Читать книгу Kelly Vana's Nursing Leadership and Management - Группа авторов - Страница 112

Annually, the Canadian government spends 10% of its GDP on its national health care system Papanicolas, (2018). The Canadian health care system is administered by each Canadian provincial or territorial government. Seventy percent of health spending is publicly funded through federal and provincial taxation of individuals and corporations, and the remaining 30% is paid through private and out‐of‐pocket sources for additional services such as prescription medications or dental and vision care (Canadian Institute for Health Information (CIHI), 2006). All Canadians have equal access to the same quality and quantity of health care. Under the Canada Health Act of 1984, comprehensive health care is publicly administered, portable between provinces, and accessible to all. Primary care is provided by physicians and nurse practitioners, who may work in private clinics or public institutions. These health care providers are reimbursed on a fee‐for‐service basis, which allows them to be reimbursed by each provincial or territorial health plan for each health care service rendered to a patient.

Unlike the privatized health care system in the United States, extra billing, deductibles, and copayments are not allowed. The health care provider bills the provincial or territorial health plan and is reimbursed with an agreed‐upon amount for each health service given. No additional charges or costs can be billed to or recovered from the patient. With only one insurance payer, referred to as a single‐payer system, many of the problems embedded within the American health care system are eliminated. The problem currently facing the Canadian health care system is the lengthy wait times to access family practitioners, specialists, emergency room services, diagnostic tests, and surgical procedures (NCHC, 2008). To help remedy this issue, Canada has established benchmarks for treatment and waiting times. 2018 data for the Canadian Institute for Health Information reveals that the Canadian benchmark for hip replacement is 182 days and they are currently at 75% compliance with the benchmark. In the U.S., patients cannot imagine a “standard” wait time of 6 months to have a hip replacement. With more life threatening issues such as a hip fracture, their benchmark for a hip fracture repair speeds up to 48 hr and they are at an impressive 88% compliance with the benchmark (Canadian Institute for Health Information, 2018). This illustrates that wait times in Canada are circumvented based on the gravity of a patient's condition, but this solution aggravates the waiting time for less urgent cases. In a geographically vast country with a small population compared to the United States, some Canadians in rural or isolated locales often travel long distances to obtain specialized services (Canadian Institute for Health Information, 2018).

As an example of the comprehensiveness and affordability of the Canadian health care service, a 51‐year‐old Canadian nurse working in the United States recently returned with her spouse and 15‐year‐old child to her home province of Alberta for 1 year. During that time, the family enrolled in the Alberta Health Care Insurance Plan for a cost of $88 per month (Alberta Health and Wellness, 2004). Health care for the nurse included an annual physical examination, lab tests, mammogram, bone density testing, and a routine colonoscopy. The colonoscopy required a 5‐month wait. Her husband underwent elective day surgery, which was booked 7 months in advance. Her daughter was immunized at school, and she was once treated at a community health center for a persistent respiratory infection. Beyond payment of their monthly premium, the family was issued no bills for the health care they received.