US and Canadian health insurance Essay Example | Topics and Well Written Essays - 1250 words

US and Canadian health insurance - Essay Example Health insurance in the United States is failing patients and physicians alike.Competitive strategies have also failed their most ostensible goal--cost control.In contrast,Canada offers a model of a national health insurance plan that provides universal and comprehensive coverage,succeeds at restraining health care inflationIn this country 37 million uninsured face economic barriers to care, and the health of many suffers as a result. The "corporatization" of medical care threatens professional values with an unprecedented administrative and commercial intrusion into the daily practice of medicine.The big difference here in the US is that there are multiple insurance companies. In Canada you really only have one (one for each province) those offering extended insurance for things like private hospital rooms, vision, dental, etc.The next big difference is managed care. In regards to optometry, you can think of this as the insurance companies that only provide for well vision care cont acts and glasses. If there is a medical eye problem (i.e. a disease) they do not pay for the necessary care (generally), and those things should be billed to the major medical. They also pay much discounted fee's compared to medical, Medicare (gov't insurance for seniors) and private pay patients.Optometrists in the US also tend to directly bill the insurance companies, OD's in Canada tend to only bill their respective provincial insurance plans, veteran's affairs, or Indian affairs, while patient's not covered by the above are billed directly by paying cash. If those patients have supplemental vision insurance then they can submit a claim for reimbursement. When KHE talks about insurance discrimination he means that there are many insurance companies in the US that will not pay an optometrist for services performed that they will pay ophthalmologists for, even if the optometrist is licensed to do so in that state. There are some states that have "any willing provider" laws to prevent this, but it still occurs. However, the same thing happens in Canada: Take a look at the OHIP schedule of fee's for optometry, and then compare to that for ophthalmology. You'll find that many tests, procedures, and treatments that optometrist are licensed to perform are covered by OHIP if done by an ophthalmologist, but not an optometrist. However, it could be argued that is just as well since OHIP isn't exactly known for generous fees. In making a rational comparison of the Canadian and American health systems it is more reasonable to contrast service levels and costs of the systems rather than trading anecdotes. Canadians pay about 9% of national GDP to insure 100% of citizens in our single-payer system, compared with more than 14% of GDP to insure 85% of Americans. The Kaiser Family Foundation reports that the average compound annual growth rate in U.S. health insurance costs has been 11.6% over the past five years. It is therefore not surprising that polling by Kaiser found that 75% of Americans were worried or very worried about the amount they would need to pay for health insurance in the future and that 63% were worried or very worried about not being able to afford health-care services. There is no question that restriction of supply with sub-optimal access to services has contributed to the lower cost of health care in Canada. However, a new approach of targeting investments to reduce waiting times combined with transparent reporting of wait times is having a substantial impact on access in the Canadian system. Canadians spend about 55% of what Americans spend on health care and have longer life expectancy, and lower infant mortality rates. Many Americans have access to quality health care. All Canadians have access to similar care at a considerably lower cost. The introduction of private insurance or private-for-profit health care for medically necessary services is not the answer to