Canadians keep eye on U.S. health care debate

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(Host) Canadians have been watching the debate in this country over health care legislation being considered by Congress. 

Studies show the Canadian system provides care at a lower cost than in the United States.  The savings comes from the reduced administrative expense of a single payer system and through negotiated fees for services and procedures.

Canada went through its own health system overhaul a quarter of a century ago, transitioning from a system of privately insured care similar to the United States, to one where medical bills are paid for publicly. 

Antonia Maioni is a health care policy expert who directs the McGill Institute for the Study of Canada. 

Speaking on VPR’s Vermont Edition, Maioni said there was a great deal of debate when Canada adopted its single payer system and much of it surrounded concerns that the government not take over the medical profession. 

For that reason, Maioni says the government does not run hospitals or employ the physicians who provide care.

(Maioni) "Part of the success of the system up until now in Canada is the sense that medical care is still in the hands of professionals, not in the hands of government.  That doesn’t mean that government doesn’t make some pretty important decisions about how much money to pay hospitals and how much to reimburse doctors."

(Host)  Under the current Canadian system, each of the country’s 10 provinces is required to provide universal, publicly financed health coverage.  The cost is shared by the federal government and by each of the provinces. 

Maioni says there is growing concern that too much of the burden is being shifted onto the provinces. 

(Maioni) "But essentially the provinces are carrying the heavy part of the burden and then they receive money from the federal government based on their population. That money has been declining over time, so many of the provinces are now restless – asking themselves why they have to be bound by these federal conditions if the federal government is not pulling its weight."

(Host) One expense that is generally not covered under Canada’s public health care system is the cost of prescription drugs, which has increased dramatically in recent years. 

That’s helping to drive up the share of overall health care expenses that have to be paid for by consumers or through private insurance. 

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