Health Care in Canada and the U.S.

In the United States, health care system changes this decade have primarily been driven by financial considerations. According to Nancy McKenzie (1994), the debate about health care has not been about caring for the sick, or preventing disease and disability. Instead, the focus has been on controlling costs. While access to insurance has been promoted, this is not the same thing as having access to quality medical care, since insurance companies are able to devise ways to avoid covering people and needed services (McKenzie, 1994).

Health care changes in Canada have also been driven by cost considerations. The turning-point in Canadian health care came earlier this decade when the government began to acknowledge that it was unable to continue to provide the same level, or an increasing level, of health care services to all citizens. Health care costs were increasing, as in the United States, and the government was unable to meet the need. The government changed its handling of funding for health care, moving it into block

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re for the wealthy and mediocre care for everyone else. She also noted that the Medicare+Choice system may result in the actual abolition of Medicare. In looking specifically at Medicare in managed care, recent results seem to indicate that this is not a good match. In Ohio, for example, Medicare programs have been linked with managed care, but the result has been millions of dollars worth of losses (Page, 1998). As a consequence, a recent trend there has been to detach Medicare from managed care, including a reversal of plans to move into rural areas of Ohio with managed care efforts (May, 1998). Possibilities According to Judith Lave (1996), experts have been rethinking the Medicare system virtually since its inception. Some of the major proposed changes to the system have included expanding Medicare to include long-term-care benefits and prescription drugs, restructuring cost-sharing provisions and limiting out-of-pocket payments, and changing Medicare from a defined benefit to a defined contribution or voucher program. Lave (1996) herself, however, has other recommendations. She noted, for example, that cost issues could be addressed by merging the Hospital Insurance and Supplementary Medical Insurance programs, impro
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Approximate Word count = 5686
Approximate Pages = 23 (250 words per page)

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