Ramandeep Kaur (Sonographer)
THE CANADIAN HEALTH SYSTEM
As a healthcare employee, I strongly believe it is necessary to have a clear understanding of how the health system works in Canada. It is crucial to know what are the health acts set by the government at federal and provincial levels and how the healthcare expenditures work. Based on my learning in this course as well as my experience as a healthcare professional, I have a brief summary explaining the Canadian healthcare system, it's healthcare expenditures as well as my own view point as a sonographer on the amendments that can be brought to provide better care.
Canada as country has its own act named the Canada Health Act (CHA), which is under the federal legislation.The Canada Health Act which governs the Canadian health system is funded by the publicly paid taxes in the form a health care insurance for their respective provinces. The goal of this act is to deliver effective healthcare services to Canadians without any monetary or other barriers. The Canada Health Act is also responsible to deliver healthcare services to a certain group of people such as the First Nations people, Inuit, eligible veterans, some inmates and groups of refugees. Every province and territory need to meet the terms and conditions set by the Canada Health Act, to be able to utilize the federal funds for their health insurance plans. The Canada Health transfer is a means by which the federal government delivers funds to the provinces and territories. The federal government also aids the low-income provinces and territories by equalizing their payment delivery (CHA, 2018).
Just like we have the Canada Health Act on a federal level, we have different acts on provincial levels governing the Canadian health system. For example: Ontario has the Regulated Health Professions Act (RHPA) established in 1991 and the associate health professions act that administer the healthcare professions (Ministry of Health, n.d.).
HEALTHCARE EXPENDITURES
The public paid taxes fund the healthcare system of Canada. However, the funding and expenditures differ in each province and territory due to difference in services and variation in population demographics. The graphic demonstration below is an example of healthcare expenditures on a federal level, showing the areas of expenses and the amount of expenditure between the years 1975-2010.
("Source: https://www.canada.ca/en/health-canada/services/health-care-system/reports-publications/health-care-system/canada.html#a7").
According to the statistical information provided by the Canadian Institute for Health Information in 2010, most of the spending as shown in the graph above was made by the hospitals, followed by expenditure on drugs and lastly on payments made to physicians. This gives us an idea as to how much and on what areas are the healthcare expenses being spent on.
AMENDMENTS TOWARDS MODERNIZING THE CHA (SONOGRAPHER'S VIEWPOINT)
A modern healthcare system is one that advances with time and population needs. It needs to be just and equitable to its citizens and must be able provide for their necessary treatments. From my experience and knowledge as a healthcare professional, the following are the areas that can be amended towards modernizing the Canadian Healthcare system in terms of ultrasound as a profession.
Flood & Thomas (2016) suggested the following amendments towards the Canada Health Act published in the Dalhousie Journal named "Modernizing the Canada Health Act". After reviewing and agreeing with their suggested amendments, I believe few reformations in my field of ultrasound can aid in enhancing the quality of care.
1. The Canada Health Act should reevaluate the health care services delivered and should expand the range of services provided to include mental health, diagnostic services, dental care, home based care and prescriptions. I have noticed as a healthcare professional that the mental health issues seem to be on the rise within the Canadian population in the last decade. Therefore, the Canada Health Act must make necessary amendments to enhance the above-mentioned areas of services along with clearly defining the mental health services that can be delivered.
2. The explanation of “medically necessary” services by Canada Health Act must be well clarified. Unfortunately, there is not a clear definition of “medically necessary” services. While doing so, the needs of various provinces should be kept in mind so that the health care services and medications that are insured by the public is justified. In the field of ultrasound in Ontario and other provinces, the range of ultrasound services needed for medical treatment should be well defined in the list of medically necessary services. This fact has already been stated several years ago in the article published in 1998 by the European journal of ultrasound where it was recommended that the use of ultrasound in the field of dermatology, ophthalmology and stomatology for treatment and diagnosis purposes must be incorporated.
3. All individuals seeking medical treatment for drugs or treatment plans not included under the Canada Health Act should have the opportunity to appeal with proper evidence of their medically necessary treatment services. Unfortunately, a lot of my patients who have injuries in their muscles, tendons due to age or trauma related are unable to get the necessary medical treatment because of their intensity of pain being mild to moderate and this pain in the future aggravates to a severe musculoskeletal disorder. These individuals should be given the opportunity to appeal for a treatment at the earliest so that the future chronic injuries can be minimized.
4. Lastly, an attempt to find a long-term solution for the current wait times for surgeries and medical imaging tests should be worked on with a panel of ministers and physicians to modernize and bring necessary reformations. The wait times to get a basic ultrasound exam for even regular check-ups is a huge concern at my workplace. This requires a lot of effort, planning and alterations on the Canada Health Act’s part so that people can get medical imaging tests done with shorter to minimal wait times.