Canada Health Act Essay Example

to healthcare. However, as we enter the new millennium, these fundamental values are under threat, particularly in Alberta where restructuring measures are already impacting its residents.

Insufficient funding and budget cuts are endangering the accessibility and quality of healthcare, which was once assured in the CHA and highly valued by Canadians. This decline in the healthcare system is acknowledged by medical professionals, the public, and the government. Nevertheless, federal funding is decreasing while provincial debt loads are increasing. Although both the minister of health and premier have provided reassurances regarding rising healthcare costs, residents of Alberta have observed a continual decrease in government investment in healthcare.

The province of Alberta has the lowest allocation of gross domestic product (GDP) to healthcare among the ten provinces, resulting in a struggling healthcare system and lengthy waiting lists (Taft, 1997). The government's proposed solution is to incorporate the private sector into the healthcare system in order to decrease costs and increase accessibility and efficiency.

Universality and Accessibility vs. Choice

Universality and accessibility ensure that all Canadians have equal access to healthcare, regardless of their financial situation. However, some argue that the absence of a private market in the current system limits individuals' freedom to choose. Supporters of privatization believe that these principles clash with Canadians' right to decide whether they want to pay privately for healthcare, as well as physicians' right to provide preferential treatment to those who pay privately (Dirnfeld, 1996; Gordon, Mintz & Chen, 1998). Nevertheless, allowing more choice in this manner may lead to harmful practices like cream skimming (Dirnfeld, 1996).

Insurance companies may choose to only cover individuals who meet specific low-risk physical criteria, while physicians may only care

for those who can afford it or those whose diagnosis is most profitable. This shift could mean a regression in Canadian healthcare, returning to an older medical model that prioritizes disease and treatment instead of promoting health and preventing illness. Privatization introduces private insurance, which then has control over determining how, who, where, and when healthcare services are accessed, greatly limiting individual choice (Armstrong & Fegan, 1998). Only those with sufficient insurance coverage or the means to pay out of pocket would have access to a private, for-profit system.

Access to services may also rely on business hours and facility rights specified by private owners and restrictions set by insurance plans. Availability will also be impacted by the location choices of for-profit hospitals, potentially leaving rural areas with limited options. Due to their low population, rural communities are less likely to attract free-market competition. Consequently, while more populated areas are flooded with various healthcare providers competing for customers, rural communities risk being left behind.

Businesses and employees will be attracted to the potential for increased financial gain as profit is exchanged for individuals.

The Choice between Cost Reduction and Non-profit

A key motive behind privatization is the aim of reducing and controlling escalating healthcare costs. The belief is that a private, for-profit sector would encourage competition among healthcare providers, leading to lower expenses for consumers as different companies vie for customers.

Despite evidence showing the negative effects of privatization, investments in advertising and marketing are still necessary for competition. This incurs an additional cost that is absent in the current system (Wilson, 1995). However, applying the concept of free-market competition to healthcare is not appropriate. In this sector, individuals act

as consumers who seek the best product at the best price. Unfortunately, waiting for a sale or exchanging services if unsatisfied is unrealistic when it comes to medical care. Furthermore, this approach contradicts the principles outlined in the CHA which prioritize publicly funded medically necessary services over profit-driven motives (Armstrong & Armstrong, 1996).

The introduction of a private healthcare system in Canada goes against the core principle of ensuring accessible healthcare for everyone. The implementation of a private system could lead to increased expenses, while a public system with less bureaucracy can prevent additional costs associated with overhead and operating expenses (Armstrong & Fegan, 1998). The additional expenses arise from the paperwork and administrative tasks required to regulate a private system. In Canada's single-payer system, there is no necessity to create an itemized equipment list for every patient in order to generate a bill for services.

By implementing a single-payer system, the need to maintain records of individuals' insurance plans, payment details, and treatment choices would be eliminated. Nevertheless, Canada's decision to de-insure certain medical services such as eye exams and prescriptions has led to higher expenses for consumers. Although privatizing healthcare is unlikely to reduce operating costs, it will shift the financial burden from public funds to individuals.

Efficiency and Quality

Many people believe that the increasing competitiveness in for-profit markets will lead to reduced waste and increased efficiency. The private market is focused on controlling costs to increase profit, which is expected to result in more efficient waste management and less abuse or misuse of healthcare resources. However, there is little evidence to support the claim that the current system is abused

or overused (Armstrong ; Fegan, 1998; Wilson, 1995). On the contrary, if the private sector prioritizes profit, there is a possibility that healthcare administration may prioritize profit over proper diagnosis and treatment. Both proponents and opponents of private healthcare acknowledge that the quality of care is suffering. Supporters of privatization believe that the single-payer system has led to rationing through queues, decreased accessibility, and diminished quality (Dirnfeld, 1996, p.409).

Adding a private option in health care is believed to improve access for those using the public system by reducing waiting lists. However, evidence suggests that instead of reducing waiting lists, the presence of the private sector would simply change how waiting lists are organized and prioritized. This means that individuals who can afford to pay would bypass the list and receive essential care, potentially leaving patients with higher need behind.

Relevance to Nursing Practice

Nursing is an ethical profession.

Accountability is crucial for nurses as they must bear responsibility for their actions and the care they deliver. However, the introduction of profit-driven private sectors into the healthcare system can compromise accountability, as hospitals prioritize financial gain over maintaining standards. Nurses also have an ethical obligation to ensure that clients receive safe, competent, and high-quality care (CAN, 1997). As mentioned earlier, when money becomes the primary motivating factor in healthcare provision, a decline in quality is expected. Fairness and equitable distribution principles dictate that healthcare should be based on need rather than an individual's ability to pay.

The AARN, in their 1995 position statement on privatization, reinforces the belief in maintaining the principles of the CHA. Nursing, as a profession, takes pride in its holistic approach to care. However, the alignment

of the medical model and profit prioritizes their authority in healthcare, potentially leading to a neglect of individual needs. This would result in a focus on fixing a specific quota of parts within a given time frame. Consequently, if the principles of the CHA are disregarded for the sake of privatization, it will adversely impact the integrity of nursing practice (Armstrong & Armstrong, 1996).

Conclusion

All of this is not meant to indicate that the current Canadian Health Care system is ideal. Nor does it suggest that radical restructuring is not necessary in the evolution of Canada's Health Care system. Instead, the restructuring required for the system to thrive must be undertaken holistically, not solely focused on cutting costs for the public sector. Implementing cutbacks and downsizing will not revitalize an ailing health care system. Moreover, the introduction of investor-owned hospitals aiming to maximize profits, rather than reduce costs, is not the solution.

Reform and restructuring must begin at the grassroots level, with fundamental changes in our perception of health and healthcare. The focus should shift away from the outdated medical model towards promoting health, preventing illness, and meeting the needs of a changing population. However, it is crucial to maintain the core principles of the Canada Health Act.

References

1. Alberta Association of Registered Nurses. (1995). Position Statement on Privatization. Edmonton: Author.
2. Armstrong, P., ; Armstrong, H. (1996). Wasting Away: The Undermining of Canadian Health Care. Toronto: Oxford University Press.
3. Armstrong ; Fegan. (1998). Universal Health Care.

New York: New York Press.

Canadian Nurses Association.

(1997). Code of ethics for registered nurses. Ottawa: Author.

Dirnfeld, V. (1996).

The article "The benefits of privatization" by the Canadian Medical Association,155 (4), 407-410, discusses the advantages of privatization in the healthcare system.

(1997). The NACA position on the privatization of health care. Ottawa: Author.

Edmonton: The University of Alberta Press and Parkland Institute.