| Two-tier Health Care |
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USAGE IN CANADA The term is often used in in Thornhill, Ontario ) continue to operate, although they may not bill additional charges for medical procedures (the Shouldice Hospital does, however, make mandatory additional room charges not covered by public health insurance which place it in the upper tier of a two-tier system – welfare recipients, for example, cannot be referred there). Clinics are usually private operations, but may not bill additional charges. Private health care may also be supplied in uncovered fields and to foreigners. The proponents of two-tier system argue that it would introduce more flexibility into the system, reducing wait lists and that competition from the private sector would make the public one more efficient. Opponents argue that a two-tier system would tend to draw many of the best doctors out of the public system, reducing the overall level of care. The Canada Health Act is also committed not only access to health care to all, but access to the best health care available for all. Many on the left consider access to the best possible care an important right of all citizens. Competition from the private sector would also almost certainly drive up the wages of doctors and other medical professionals in the entire system. Those who support a wholly public system also say that there is some concern that if Canada would allow a parallel private system within the country, it would be opening itself up to trade sanctions under some of its trading agreements. The Canadian people are largely opposed to the notion of two-tier health care, and no major political parties support the notion. In the 2000 Federal Election , the Liberals and the New Democratic Party accused the Canadian Alliance of secretly supporting it, leading to a famous incident when in the leaders debate Canadian Alliance leader Stockwell Day began waving a hand written "No Two-Tier Medicine" sign. Some argue that Canada already does have a two-tier health care system as the wealthy can go to the United States for treatment, and quite a few Canadians do each year. Some provinces have increasingly allowed the private sector to provide medical services for a fee. Quebec has especially allowed the private sector to provide enhanced medical services to the public for a fee. Other critics, such as Margaret Wente of the Toronto Globe And Mail , argue that the system is two-tiered in favouring the well-connected, the well educated, and those with a good understanding of Canadian culture (that is, those who are not recent immigrants). These people are more aware of alternative methods of obtaining treatment and more likely to know how to persuade physicians. OTHER COUNTRIES The phrase is also used in other countries and among health care experts. It is a phrase usually entering into any discussion of health services in the Republic Of Ireland , which has a particularly high rate of private health insurance take-up, and treatment of private patients in public hospitals (thus denying beds and facilities to those on the lower tier of health service). In Europe , it often has the same meaning as in the Canadian context, but is used there to describe the status quo. However, sometimes it has a somewhat different meaning relating to the expansion of private sector involvement through Voucher programs or other initiatives. SEE ALSO |
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