (Fox & Poirier, 2018). Based on the studies, it can be perceived that Canada has facilities that offer more efficient healthcare services than the United States. Evidently, the single-payer system in Canada has allowed the country to improve the performance of a large number of healthcare services.
In addition to the mentioned implications, the single-payer system is the leading cause of monopolization in the healthcare sector. The absence of parallel and concurrent insurance coverages means that single private entities maintain control over crucial medical resources. Resultantly, the single-payer system has triggered widespread unemployment for graduates who pursued healthcare courses (Mckee, 2019). There is a lot of unrest among healthcare trainees and graduates owing to the lack of sufficient career opportunities. Moreover, when career opportunities become available, the positions are often closely monitored due to resource limitations. In Canada, it is common for healthcare workers to attain vacancies where they work for a single day every week (Mckee, 2019). Thus, the single-payer plan is quite devastating to students and fresh campus graduates in health-related professions.
Recommendations
The key problems involving the single-payer system stem from the imbalance between public and private entities. The single-payer system is based on a financial mechanism where 70% is derived from public sources, whereas the remaining 30% stems from private inflows (Martin et al., 2018). Researchers suggest the imitation of Germany and Netherlands healthcare structure which rely on 'hybrid' systems. Hybrid systems refer to a framework where wealthier citizens are allowed to leave public coverage so that they can enroll in private insurance plans. Nonetheless, individuals who opt out of public coverage are required to enroll in a private plan that comprehensively covers all their medical needs (Martin et al., 2018). This initiative is based on the idea that individuals with higher incomes can choose medical plans that match their preferences and their socioeconomic status quo. By bridging the public-private divide, Canada will reduce the congestion levels of public facilities, thereby reducing patient wait times across all hospitals.
Another recommendation is to convert the healthcare system from a decentralized structure to a centralized framework. This problem started in 1867 when the Constitution Act delegated health care responsibilities on a provincial level (Ivers et al., 2018). Instead of having a single health system, Canada possesses a fractured system where each province implements its own health coverage plan. The decentralized nature of Canadian healthcare hampers the federal government’s ability to regulate imbalances between respective provinces (Ivers et al., 2018). If a centralized healthcare system is created, Canada will be able to remove many socioeconomic barriers. For example, to solve the problem of drug monopolies, the country can take advantage of economies of scale to renegotiate drug prices offered by private healthcare organizations. In order for Canada to resolve the problems caused by the single-payer system, it is crucial to decipher the main weaknesses of the country’s health coverage scheme.
Despite the novelty of the recommended proposals, there are several problems that hinder the implementation of the healthcare suggestions. The key areas that need to be addressed before revising the single-payer plan are fiscal and social constraints (Martin et al., 2018). According to recent studies, the greatest healthcare determinants are social, economic, cultural, and gender-based factors (Martin et al., 2018). Foremost, the country of Canada experiences retarded economic growth since the recession that transpired between 2008 and 2009. For a country like Canada, where health services contribute less than 25% to the national income, the impact of poverty escalates (Martin et al., 2018). These problems are more severe for low-income Canadians and citizens from vulnerable communities than for wealthy individuals. Therefore, Canada needs to remove critical socioeconomic barriers before it begins revising the single-payer system.
Conclusion
The single-payer healthcare plan has been operational in Canada for several decades. Facing severe socioeconomic challenges during healthcare delivery, it can be concluded that the single-payer plan has been a slightly successful model in Canada’s provinces. In the same way, several countries have attempted to imitate Canada’s health sector so as to enjoy benefits such as universal care and simplified administration processes. However, this insurance coverage plan has escalated problems regarding long patient wait times in healthcare facilities. For Canada to get to the bottom of these problems, government authorities need to allocate significant resources to bridge the public-private divide. All in all, supplementary efforts need to be undertaken to increase the efficiency of the single-payer coverage plan.
References
Beswick, A. (2017). OECD single-payer policy review. University of Western Ontario
Medical Journal, 86 (2), 84-85. https://ojs.lib.uwo.ca/index.php/uwomj/article/view/2078
Flood, C. M., & Thomas, B. (2018). A successful Charter challenge to medicare? Policy
options for Canadian provincial governments. Health Economics, Policy and Law, 13 (3-4), 433-449. https://www.cambridge.org/core/journals/health-economics-policy-and-law/article/successful-charter-challenge-to-medicare-policy-options-for-canadian-provincial-governments/5F7D37BAE33A02DAF5C952F49EA4B8C0
Fox, A., & Poirier, R. (2018). How single-payer stacks up: evaluating different models of
universal health coverage on cost, access, and quality. International Journal of Health Services, 48 (3), 568-585. https://journals.sagepub.com/doi/abs/10.1177/0020731418779377
Hajizadeh, M. (2018). Does socioeconomic status affect lengthy wait time in Canada?
Evidence from Canadian Community Health Surveys. The European Journal of Health Economics , 19 (3), 369-383. https://link.springer.com/article/10.1007/s10198-017-0889-3
Ivers, N., Brown, A. D., & Detsky, A. S. (2018). Lessons from the Canadian experience with
single-payer health insurance: just comfortable enough with the status quo. JAMA Internal Medicine, 178 (9), 1250-1255. https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2695512
MacKinnon, J. C. (2017). Wait times in Canada. Healthcare Management Forum, 30 (4), 190-
192. https://journals.sagepub.com/doi/abs/10.1177/0840470417700162
Martin, D., Miller, A. P., Quesnel-Vallée, A., Caron, N. R., Vissandjée, B., & Marchildon, G.
P. (2018). Canada's universal healthcare system: achieving its potential. The Lancet, 391 (10131), 1718-1735. https://www.sciencedirect.com/science/article/pii/S0140673618301818
McKee, M. (2019). Canada’s Single-payer Health Care System. Jama, 322 (19), 1922-1922.
https://jamanetwork.com/journals/jama/article-abstract/2755606
Oberlander, J. (2016). The virtues and vices of single-payer health care. The New England
Journal of Medicine , 374 (15), 1401-1403. https://www.nejm.org/doi/full/10.1056/NEJMp1602009
Orzechowski, P. E. (2018). The Case for a Private Healthcare Insurance Monopoly. Applied
health economics and health policy , 16 (4), 433-443.
Pipes, S. (2018, June 11). Canadians Are One in A Million -- While Waiting For Medical
Treatment. Forbes. https://www.forbes.com/sites/sallypipes/2018/06/11/canadians-are-one-in-a-million-while-waiting-for-medical-treatment/#2ec657bf3e7d
