Health

Monday 1 September 2014

Canadian system is efficient, despite pressure

FREE healthcare for children is standard practice in Britain and many other European countries. It was also the starting point for the creation of Canada's Medicare system in the 1940s.

Today, all Canadians receive free primary care from family doctors who increasingly work within teams of practitioners in neighbourhood clinics.

Once they fulfil their time and residency qualifications, the 10,000 young Irish who are now setting off for Canada with their two-year working visas will no longer have to pay to see the GP, or receive other primary care services.

Even when I was a child in Canada in the 1960s and '70s, the Canadian family doctor was paid per patient visit by the provincial health authority.

It can sometimes be difficult to find a GP that will add you to their patient lists, and in poorer maritime provinces like Newfoundland, but also in some deprived urban areas in richer provinces, waiting lists can be long and patients sometimes have no choice but to resort to hospital accident and emergency departments for treatment.

Unless it is an emergency, Canadians have to make appointments to see their GP. Family members who live in Montreal, Ottawa and Toronto tell me that you can usually expect to be seen within 48 hours if you are sick. Those who can afford to, buy supplementary risk-rated private health insurance to bypass the Medicare system and even to secure semi-private and private accommodation in public hospitals, once you get in.

Many more private clinics and hospitals have also sprung up across Canada in the past 20 years, but there is no public funding available and only cash buyers or the well-insured have access. There is no queue jumping over the public hospital waiting lists.

The Canadian public health system is under considerable pressure from its ageing population, and rich provinces object to the Medicare transfer payments they make to the poorer ones' schemes. Yet most Canadians claim to be satisfied with the free primary care system.

The Medicare system, they say, is relatively efficient and relatively cost-effective because it avoids using insurance companies as middle-men.

Which, ironically, is exactly what is being proposed for currently private, but contracted Irish family doctors' services from 2019 when the new risk-rated universal health insurance system is supposed to begin.

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