single-payer model

The primary obstacles of single-payer health care in American states

Canadian Medicare did not start out as a national institution. It started in one province, Saskatchewan, and spread to others over the years.
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Modern medicines are essential for improving health outcomes, alleviating pain and suffering, increasing longevity, and reducing expenditures on other medical services. While there is merit to pursuing a policy that expands access to those in need, it should be recognized that several avenues exist between the current, decentralized approach in Canada, and the sort of government-run, universal program that proponents of the single-payer system propose.  Expansions in government insurance coverage are also not costless, and must be judged against coverage already provided by governments to lower income Canadians.

The two essays in this study seek to help inform the debate over drug insurance policy in Canada.

The first essay by Nadeem Esmail explains the drug insurance coverage already available to lower income Canadians. Specifically, in every province, those on social assistance receive coverage for drugs at very low or no cost to the patient or insured individual. And while qualifying income levels vary across Canada, lower-income Canadians have access to at least catastrophic insurance for prescription drugs.

In the second essay, Bacchus Barua examines how Switzerland and the Netherlands, two nations with high performing universal access health care systems, provide drug insurance coverage to their populations. Both nations provide more timely access to higher quality health care services at a similar or lower cost than Canada. Neither has opted to pursue a government-run insurance scheme; both provide universal pharmaceutical coverage as a fundamental component of universal health insurance coverage, which is provided through regulated, competing, private insurance companies.

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When comparing Canada's single-payer health insurance system with the pluralistic system in the United States, many people mistakenly assume that Canadians enjoy universal coverage while receiving the same quality and quantity of medical goods and services as Americans, but at lower costs. The reality is that, on average, Americans spend more of their incomes on health care, but get faster access to more and better medical resources in return for the money spent.

In truth, the Canadian health insurance system is not cheap at all: it is actually among the most expensive in the world. Recent statistics show that only three other comparable countries (United States, Iceland, and Switzerland) spend more of their national income on health care than Canada. More importantly, Canadians do not get good value for money from their health system. There are many hidden costs in Canadian health care that are ignored by advocates of single-payer systems.

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