HealthCare System
In the wake of the passing of the Health Care and Education Reconciliation Act by Congress, the health care systems that will be in practice in North America in 2014 when the new American law takes effect will become very similar. Some key differences will still exist in the ways they function, however. The Canadian health care system is and will remain the most expansive. The health care provided in American represents the more moderate version of the three, while the Mexican system is the least inclusive. The Canadian health care system is governed by the Canada Health Care Act, passed in 1984. The health care system in Mexico is provided by the Instituto Mexicano del Seguro Social (IMSS), or Mexican Social Security Institute, which is also responsible for managing the Mexican people’s pensions and social security payments. The IMSS was established in 1943 due to an amendment to the Mexican Constitution. The American system is currently governed by a variety of laws, although the new bill should consolidate some of the complications found at present in the American health care system, is expected solve many of the problems in the system, and address various shortfalls.
Under the Canadian Health care system, each Canadian is provided with an health card which is issued by the Provincial Ministry of Health. This card is used to access all health services, whether provided by a doctor or hospital. Each person receives the same level of care in this heath care system. All basic medical procedures and services are covered, including maternity and infertility problems, although dental and vision services may or may not be covered. Whether to provide access to dental and vision care is determined on a provincial level. Cosmetic and elective services are not covered in any province. Under the Canadian health care system anyone electing to seek out these services must pay the costs through alternative means. Alternative methods of coverage include obtaining private insurance or by paying for them out of pocket. There is no restriction on the coverage provided for preexisting conditions, and health care is not affected by employment status, or a lack of it. The elderly and homeless have prescription coverage provided by the government, with all other people able to acquire drug benefits through employment based coverage.
The current American health care system provides for uneven levels of health care coverage. The government is involved in providing health care to or reducing the costs of health care for many different facets of American society. Poor children are covered by the State Children’s Health Insurance Program. Medicare is provided for the elderly and disabled persons with a work history. Some poor people qualify and are covered by Medicare. However, not all of those eligible for Medicare are aware of their eligibility and thus do not collect the benefits. The Veteran’s Health administrations operates hospitals for veterans. TRICARE provides service for active duty and retired members of the military, as well as their dependants. As a result of these programs the American government serves as the largest health care insurer in the nation. Most people, however, receive health care from private sources, such as private doctors or hospitals. A study conducted across five states in 2001 found that personal bankruptcy was a contributing factor in sixty-two percent of those filing. According to figures released by the US Census in 2008, fifteen percent of the American population is completely uninsured. The same report stated that an additional twenty-one percent of the American population can be described as being underinsured. Being underinsured means that they are unable to cover the costs required to provide the needed level of health care
In the Mexican health care system, is provided to all Mexicans, and guaranteed under Article Four of the Mexican Constitution. The federal government allocates a portion of its subsidization of care based upon the employment status of the individual. Under the Secretariat of Health agency all citizens are provided with the use of a system of health care facilities. For employed Mexicans and their dependants the IMSS coordinates a three-payer system to fund the health care system. The funding is provided in equal parts by the employer, the employee, and the government. The IMSS only provides care to private employees; public employees are provided their health care by the Institute for Social Security and Services for State Workers. This institute provides care for all local, state, and federal employees. Mexican state governments also provide an additional health care system governed independently of the federal system.
Despite the varying methods of providing health care to their citizens, all three North American health care systems provide comparable levels of service. In 2009 a list complied by the United Nations Population Division was published. The worldwide infant mortality rate was 49.4 deaths per 1000 live births. The mortality rate for children under five years old was 73.7 per 1000 live births. Canada had an infant mortality rate of 4.8 deaths per 1000 live births, while the mortality rate for Canadian children under five was 5.9 deaths per 1000 live births. During the same time period, the infant mortality rate for the United States was 6.3 deaths per 1000 live births, and 7.8 deaths per live births for children under the age of five. Mexico’s care was lower, with an infant mortality rate of 16.7 per 1000 live births and 20.2 deaths per 1000 live births under five years old. This can be attributed to differing levels of neonatal care provided by the health care systems in each country. The life expectancy for residents of these countries are among the highest in the world. In Canada the combined male and female life expectancy is older than eighty years of age. In the United States the combined life expectancy for men and women is between seventy seven years and six month to eighty years old. The Mexican life expectancy is only slightly lower, between seventy five years and seventy seven years and six months. Mexican life expectancy being so similar despite much higher rates of infant mortality may be due to the prevalence of medical treatment options.
The quality of care in all three countries is practically identical. In areas lying along the American borders, Mexican and Canadian physicians may have received their training in American medical schools, just as American doctors may have been trained in leading Canadian or Mexican medical schools. As a result of this free interchanged of practicing physicians and medical expertise the physicians available on either side of both the northern and southern borders of the United States is at the same level of medical proficiency available anywhere. The only limits are those of modern technology and the proficiency of the individual doctor.
One of the biggest difference between the three North American health care systems can be seen in the widely varying amount of money spent on providing approximately equal levels of care. The United States spends the most of the three North American countries, and in fact the most of any developed country on its health care system. The United States spends almost three seventy five thousand American dollars per capita on health care. In comparison Canadian spends approximately three thousand American dollars on health care per capita. Mexico is able to achieve comparable results while spending less than one thousand American dollars per capita on its health care system.
Another difference is the means by which the care is provided to the participants in the health care systems. In both the United States and Canada health care is primarily provided by private entities. These entities include physicians enrolled to private practice and private, for-profit hospitals. In Mexico, however, health care is, as mentioned above, provided primarily by the government. While Mexico’s health care system is governed by the federal government, the system in Canada is run on a provincial level. Each Canadian province has great discretion in how it allocates the funding it receives from the federal government. The Canadian provinces are required to meet a minimum standard of coverage and to not violate the groundwork laid out in the Canada Health Act.
The Health Care and Education Reconciliation Act should cause the American health care system to become more similar to the Canadian system. It is expected to lower costs for most people on a daily basis. Its expansion of benefits for those with preexisting conditions should make insurance more readily available for some who were unable to otherwise obtain it. It is possible that the passage of the bill will reduce the incidence of “medical tourism,” which is when American citizens seeking medical procedures travel outside of the country to receive treatment at a lower cost. Mexico has been a particularly popular destination, because its costs are generally one third of the cost if the procedure is performed in Mexico as compared to if the same work were done in an American facility.