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Unlike in Canada, it builds inequality right into the system
November 7, 2013
TORONTO, ON, Nov 7, 2013/ Troy Media/ – Will Obamacare impact Canadian healthcare policy?
It’s among the many questions that were posed to Trudy Lieberman, past president of the Association of Health Care Journalists and press critic for the Columbia Journalism Review. Lieberman recently completed a cross-Canada public speaking tour, as a Fulbright Scholar and guest of the Evidence Network of Canadian Health Policy, more commonly known as EvidenceNetwork.ca.
Lieberman’s timely visit occurred shortly after the official U.S. government implementation of the Patient Protection and Affordable Care Act (PPACA), also called the Affordable Care Act (ACA) or “Obamacare.” Signed into law by President Barack Obama in 2010, PPACA legislation initially inspired some to hope for a more “Canadianized,” equitable version of American healthcare.
But closer analysis reveals this is far from the case.
Lieberman is quick to point out that Obamacare builds inequality into the system rather than legislating fundamental reform. Lieberman cites two major differences between attitudes toward healthcare in Canada and the United States:
Canadian healthcare ideology dramatically differs from how Americans view healthcare. Lieberman admits that a market-driven economy and powerful politics from stakeholders, particularly healthcare providers and insurance companies, are major obstacles to changing cultural attitudes toward equitable healthcare coverage.
“If we (Americans) ever adopt a different system, the impetus would have to come from the business community. It won’t come from advocates or academics, or the media,” says Lieberman. “We have a largely employee-based system with 160 million people covered by their employers. The spark for wholesale reform of the system will have to come from employers.
2) Focus on Aboriginal healthcare
“I don’t recall ever writing about the Indian Health Service,” Lieberman muses. “In Canada, I’ve heard more discussion of aboriginal health than wait times.
Lieberman points out that the results of Obamacare legislation may take years to determine. In the meantime, there are ways our two systems have similarities:
1) Health care costs increasingly shifted to individuals
“We can see a shift in both countries toward making the patient pay for more,” Lieberman notes. “Americans are paying more out of pocket for healthcare. In Canada, many services are not covered, and depending on the outcome of a court case in British Columbia, Canadians may pay more out of pocket, too.”
2) Quality concerns
“Both countries have various problems with aspects of medical quality and both have to work on improving care, especially long-term care for the elderly,” Lieberman points out.
AS to the increased demand for and cost of technology, Lieberman says that the U.S. still hasn’t “. . . figured out a way to reign in the cost of technology. Patients want the latest and greatest but the U.S. doesn’t have anything like the United Kingdom’s National Institute for Health and Care Excellence(NICE), which looks at the cost and efficacy of new treatments before recommending these to NHS doctors.”
So, will Obamacare give Canadians a new perspective on their healthcare system? While both countries have distinct healthcare policies, the costs for technology, provider services and long-term care, among other items, continue to escalate. Finding new and improved ways to meet and manage these costs will be the challenge on both sides of the border.
Janna Stam is a Toronto-based freelance writer and communications professional in Canada. She has written for diverse audiences, including healthcare IT users, non-profit organizations, and political campaigns. She holds a Master of Arts in English Literature from Queen’s University.
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