Health System Reform Analysis in Canada

Introduction

Being a labor-intensive industry, health care and human resources are important inputs into providing health care. A global perspective will still show that health care systems are underdeveloped, under-researched, and poorly managed even in developed countries (Bloor and Maynard, 2003). Most nations had only a partial planning approach and there happened to be no effort to improve relationships between health professionals. The central planners had a vision, though inadequate, of the student’s intake in the medical and nursing profession and the future requirement for them. Numbers were maintained but the distribution of specialized professionals among regions and specialties showed inequality. Shortages and surpluses of staff occurred alternately due to the improper planning process. Immigration of health professionals helped to ease acute shortages but this approach became unsteady (Bloor and Maynard, 2003).

Performance management is poor, the measurement of efficiency is difficult. Even with the information management all round and internet access, health professionals fail to keep up with continuing medical education and are not up-to-date with the recent advances. Basic economic principles are hardly adhered to. The role of incentives in enhancing performance is ignored. The management of price control alone is perceived to cover the labor market but this perception has been proved wrong. An integration of shrewd planning by skillful planners from various disciplines and geographic regions and who could motivate the policymakers and legislative changes could initiate health reforms (Bloor and Maynard, 2003).

Thesis Statement

Sound management of performance and information and shrewd planning of workforce and health care reforms will produce a successful health care system in Canada.

Background

Review of Canada’s Health care System

The population is 32 million in a total area second only to Russia (Grzeskoviak, Health care in Canada). Canada is a constitutional monarchy. Being made up of 10 provinces and 3 territories, the population is distributed in a concentrated area within 200 kilometers of the boundary with the United States. Canada has a National Health care system that is funded by the Government and founded on the 5 basic principles of the Canada Health Act (Grzeskoviak, Health care in Canada). Permanent residents must have the benefit of healthcare universally. The healthcare system services must be comprehensive and accessible to all whatever the economic status. Being portable within the country and outside, it must be publicly administered. Providing healthcare by themselves becomes the responsibility of the provinces.

Strengths of the healthcare system

Apart from the planning, financing, provision of hospital care, public health facilities, and medical care, dental care, prescription drugs, optometric services, hearing aids, and home care constitute the services for the people of Canada (Grzeskoviak, Health care in Canada). The portability of medical services is between the provinces. People who travel abroad avail of medical insurance as treatment is costly in some countries like the US.

Healthcare funding is from the Federal Government, provincial and territorial governments. Personal and corporate taxation of revenue sources provides the main funding. Some provinces have sales tax (Grzeskoviak, Health care in Canada). The expenditure on Health comes to about 9.5% of the Gross Domestic Product (GDP). The GDP in the US is 13.9 % while that in the UK is 7.6%. Health expenditures in Canada have risen to a total of C$ 97.6 billion. Per capita expenditure was C$ 3174in 2000-2001. Expenditure on prescription drugs is increasing while that for the doctors is decreasing.

The healthcare services have been deemed satisfactory by 87% of Canadians according to the Joint Canada/ United States Survey of Health (Grzeskoviak, Health care in Canada). The quality of life is good too. The Mercer Human Resource Consulting’s 2004 Quality of Life Survey found Canada ranking within 20. The rural areas and northern communities do not have the same picture of satisfaction. Recently the public debate on government funding and the quality of healthcare services has taken a turn for the worse.

Limitations

Currently, four areas have been regarded as requiring improvement. They include patient waiting times; “overall healthcare funding; shortages in personnel and improvement of medical technology; and the expansion of the healthcare system to include home, pharmaceutical, and long-term care” (Grzeskoviak, Health care in Canada). Nursing is facing problems too; the number of nurses is too few, education facilities for nurses are not sufficient and the scope of practice is limited. Patients have complaints too: “waiting times to see specialists and for diagnostic tests are distressingly lengthy. It has reached 17.9 months in 2004. The wait for elective surgery is an added issue. Crowded emergency rooms are another. Medical tourism has led many patients to reach countries like the US to have surgeries and other services earlier. This queue jumping is taboo for some.

The proposal

A health plan proposal for Canada should contain all the following measures or changes:

  1. Medical colleges and nursing schools need to be situated in rural areas so that the graduates have a tendency to return to the area for work. Admission of students should provide regional priority.
  2. Nursing education must modify the syllabus to suit the changes in the healthcare industry and more graduates must be facilitated to come out for taking up professions as needed.
  3. Information management and education through advertisements in the media, newspapers, and the internet would enhance the dissemination of health care reforms.
  4. Funding must be enhanced to make the health services work.
  5. Shortages in personnel must be filled by making amendments to salary patterns and also using the system of providing incentives.
  6. Doctors must be adequately compensated.
  7. Professionals should not be allowed to be lured by lucrative salaries elsewhere for want of appropriate salaries.
  8. Homecare, pharmaceuticals, and long-term care should all be incorporated into one unique healthcare system.
  9. Waiting times for patients for tests and surgery must be positively reduced. Medical tourism must be discouraged. More personnel need to be hired. Effective ways to fight cancers, heart disease, and infectious diseases need to be found. Epidemics need to be controlled.
  10. Rural areas require more outlets of healthcare services where chronic patients can approach for their complaints. Remote areas need doctors.
  11. Development of telehealth to provide services over distances.

Post- reform

The hot issue of 2009 is the health care reform. Health care reform has the potential to create a novel environment for the stakeholders who are the employees, employers, insurers, and providers (Perrin, 2009). Employers would have greater administrative burdens and higher costs with health reform. Employers would be prone to change their benefits strategies with the reform. The balancing of the cost and talent management would be the main ingredient of the thought process. If the economic climate becomes a challenge, cost management will become the most important issue (Perrin, 2009). For the health management tool to be doubly effective for benefits, workforce health must provide strong business value. Employer reaction would be based on the type of industry. Companies would drop their health care plans despite having a high turnover and low wages if alternatives were attractive. Some companies would not drop their plans of giving better benefits for managing talent (Perrin, 2009). The sponsoring of health care coverage of employees and retired personnel may be thought about twice. Alternatives may be considered in terms of increments or drastic changes in future policies. 80% of employers are tracking the efforts to change health care policies but they are in no rush to change. 35% of employers claim that employees are also following the monitoring efforts. 90% of employers provide maximum priority for containing health care costs. Next comes the improvement of quality care at 74% (Perrin, 2009). The reform has an impact of 65% on consumer behavior. 59% consider that the use of better technology is most important. Improved equity payment for insurance and care is the most significant change expected by 53%. Reducing the number of people uncovered by health care services happens to be the least important (Perrin, 2009).

2 major issues in the UK

The participants of a seminar in London wanted a reform that would provide ample security to the most vulnerable populations especially the mentally ill (Ferriman, 2000). They also wished that the protection would be equitable that treatments that were available in one community would be made available in all communities. Nobody could offer a proper solution that would allow all patients to purchase necessary drugs (Ferriman, 2000).

Evolution of the health care system

Pressures within the community help the academic health centers. Plenty of Americans could not pay their bills in America for health care and experienced bankruptcy (Karpf et al, 2009). Reducing health costs may harm the operating margins thereby affecting the medical education process. The greatest contribution comes from managing complex patients. A common vision, goals, and decision-making help to integrate the health care process. The success of UK Health care depends on several approaches. The first is a model that leads to an integrated planning process (Karpf et al, 2009). Resources must be ably and effectively allocated for programs and infrastructure. The third is a unified process for the regional network. In order to implement a shared vision, UK healthcare expanded to advanced subspecialty care.

Hospital responses to health care reform

Hospital response is important to policymakers (Biorn et al, 2010). A positive effect is expected from a reform. However if the efficiency of a hospital declines because of that, the reform will be considered less attractive by the policymakers. This is because geography will have an impact on accessibility to services if there is an increased variance in efficiency. An increase in the efficiency of the hospital would have a tremendous effect on the national health services (Biorn, 2010). Even though the number of treatments increased and waiting time declined, three factors were found to be dysfunctional to the system: financial dependence on the central government, larger deficits in the budget, and lack of transparency in the financing system.

Conclusion

Health care systems are underdeveloped, under-researched, and poorly managed even in developed countries (Bloor and Maynard, 2003). The improper planning process, poor performance management, inadequate information management, reduced incentives, lack of planning, improper policy-making, and inadequate legislation are the reasons for the under-developed health care reforms. A reversal of each of these shortfalls would contribute to a good proposal of health care reforms for the 12 million people of Canada. The proposal should include lesser patient waiting times; appropriate healthcare funding; more personnel and improved medical technology; and the healthcare system expanded to include home, pharmaceutical, and long-term care. Modifying the education system of health care professionals would be a beginning in the dissemination of information regarding health care reforms. Information management and education through advertisements in the media, newspapers, and the internet would enhance the dissemination. Health care reforms have the potential to create a novel environment for the stakeholders who are the employees, employers, insurers, and providers (Perrin, 2009). For the health management tool to be doubly effective for benefits, workforce health must provide strong business value. The sponsoring of health care coverage of employees and retired personnel may be thought about twice. Alternatives may be considered in terms of increments or drastic changes in future policies. 80% of employers are tracking the efforts to change health care policies but they are in no rush to change (Perrin, 2009). Employers would have greater administrative burdens and higher costs with health reform. The employers would be prone to change their benefit strategies with the reform. The balancing of the cost and talent management would be a main ingredient of the thought process. If the economic climate becomes a challenge, cost management will become the most important issue (Perrin, 2009). For the health management tool to be doubly effective for benefits, workforce health must provide strong business value. A common vision, goals, and decision- making help to integrate the health care process. Hospital response is important to policy makers (Biorn et al, 2010). An increase in the efficiency of the hospital would have a tremendous effect on National Health Service

References

Biorn, E., Hagen, T.P., Iversen, T. and Magnussen, J. (2010), How different are hospitals’ responses to a? financial reform ? The impact ofn efficiency of activity-based refinancing. Health Care Management Science. Vol. 13. P. 1-16, Springer Science and Business Media

Bloor, K. and Maynard, A. (2003). Planning human resource in healthcare: Towards an economic approach An international comparative review

Ferriman, A. (2000). BMA launches review on UK healthcare spending. British Medical Journal, Vol. 320, p. 7242.

Grzeskoviak, M. ( n.d.). Healthcare in Canada. Web.

Karpf, M., Lofgren, R., Bricker, T., Claypool, J.O., Zembrodt, J. and Perman, J, (2009). Defining the role of University of Kentucky health care in its medical market-How strategic planning creates the intersection of good public policy and good business practices.

Perrin, T. (2009). Health Care Reform 2009: Leading employers weigh in. Pulse Survey Report.

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