title: Canadian health system. Rationing, social policy and hysteria.
abstract: The Canadian health care system is a recipe for lowest common denominator medical care. It imposes many of the same restrictions experienced in the United States in the gatekeeper HMO model. Centralized government control allows a more thorough ratcheting down of costs and growth limitation by bureaucracy at all levels responding to political expediency without needing to address actual medical need. Yes, in theory Canadians enjoy the full range of therapies and services available in any medical market in the United States and, yes, undoubtedly it is cheaper. Access in theory to first-dollar coverage for services does not translate well to practice if patients do not survive long enough to keep their appointment for that therapy or service. Clearly, the advocates of an American adaptation of the Canadian health care system are serious and should not be treated lightly. They understand dollars but not patients and their needs. They measure quality and efficiency of care in terms of hospital bed utilization and generic screens, not in terms of being able to deliver the best achievable appropriate care to the greatest number of eligible patients. The multiple levels of government control and the absence of effective competition in the Canadian model allow significant cost reductions in health care, but at the expense of the available range of treatment options and access to treatment. Imposition of this model in the United States would require closure of some existing facilities and reduced access to those remaining, leading inevitably to a substantial reduction of the standard of medical care practically achievable by each of us for our patients.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.forename: B S
authors.initials: BS
authors.lastname: Tepperman
mesh_terms: D002170:Canada; D003365:Costs and Cost Analysis; D015276:Health Care Rationing; D006268:Health Facilities; D006801:Humans; D007348:Insurance, Health / Q000191:economics; D009313:National Health Programs / Q000191:economics; D011640:Public Policy; D012017:Referral and Consultation