Since there are no evident definitions that could help in distinguishing a one-tier and a two-tier health care system, it is rather difficult to answer what system exists in Canada. A one-tier system is commonly understood as the system that allows the citizens to have a public access to medical care. In a perfect situation, it means that people can obtain an equal and free access to health services. On the other hand, a two-tier system implies that the citizens are provided with an option to choose between public and private medical assistance. According to the Health Act, Canada has a one-tier system. In the meantime, many citizens of Canada do not like that they lack an option concerning their health care. The experience of many other countries that use the two-tier system shows that this approach to health care is successful. Over time, Canada might also take this approach and move to the two-tier system.
In Canada, the health care system is built in a way to allow the citizens to get required procedures only through the public sector. According to the Health Act of Canada, the sponsorship of such medical procedures as knee or hip replacement is prevented by the private sector. Many Canadian citizens like the one-tier system and think that every citizen of the country is able to get an equal access to medical assistance. They consider that the quality of care provided by the private sector is lower and that it does not offer care to individuals with a lower income. Many people also say that it is more efficient to use the centralized public system than the system which allows having funders and providers. Nevertheless, there are also people who oppose the one-tier system.
In the two-tier system, citizens are provided with an option to choose either public or private medical care. Many people think that Canada has a two-tier system. Nevertheless, it is a one-tier one. This system does not publicly cover such services as supplemental coverage, ambulances, nursing home services and dental care. In the meantime, even though Canada uses only a public system, people who have money and connections can get medical care before the individuals who do not. It creates inequality in the system.
Evidence shows today that Canada is moving toward acquiring a two-tire system in health care. It is happening due to such reasons as:
- The one-tire system has rather vague rules and regulations;
- This system fails to provide the citizens with free medical assistance (it especially concerns drugs and some services);
- A number of educated, affluent and privileged individuals get medical services quicker and more effectively than others.
The one-tier system in Canadian health care fails to reflect equality among all Canadian citizens. Considering the steps made on the public level towards the two-tier system, it is important that Canada accepts it on the governmental level. After all, citizens do need to have an option to choose between private and public medical care.
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