The Canadian healthcare scheme, also known as Medicare, is one of the few functional public systems that remain today. Commercial organizations provide free healthcare coverage to Canadians, while the government covers the costs of funds raised by income taxes. The scheme is managed in compliance with the regulations codified in the Canada Health Act of 1984, which, among other aspects, forbids competitive activities and sets quality care requirements. To access the coverage, residents must enroll in the Medicare program to receive an insurance card, which they must bring to a doctor while seeking treatment. While the essential basic care is covered, services such as vision care, mental care, dental care, home care, cosmetic surgery, drug prescription and infertility treatments are excluded, although some provinces offer partial coverage. General public opinion among Canadians supports the sustenance of the healthcare system, despite most of the challenges that plague it. In fact, surveys indicate that it is the most cherished social program and a source of national pride for many Canadians. However, there is also fierce debate on whether or not the policies that support the system ensure its sustainability, with most arguments being based in ideologies and differing standpoints. Excellent examples of such ideologies include Pat and Hugh Armstrong's argument posed in their textbook titled About Canada Healthcare and the discussion outlined by Patrick, Malcolmson, Richard Myers, Gerald Baier, and Thomas Bateman in their book titled The Canadian Regime. A comparison of these two perspectives will highlight their views on the healthcare policy in Canada and identify the superior viewpoint.
Brief Overview of the Books
Pat and Hugh Armstrong's About Canada Healthcare
About Canada Healthcare was authored as a contribution towards the defense of the public status of the healthcare system. They readily dismiss the calls for privatizing medical care, calling it an infringement of Canada's democracy. The content of the book is provided to help the involved stakeholders in the designing of proper tools that will ensure the inclusion of the members of the public in the restructuring of Medicare. Both authors are of the opinion that access to healthcare should be treated as an alienable human right that should never be a source of profit for any entity. They acknowledge that the system is riddled with problems, citing examples that have been featured in news and court cases in which the government has been sued. Furthermore, they also hypothesize that the severity of the problems affecting the system is bound to increase due to the large percentage of aging baby boomers, the high cost of new technology and medicine as well as the emergence of new pandemics. Like many Canadians, the authors admit that they are concerned, a factor that prompted them to devise applicable solutions for the problems by analyzing the structure and finding out what works and what is impaired. The result is a comprehensive and compelling book which offers a history of the system, the source of its problems, its benefits and failures, present issues and strategies that may lead to the desired change.
The Canadian Regime by Patrick, Malcolmson, Richard Myers, Gerald Baier, and Thomas Bateman
The Canadian Regime analyzes the characteristics of the Canadian government, most especially the status of its democracy. The authors believe that the civic education in the country is lacking and as a result, many citizens are unaware of what to expect from political actors, they are oblivious of the limitations of political institutions and are ill-informed on basis of all political action. As per the authors, the majority of the challenges that are being faced within the country are a result of the actions of political structures and institutions. As such, they indicate that a person that is unaware of how the government works cannot accurately form opinions on pressing issues. Therefore, the inspiration behind the book is to ensure that all Canadians are introduced to political institutions that constitute the Canadian government. The book is also written to increase the appreciation of the Canadian system of government, which is being eroded by the ideals of the American system. The authors are wary that the systems of their neighbor are increasingly becoming more appealing to the masses, citing changes that have been made to mimic American political practices. The aim of the book is to increase knowledge on the Canadian regime and its inner workings as well as indicate why the system is fitting for the country as compared to foreign ideals.
Comparison of the Perspectives
As indicated by the overview of the books, both sets of authors were inspired to discuss the health policy system for different reasons. However, one similarity that is at the core of both discussions is the need to inform the public of the inner workings of the health care system. The Canadian Regime looks into the healthcare policies as part of its mission to educate the public on how political institutions function. The authors begin by outlining that health is a prerogative of the provincial administration, as outlined within the constitution. However, the Federal government still contributes largely to the system as it is in charge of contributing the additional funding that is required by the state. They then look into how the different actors and factors complicate the system thus affecting its ability to provide free healthcare. The citizens are blamed for expecting the quality of service that is described on the internet without considering the impact of the public nature of care on the system. Doctors are accused of pushing their personal agendas, an action that is made easier by the high regard to which the public holds their profession. The high cost of sustaining the system is also indicated as a cause of its problems. The authors criticize the notion of considering healthcare as a commodity by arguing that unlike coffee, cars and pizza, the public is unable to tell a good doctor from a bad one. They further argue that it is an impossible task to attempt to estimate the demand for health care and dismiss the statement that private care will improve health services for Canadians, asserting that it is bound to create more inequalities thus denying access to the needy while providing the same to the poor. The rigidity of the system is cited as a major hindrance to enacting proper reforms. On the other hand, Pat and Hugh Armstrong illustrate the workings of the system by exploring all its aspects. The roots of the system are identified as the great depression, the political benefits of providing free healthcare and the demand for the involvement of the Federal government in paying doctors. They also highlight what the free care consists of and what it excludes. The status of reforms is then analyzed and the main present day issues that plague the structure are outlined. The severity of the privatization threats are also explored. The authors conclude by outlining applicable strategies that the government can utilize to change the problematic parts of the system. Reading both perspectives offers one knowledge on the system and how it operates. Both outlooks similarly look into the problems that plague the healthcare system. Malcolmson et al. details the political causes of the challenges. First, they cite the complexity that stems from the involvement of both the Federal and Provincial governments in providing healthcare. While the constitution delegates this duty to the Provincial administration, the Federal government seems to have more power as it allocates funding based on the needs of a province. Additionally, the authors indicate that there is a significant knowledge gap between the patients and the medical personnel that provide care. As such, most of the opinions that citizens form are misguided because they fail to understand the tradeoffs that have to be made to institute a universal healthcare system that will provide free healthcare. Another factor that makes Medicaid problematic as per the authors is the prestige and influence that doctors in the country have due to the nature of their work, which allows them to articulate and push for their interests, such as higher salaries, over those of their patients. Likewise, Pat and Hugh Armstrong explore the difficulties that prevent the efficient functioning of the Canadian healthcare system on different levels. First, they discuss the pitfalls of the system by looking into the importance of the services that are not covered, most especially the provision of prescription medicine, residential care, long term care, dental services and mental health care. The authors state that by excluding these amenities from the Canada Healthcare Act, the government created room for the progression of the profit-seeking private insurers that are presently at the forefront of campaigning for privatization of healthcare. They posit that the establishing of an extended cover will eliminate problems such as the lack of equity, the incongruent integration of the health system, the high costs resulting from inefficiencies and the lack of accountability. The second level focuses solely on the adversities faced within primary care, such as the pay for care system that encourages doctors to offer as many and as complex services as possible to make more money. There are also the growing needs of the patients which may overwhelm the few physicians that are available leading to fatigue and burnout. The authors additionally feature the current issues that the system is facing, which include the shortage of labor, the increase of the aging population who have more healthcare needs, extensive wait times and the exclusion of important services. The final level of problems featured are those posed by calls for privatization. Both perspectives provide readers with knowledge on the factors that affect proper care by Medicaid.
The Superior Perspective
After the in-depth comparison of the ideologies that have been proposed by both sets of authors, it is apparent that the superior argument is presented by Pat and Hugh Armstrong. Literally judging the book by its cover, the title 'About Canada Healthcare' immediately informs the readers that the sole topic that is explored by the book is the Canadian universal healthcare system. If one were to be sent to a bookstore to get a text on the subject, it is far-fetched to assume that one would pick 'The Canadian Regime', unless they knew beforehand that the topic is discussed within its pages. Furthermore, the significant difference in lengths between the two texts also indicates that About Canada Healthcare is based on a more inclusive perspective as compared to The Canadian Regime. The former discusses the Canadian healthcare system over the course of 74 pages, giving details about the history of the system, where it has gone wrong, how it serves the people and how it can be altered to continue providing the free services to all Canadian Medicare card holders. In contrast, the latter book discusses the health care system very briefly, first mentioning it in passing in the fourth chapter and dedicating a subtopic in the eleventh chapter which features case studies on a variety of public policy systems. While The Canadian Regime authors cannot be faulted for discussing other topics, the subject of the Canadian care system is not adequately covered. Besides the first impression, there are other aspects of both texts that set Pat and Hugh Armstrong's perspective apart from the discussion presented by Malcolmson et al. The outlook of About Canada Healthcare is better as compared to The Canadian Regime because it outlines the strategies that can be used to resolve the issues that the system is facing as well as possible measures that the government could take to resolve them. Both sets of authors show the appreciation that they have for Medicare. Pat and Hugh Armstrong dub it a beloved national treasure that is appreciated by all while Malcolmson et al. dub it a hallowed hallmark of Canadian citizenry. However, Malcolmson et al. are more concerned about how it works and how the progressive actions of the main actors, namely the federal and provincial government, the doctors, the private insurance providers, and the citizens themselves have contributed to the failure of the system. Granted, the exposure of these factors might aid others in the development of possible solutions by highlighting the specific factors to rectify. Nevertheless, a mere critique of the issue at this juncture is not as critical as devising solutions that may sustain the national treasure that is Medicare. While Canadian citizens might not be entirely aware of how the government and politics contribute to the core causes that delay their healthcare, they continue to suffer its consequences. Therefore, it is more practical to seek for solutions rather than focus on the problems. About Canada Healthcare thoroughly achieves this goal. After analyzing the past and present state of Medicare, Pat and Hugh Armstrong offer solutions such as increased involvement of the Federal government in the disbursement of funds, an expansion of the current national plan to include a few excluded services, namely dental, visual, prescription, long term, and home care. They also propose that the services offered by the numerous care centers should be coordinated to ensure that all patients receive care in a timely fashion and eliminate any instances of duplication. About Canada Healthcare's perspective is better as it is fitting for the current needs of the Canadian citizens.
Conclusion
The emerging problems that affect the Canadian Healthcare system have been a source of many debates among its citizens. The Canadian Regime and About Canada Healthcare are two among myriads of texts that dissect Medicare from varying outlooks. If you seek a strictly political view of the healthcare system, then The Canadian Regime is a perfect read as it assesses the political actors and actions that contribute to its failures. However, if one is interested in a holistic outlook of the Canadian healthcare system, including its history, benefits, the pitfalls, the core issues, possible solutions, and means to implement them, then About Canada Healthcare is the book to read. Given the overwhelming support that the citizens show for the program, the perspective that includes applicable solutions for their resolution is best. Pat and Hugh Armstrong have done their part in supporting the Canadian Health system. Perhaps with such support from other individuals and institutions, Medicare shall overcome all its current obstacles.
Bibliography
Armstrong, Pat, and Hugh Armstrong. About Canada Healthcare, 2nd ed. Nova Scotia: Fernwood Publishers, 2016.
Health Canada. “Overview of the Canada Health Act.” Wayback Machine. Last modified May 16, 2005. https://web.archive.org/web/20090414052008/www.hc-sc.gc.ca/hcs-sss/medi-assur/cha-lcs/overview-apercu-eng.php.
Malcolmson, Patrick, Richard Myers, Gerald Baier, and Thomas M. Bateman. The Canadian Regime: An Introduction to Parliamentary Government in Canada, 6th ed. Toronto: University of Toronto Press, 2016.
