Dear Dr. McPherson and all, thank you Dr. McPherson.
I wanted to share again as I am a Canadian citizen and find this very interesting. I agree, we have to keep the discourse 'evidence based'. Yet I cannot sit idly by while Canada is bashed and in the same, England, as to health care provision.
Let me share what is so 'bad' about Canada's unique health system under our Medicare act or Canada Health Act (CHA)..
There are ongoing efforts at reform as time unfolds and reforms have been made and no doubt will continue in response to changes within medicine and throughout society. The basics, however, remain the same - universal coverage for medically necessary health care services provided on the basis of need, rather than the ability to pay
Our health care system, often bashed, is framed by 5 criteria....it is not perfect yet no Canadian, citizen or legal resident, is to be denied health care if there is a need, and certainly not based on one's financial status....
- Public Administration (section 8)
The public administration criterion, set out in section 8 of the CHA, applies to provincial and territorial health care insurance plans. The intent of the public administration criterion is that the provincial and territorial health care insurance plans are administered and operated on a non-profit basis by a public authority, which is accountable to the provincial or territorial government for decision making on benefit levels and services, and whose records and accounts are publicly audited.
- Comprehensiveness (section 9)
The comprehensiveness criterion of the CHA requires that the health care insurance plan of a province or territory must cover all insured health services provided by hospitals, physicians or dentists (i.e., surgical-dental services which require a hospital setting) and, where the law of the province so permits, similar or additional services rendered by other health care practitioners.
- Universality (section 10)
Under the universality criterion, all insured residents of a province or territory must be entitled to the insured health services provided by the provincial or territorial health care insurance plan on uniform terms and conditions. Provinces and territories generally require that residents register with the plans to establish entitlement. Newcomers to Canada, such as landed immigrants or Canadians returning from other countries to live in Canada, may be subject to a waiting period by a province or territory, not to exceed three months, before they are entitled to receive insured health services.
- Portability (section 11)
Residents moving from one province or territory to another must continue to be covered for insured health services by the "home" jurisdiction during any waiting period imposed by the new province or territory of residence. The waiting period for eligibility to a provincial or territorial health care insurance plan must not exceed three months. After the waiting period, the new province or territory of residence assumes responsibility for health care coverage.
Residents who are temporarily absent from their home province or territory or from Canada, must continue to be covered for insured health services during their absence. This allows individuals to travel or be absent from their home province or territory, within a prescribed duration, while retaining their health insurance coverage.
The portability criterion does not entitle a person to seek services in another province, territory or
country, but is intended to permit a person to receive necessary services in relation to an urgent or emergent need when absent on a temporary basis, such as on business or vacation.
If insured persons are temporarily absent in another province or territory, the portability criterion requires that insured services be paid at the host province's rate. If insured persons are temporarily out of the country, insured services are to be paid at the home province's rate.
Prior approval by the health care insurance plan in a person's home province or territory may also be required before coverage is extended for elective (non-emergency) services to a resident while temporarily absent from their province or territory.
- Accessibility (section 12)
The intent of the accessibility criterion is to ensure insured persons in a province or territory have reasonable access to insured hospital, medical and surgical-dental services on uniform terms and conditions, unprecluded or unimpeded, either directly or indirectly, by charges (user charges or extra-billing) or other means (e.g., discrimination on the basis of age, health status or financial circumstances). In addition, the health care insurance plans of the province or territory must provide:
- reasonable compensation to physicians and dentists for all the insured health services they provide; and
- payment to hospitals to cover the cost of insured health services.
Reasonable access in terms of physical availability of medically necessary services has been interpreted under the Act using the "where and as available" rule. Thus, residents of a province or territory are entitled to have access on uniform terms and conditions to insured health services at the setting "where" the services are provided and "as" the services are available in that setting.
Best,
Paul
--- On Mon, 8/24/09, Klim McPherson <[log in to unmask]> wrote:
From: Klim McPherson <[log in to unmask]>
Subject: Re: Combating misinformation about the NHS: do your bit for the NHS which we are all proud of in the
To: [log in to unmask]
Received: Monday, August 24, 2009, 9:53 PM
Douglas et al. This discussion is excellent. I want to tell a story of US Health Care in the 1970's which is relevant. I was working in Preventive Medicine at Harvard and when I got back to the UK in the mid 70's I got a job at Oxford where ultimately part of what I did was to teach Health Care Organisation in the public health bit of the clinical curriculum. I received one day a copy of a letter from a US colleague from the AMA to him - which for some reason ( I can't now remember exactly why ) identified the (supposed) horrors of the NHS as argument for resisting change in the US. I wrote to the AMA and asked if I could use the material on my course - since it seemed to characterise so well the amazing misconceptions about 'socialised medicine', none of which were factually correct. Interestingly I received a reply very quickly saying a) ' no please don't' and b) they had decided to change their
propaganda to a more evidence based approach. I don't know whether they did - but if so it hasn't had any permanent effect ! At the very least what is said about UK (and Canadian) health care ought surely to be accurate ?? I strongly commend the efforts of you and Ash in pursuing this objective. Klim Klim McPherson Fellow of New College Chair of the National Heart Forum Visiting Professor of Public Health Epidemiology Nuffield Dept of Obstetrics & Gynaecology Oxford University Womens Centre, Level3 John Radcliffe Hospital Headington
Oxford OX3 9DU Tel: 01865 740885 Home: 01865 558743 Mobile: 07711335993 [log in to unmask]" ymailto="mailto:[log in to unmask]"> [log in to unmask] [log in to unmask]" ymailto="mailto:[log in to unmask]"> [log in to unmask]
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