HEALTH CARE ISSUE

Health Care Issue

Health Care Issue

Introduction

Health care in Canada has long been a source of national pride. Known as 'medicare', the system is publicly financed but privately run, it provides universal coverage and care is free at the point of use. The system is based on five founding principles. Care must be universal, portable, comprehensive, accessible, and publicly administered. But does medicare adhere to these principles? Many think not.

Ten Systems and Five Founding Principles: The Development of Medicare

Canada's version of national public health insurance is characterised by local control, doctor autonomy and consumer choice - patients theoretically have a free choice of physician and hospital. (Kraker, 2002). The ten provincial governments are the key providers of health care, having the constitutional responsibility for planning, financing, and evaluating the provision of hospital care, negotiating salaries of health professionals and negotiating fees for physician services. The result is that each provincial insurance plan differs slightly - mostly in how far each extends public insurance coverage beyond medically necessary hospital and physician services (Kraker, 2002). Additional services may include optometric services, dental services, chiropractic services and prescription drug benefits.

Registered Practical Nurse

The Registered Practical Nurse is accountable for his/her knowledge skill and judgment. The Registered Practical Nurse cares for stable, less complex clients with more predictable outcomes. RPN's work in collaboration with other members of the health team.

The Registered Practical Nurse, through basic education and continuing learning, possesses knowledge relevant to her/his practice. The Registered Practical Nurse possesses a focused or basic foundation of knowledge in clinical practice, decision-making, critical thinking, research utilization and leadership.

The Registered Practical Nurse assesses each patient's state of physical or mental health, provides recommendations pursuant to the assessment and accurately documents information in a comprehensive, subjective manner reflecting observations, assessments, management plan and interventions. The RPN will have greater autonomy in this role when caring for a client with less complex conditions. As client complexity increases, there is a corresponding increase in the need for RPNs to consult with RNs, supervisor or physicians.

Health Care Without Hindrance

The Canadian Health Act of 1984, which was drafted in response to these protests, denies federal support to provinces that allow extra-billing within their insurance schemes and effectively forbids private or opted-out practitioners from billing beyond provincially man-dated fee schedules. The 1984 Act also defines and solidifies the principles of medicare, including: comprehensiveness (provinces must provide medically necessary hospital and physician services), universality (100 per cent of provincial residents are entitled to the plan), accessibility (there should be reasonable access to services, not impeded by user charges or extra billing), portability (protection for Canadians travelling outside of their home province), and public administration (provinces must administer and operate health plan on a non-profit basis) (Klatt, 2002). These principles aim to provide a one-tiered service.

Since 1977, cost sharing has been transformed through several negotiated legislative steps from the 50-50 split between the federal and provincial governments to a reduced single block fund called the Health and Social Transfer (WHO, ...