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KFU convention features health care panel
Canada is known for ice hockey, cold winter weather and, in recent years, its health care system. Canada's national health care system is either held up as an example of what we should do here in the U.S. or held up as an example of what we should not do here in the U.S. Along with some arctic temperatures, three Canadians made their way to Lawrence, Kan., on Jan. 8 to share their personal experiences with Canada's national health care system. Dale Kuyek, Nial Kuyek, and Harry Van Mulligen took part in a health care panel discussion during the annual convention of the Kansas Farmers Union on Jan. 8 and 9. Dale Kuyek is a licensed practical nurse from Saskatchewan. Since 1994 she has worked at the Regina General Hospital in the emergency and maternity wards. Her husband, Nial Kuyek, is general manager of the Agricultural Producers Association of Saskatchewan. This is Saskatchewan's general farm organization formed to provide farmers and ranchers with a democratically elected, grassroots, non-partisan producer organization to develop policies on their behalf. Harry Van Mulligen served 30 years as a member of the Saskatchewan Legislative Assembly and as a Regina City Councilor. Taxes "The government collects taxes and they pay for all health care services," Van Mulligen said. Canada's health care system, called Medicare, started in Saskatchewan, according to Nial Kuyek, and was later introduced across the country. "The doctors went on strike when this was introduced in 1962," Kuyek said. Health care in Canada is provided through a publicly funded (income tax) health care system. Provisions in the Canada Health Act guide their national health care insurance system. The system provides Canadians with coverage for all medically necessary services. Van Mulligen said doctors determine what is medically necessary and typically there is not much disagreement about it once the decision is made. The system does not include coverage for dental or vision care unless it requires a hospital stay. Kuyek said many people in Canada get their vision and dental care as part of their employee benefits packages. Van Mulligen said the provinces have primary jurisdiction for delivery of the health care services. The role of the federal government is the transferring of funds to cover those services. Canada's health care system is universal in that it must cover all Canadian citizens in the same manner. Of the countries included in Organisation for Economic Cooperation and Development reports, only Mexico, Turkey, and the U.S. do not have universal health care coverage. It is accessible. There are no financial barriers to accessing the system. It is portable. Van Mulligen said their coverage travels with them from province to province if they move, and it includes out-of-country travel. Canadians are reimbursed for out-of-country health expenses. According to Van Mulligen, several provinces are challenging this provision. There are no fees, no deductibles, and no co-payments. Doctor visits "When we go to the doctor, we have a choice; we can get second opinions and we can choose our own general practitioner," Van Mulligen said. Van Mulligen said their system is different from socialized medicine because the doctors, nurses, and hospitals do not draw wages from the government. Over half of the doctors in Canada are general practitioners, according to Van Mulligen. Hospitals are non-profit entities owned by quasi-governmental agencies. One of the concerns here in the U.S. about a government run system is the potential for long waiting lines for medical service. Van Mulligan said timely access to care is a concern in Canada, as well. How long they have to wait can depend on the type of surgery requested, whether it is an emergency or non-emergency, and which doctor is chosen. A survey was done in 2005 that found 56 percent of adults in Canada sought medical care that year. Only one in six said they had trouble getting routine health care. Van Mulligen said there typically might be a wait of several weeks for a bypass surgery, several months for cataract surgery, and up to seven months for knee replacement surgery. Dale Kuyek has a unique perspective as a nurse who dispenses care and as a patient who received care. As a nurse, she said they never talk about fees or finances with patients. They just give them what they need. Kuyek works on the maternity floor and said new moms get one year of maternity leave, receive 75 percent of their income, and their jobs are held for them. She believes that a higher percentage of new moms in Canada breast-feed their babies because they have the time, thanks to the year-long maternity leave. She noted that their health care system provides home care after surgery that is all covered by the government health care program. As a patient, she thought she received great care when she broke her foot four years ago. "I would never trade our system at all," she said. "No one worries about how they will pay for health care." Nial Kuyek said rural areas in Canada have the same problems with health care that rural areas in the U.S. experience. There has been a loss of population in these regions, and it is hard to retain doctors and nurses. Outcomes No matter what type of health care system is in place, it is ultimately judged by its cost and the outcomes. A recent OECD study showed that Canada spent 10 percent of its gross national product on health care. In the U.S., we spent 16 percent of our GNP on health care. The cost per capita on a yearly basis is around $3,985 in Canada compared to $7,290 in the U.S. Outcomes can be measured in infant mortality per 1,000 births for children under 1 year of age and in life expectancy. In 2006 OECD reported infant mortality in Canada was five deaths per 1,000 births while infant mortality in the U.S. was six deaths per 1,000 births. The average for all OECD countries is five deaths per 1,000 births. Life expectancy in Canada is currently 80.7 years compared to 78.1 in the U.S., according to OECD. "Canadians strongly support their system but they can be very critical of the system and the way their government administers the system," Van Mulligen said. Doug Rich can be reached by phone at 785-749-5304, or by e-mail at richhpj@aol.com.
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