Saving Medicare Plicy Brief Octber 2006
Abut CIMCA Funded in Vancuver in 2005, the Canadian Independent Medical Clinics Assciatin (CIMCA) is a nn-prfit rganizatin that represents independent medical clinics and their supprters acrss the natin in pursuit f imprved access t high quality and timely health care fr all Canadians. Our Objectives are: T supprt high quality patient care and the highest prfessinal and ethical standards. T nurture cperatin between independent and public health care rganizatins. T imprve public plicies that impact n access t health care. T supprt innvatin and new technlgy and prmte accuntability in the Canadian health system. Canadian Independent Medical Clinics Assciatin 2
Intrductin The independent health care sectr is a staid and stable feature f Canada s health care landscape. The purpse f this plicy brief is t direct the attentin f Canada s health care decisin makers tward the untapped ptential f the independent health care sectr. The sectr shuld nt be viewed as a cmpetitin t Medicare, but as an arch f supprt that can release sme f the pressures n the public health system and cntribute twards Medicare s fiscal sustainability. The private sectr has traditinally played a pivtal rle in the delivery f health care services in Canada. Medical clinics, staffed by dctrs, nurses and health care prviders perate as private businesses treating patients and billing gvernment. The emergence f independent surgical clinics prvide services t a steady stream f patients frm the WCB, RCMP, military and sme private-sectr insurance cmpanies. Prvincial health authrities have taken advantage f private-sectr services by sub-cntracting patient care t independent health care facilities. Our sectr is meeting patient needs and the expectatins f prvincial health authrities with timely and quality care. We have, hwever, nly tapped a fractin f the ptential fr quality patient care available in the independent health care sectr. A change in the regulatry framewrk culd widen pprtunities fr greater public and private health care partnerships that culd enhance the sustainability f the public health care system. Landscape Survey f Health Care in Canada CIMCA strngly supprts Canada s universal publicly funded health care system and seek refrms t help Medicare vercme its current challenges: Apprximately tw millin Canadians are n health care wait lists (92% Increase frm 1993). 50% f Children wait a medically unacceptable length f time. The Supreme Curt f Canada stated that patients die due t widespread delays fr public health care. Health care spending is unsustainable. Nearly 45% f prvincial budgets are spent n health care and climbing. Under pressure t maintain sustainability, the prvinces are ratining healthcare services by restricting access t facilities, physicians, devices, pharmaceuticals and bilgics. Canadian Independent Medical Clinics Assciatin 3
Canada trails the wrld in health care delivery: Canada s health care system is rated 30 th in a Wrld Health Organizatin survey. Canada is ne f the tp three cuntries in health care csts (Canadian Institute fr Health Infrmatin). Canada is near bttm in access t new technlgy (OECD). Mst develped cuntries - such as France, Germany and Britain - prvide universal health care systems cmplemented by private sectr ptins. The WHO s tp six ranked cuntries have n wait lists and spend less. Canadians expect and deserve better: Supreme Curt affirms a citizen's right t prtect their wn health and t btain private health insurance in Quebec. Over seven ut f ten Canadians supprt the Supreme Curt decisin allwing supplementary private health insurance and care (COMPAS pll, January 2006). Over five ut f ten Canadians agree with the ptin t pay privately fr faster treatment (Pllara pll, June 2005). CIMCA s Health Care Objectives CIMCA encurages federal and prvincial authrities t imprve patient care with a renewed universal publicly funded health care system cmplemented by independent health care facilities. A renewed health care system shuld highlight the fllwing features: Access: T deliver health care services in a timely manner and eliminate wait lists altgether. Quality: T prvide high quality patient care and prmte the highest prfessinal and ethical standards. Chice: T give patients the chice f public and private health care delivery, financing and insurance. Innvatin: T prmte medical innvatin and the intrductin f new technlgy. Accuntability: T prmte the respnsible and efficient use f public resurces thrugh perfrmance measures f medical prcedures and cmpetitin with the independent sectr. Canadian Independent Medical Clinics Assciatin 4
CIMCA s Health Care Prpsal CIMCA recmmends the fllwing imprvements and enhancements t Canada s health care system: 1. Strengthen the publicly funded system by increasing supply f medical services thrugh independent health care facilities: Supprt expansin f independent health care clinics specializing in certain highvlume prcedures. Maximize the use f existing health care facilities. Encurage hspitals and health authrities t cntract ut prcedures t independent clinics that meet the mst stringent prfessinal standards. Imprve wrking cnditins, including pay and benefits t health care wrkers. 2. Structure health care financing thrugh a publicly-insured system cmplemented by private sectr financing and insurance ptins: Strengthen gvernment funded universal health care cverage. Amend prvincial legislatin t accmmdate private health care insurance. Lift the ban n private insurance by amending the Canada Health Act. Give patients the ptin t pay fr medical prcedures thrugh private health care insurance r ut-f-pcket. 3. Enhance patient access t new medical technlgies and innvatins: Supprt research and develpment int bilgics, devices and pharmaceuticals. Relax restrictins n listing f new pharmaceuticals. Partner with gvernment t enhance develpment and ensure ptimal use f medicines. Encurage private sectr investment in clinics t update medical technlgy. Canadian Independent Medical Clinics Assciatin 5
Imprved Health Care Outcmes Quality care and medical chice fr all patients Health care wuld be prvided when needed and wait lists wuld cease t exist. Patients wuld receive the best practices in medical treatment and prcedures with the best equipment available. The health system wuld be driven by patient results instead f bureaucratic ratining. A sustainable health care system driven by innvatin Restricting healthcare services t maintain sustainability wuld be replaced by medical innvatins such as pharmaceuticals, devices and bilgics that release pressure n frntline health services. The use f newer drugs wuld lwer nn-drug medical spending, resulting in a cst savings fr any given treating. Increased innvatin and technlgy wuld becme a pwerful ecnmic driver in tday s knwledge ecnmy. A respnsive system that meets the needs f patients and health care wrkers Imprved wrking cnditins and better utilizatin f resurces wuld help alleviate the dctr and nursing shrtage. Opprtunity fr private clinics t pen in underserved cmmunities in Canada and imprve access t medical technlgy, such as MRIs. Canada wuld rise frm the bttm t the tp f the wrld best health care systems. Canadian Independent Medical Clinics Assciatin 6