by Healer Mark Taylor, Medical Herbalist
(a.k.a. The Herbinator)
Health care in Canada is very good when compared against similarly developed countries. However, for all that is good about the health care system, much controversy surrounds many aspects of health care delivery.
The Canadian health care system is self-described as being single-payer, evidence-based medicine. In a single-payer system various levels of government pay most medical expenses. Costs are not typically born by individuals or insurance companies. Evidence-based medicine claims to use scientific proof as justification for medical practices against people.
The national health care system was created to provide equal access to health care for all citizens of Canada. In this effort Canada has largely succeeded. A so-called two-tiered system of medicine where the rich are able to obtain preferential access to health services does not exist for those services which are covered by Canada's health care system.
The Canada Health Act empowers the federal government to ensure that fair health principles are assured to all Canadians when they deal with the many provincially-controlled health plans. The principles that must be maintained are comprehensiveness of medically necessary care, universality within Canada, portability of care between provinces, accessibility to all citizens, and public administration.
Health care systems the world over are now being reigned in by governments in an effort to control costs. Canada spends almost 10% of its Gross Domestic Product of health care and provinces typically devote 30% of their budgets to health care. It is the single-payer structure of Canada's health care system that has enabled various levels of government to control spiraling health costs without affecting health care. Countries without public administration have not faired as well during these cost-restricting times. The World Bank notes, "...countries that have contained costs better have greater government control of health spending and a larger public sector share of total expenditures."
Even with health care cuts, Canada's health system remains at the pinnacle amongst other countries. Canada maintains itself year after year in the top 10 United Nations ranking of countries.
Though Canada's system of health care is among the best in the world there remains many difficulties which need to be resolved. Canada's system is an open-ended scheme with closed funding. Demands are completely unrestricted, but the money to pay for them is not. Decisions on how limited funds are allocated in health care are being hotly disputed.
Doctors, who have historically had free reign in the health care system, are being questioned as to their priorities and motives. Marion Dewar, the national chairwoman of Oxfam Canada, has called the doctor-dominated health system "elitist" and says that reform has not given ordinary people control over the health care system.
Doctors demand more salary and more scientific gadgets with which to practice their over-medicalized system of medicine. Doctor claims that deaths are resulting from health cutbacks cannot be substantiated. A recent incident where doctors claimed as many as 50 deaths occurred due to health-care cuts failed to withstand independent appraisal.
Nutrition-related chronic diseases such as cardiovascular disease, diabetes, osteoporosis and cancer are not treated with nutrition-oriented primary therapy. Instead, unproven invasive procedures predominate in health initiatives. Half a century of intensive, medicalized treatment methods have made little impact on cancer. In a study published in the New England Journal of Medicine, Dr. John Bailar writes, "In 1986 we concluded that 'some 35 years of intense effort focused largely on improving treatment must be judged a qualified failure.' Now, with 12 more years of data and experience, we see little reason to change that conclusion."
Canada's evidence-based system is little more than monopoly control of health procedures by doctors. Independent appraisal of medical practices state that 80 - 90% of medicine is inefficient, unevaluated, or ineffective. The Royal Commission on Human Reproductive Technology stated that "...doctors receive much of their information on drugs from pharmaceutical companies...No body or mechanism exists at present to assemble good data regarding drugs and to make this information accessible to physicians.
Lack of health-consumer control of the medical system is deemed to be a major drawback of the Canadian health care system. The National Forum on Health reported that there is "a broad recognition of the need to make the necessary changes to put patients, rather than providers, at the centre of the system." Citizens for Choice in Health Care members state that provider control of the health care system effectively prohibits alternative health options from being included amongst informed-consumer choices.
There is a need for alternative health coverage. Alternative health options are excluded from coverage under the health care system. Although refering to Americans, a 1990 study published in the New England Journal of Medicine says that more visits are made to complementary providers than to primary-care providers or doctors. Statistics Canada reports that last year at least 3.3 million Canadians spent $1 billion seeking treatment outside of the medical system.
Canada's health care system, although among the best in the world, can still stand to be improved by democratizing the decision making process.