While the health care system in the United States is increasingly dominated by managed care, the health care system in Canada continues to undergo changes. Although it still retains its basic character as a publicly-funded right for all citizens, the health care system in Canada is pressured by consumers to allow for more choice, including the choice to obtain private care.
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 grant monies available to provinces, with the net result of decreasing funding for health care (Newman, 1995).
One of the major problems that was already affecting Canadian health care, and continues to do so, is the desire of Canadians to take advantage of private health care services (particularly in the United States) in order to get quality services faster. Canada's system is a whole-country medicare-type of system in which all citizens are eligible for the full range of medical services. However, the problem is that there a...