Payers, and some doctors, will weigh the cost of a treatment against the expected outcomes to determine whether the treatment should be made available to a patient. For example: Rationing takes place when a treatment is denied by the Canadian government. Those rationing decisions are often made by weighing the cost of the treatment against the potential improvement in the patient's health.
Like other nations experiencing limitless demand, an ageing population, and the costly advance of medical technology, Canada has faced pressure to control health expenditures. It has done so through rationing. In Canada, rationing medical care and holding down health care spending was thought to help the health care system run more efficiently and lower wait times. (Irvine, Ferguson, & Cackett, 2005).
Health care reform. The Canadian government, in an effort to improve patient care and wait times has made other recommendations: Work with the provinces and territories to ensure that meaningful reform of the Canadian health care system is undertaken, in part guided by the more successful health care models in some European countries that have demonstrated that universal, publicly funded health care systems can operate more efficiently at a lower cost and involve the private sector more fully to produce superior outcomes, with no appreciable wait lists (Reforming the Canadian Healthcare System, 2006).
Revision of rigid scope-of-practice rules. This would make health care professionals and support staff more productive, integrate health care information systems to increase the efficiency, and explore other mechanisms to address labor shortage issues in the health care system.
Hospital funding. Continue to work with the provinces and territories to change the current system of determining hospital funding. The purpose would be to recognize the need to provide incentives for increasing the volume of patients treated rather than hospitals restricting patient volume so that they don't exceed funds available in their budgets (Reforming the Canadian Health care System, 2006).
The Government's 10-Year Plan. The plan outlines strategic investments directed toward reducing waiting times for access to care, especially for cancer, heart, diagnostic imaging, joint replacement and sight restoration services. To support the reduction of wait times, the Federal Government committed to investing $4.5 billion over the next six years, beginning in 2005.
This additional investment will augment existing provincial and territorial investments and assist jurisdictions in their diverse initiatives to reduce wait times. It will primarily be used for jurisdictional priorities such as clearing backlogs, building capacity for regional centers of excellence, and expanding appropriate ambulatory and community care programs and/or tools to manage wait times (Health care system, 2008).
More health care professionals. One of the principal causes of long waits is a shortage of health care professionals in Canada. The demand for health care services keeps increasing. The health care professional workforce is ageing and static or shrinking. The Government simply needs to train, recruit, and work harder to provide and retain more of these professionals.
Accrediting and integrating foreign-trained professionals is part of the solution, but it is not a magic solution.
Clancy (2007) says that Canada can develop an adequate supply of health professionals by taking three important steps.
First, we must improve the work environment and job satisfaction for our current health professional workforce by making creative investments in financial and non-financial incentives and putting an end to an over-reliance on part-time and casual work.
Second, we must make better use of the health professionals we have presently. This means moving forward more aggressively with primary care reform, moving to team-based care, reassessing the scope and patterns of practice, and enabling health professionals to practice to their full potential in order to make the best use of skills.
Third, we must plan better for future health needs. This means we must increase enrollment spaces in health professional schools and reduce high tuition costs to train more professionals where there are severe shortages (Clancy, 2007).
In particular, it means provinces have to stop working in isolation and accept that a national approach is required. The lack of a national approach has resulted in destructive competition rather than cooperation.
Long wait times are a real problem. But real results on reducing wait times are possible once we hire more health professionals (Clancy, 2007).
A stakeholder is defined as a person or group with a direct interest, involvement, or investment in something.
The stakeholders in ensuring the success of the current Canadian system of health care, or a reformed version of the same entity, are, ultimately, two groups: the Canadian population, and the Canadian national and provincial governments. Everyone involved in such a massive, nation-wide, all encompassing system have to be regarded as holding an interest, investment or involvement in not allowing the system to fail.
The people of Canada must have a properly operating, efficient, economic, and effective health care system. Right now, they do not have such a system. The extensive waitlists for many medical procedures are example enough of this. However, they must be aware that part of the solutions might be increased taxes to pay for them.
The Canadian governments must make this system succeed or they will witness more and more of the disgruntled Canadian population "escape" to the U.S. For shorter waits and better care.
The solutions proposed, for the most part, will help the health care system. Too many Canadians are waiting too long, too often, for the critical services they need. Shorter wait times are essential for their individual health and for the health of Medicare itself.
Reducing wait times can stimulate broad constructive reform, while improving the way the health care system is organized, and ensuring that health care dollars are spent effectively. A return to shorter wait times will also restore high levels of public confidence and support for the system overall (Clancy, 2007)
Against this background, public dissatisfaction with and concern regarding the Canadian health care system has reached a high level. The federal and provincial governments have acted to increase funding for the system, but the fundamental problem remains (Reforming the Canadian Healthcare System, 2006).
Transforming Canada's ailing Medicare into a better health care system will require meaningful health care reform. In recent years, the government has made a number of positive developments on the health care front. Even with these positive steps the waiting times have only dropped a very small percentage compared to the overall problem. Without fundamental reform, just injecting more money into the Canadian health care system will not solve the problems plaguing Medicare. Finding real solutions requires Canada to look to the more successful models in some European countries who have demonstrated that universal, publicly funded health care systems can operate more efficiently at a lower cost and involve the private sector to produce superior outcomes, with no appreciable waitlists.
Every developed country except Canada harnesses the financial and business capacity of the private sector to help deliver medically necessary diagnostic and surgical services effectively and efficiently (Reforming the Canadian Healthcare System, 2006).
Reducing wait times is one of Canada's most prominent health care issues. Many believe that more extensive information about who is waiting for what, for how long, and the decisions that influence wait times would greatly improve the wait time situation.
Clancy, J. (2007, Feb 9). An urgent message for Canada's health care ministers. Retrieved Apr 4, 2009, from National Union of Public and General Employees: http://www.nupge.ca/presidentscommentary/n09fe07d.htm
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Irvine, B., Ferguson, S., & Cackett, B. (2005). Background briefing: The Canadian health care system. Retrieved Apr 4, 2009, from www.civitas.org: http://www.civitas.org.uk/nhs/download/Canada.pdf
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