Canada - World Health Organization Regional Office for Europe
Canada - World Health Organization Regional Office for Europe
Canada - World Health Organization Regional Office for Europe
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xviii<br />
<strong>Health</strong> systems in transition <strong>Canada</strong><br />
services, these provincial programmes generally target sub populations on the<br />
basis of age or income and can require user fees. On the private side, out-ofpocket<br />
(OOP) payments and purchases of private health insurance (PHI) are<br />
responsible <strong>for</strong> most health revenues. The vast majority of PHI comes in the<br />
<strong>for</strong>m of employment-based insurance <strong>for</strong> non-medicare goods and services,<br />
including prescription drugs, dental care and vision care. PHI does not compete<br />
with the provincial and territorial “single payer” systems <strong>for</strong> medicare.<br />
Physical and human resources<br />
The non-financial inputs into the Canadian health system include buildings,<br />
equipment, in<strong>for</strong>mation technology (IT) and the health work<strong>for</strong>ce. The ability<br />
of any health system to provide timely access to quality health services depends<br />
not only on the sufficiency of physical and human resources but on finding<br />
the appropriate balance among these resources. Both the sufficiency and the<br />
balance of resources need to be adjusted continually by F/P/T governments in<br />
response to the constantly evolving technology, health care practices and health<br />
needs of Canadians.<br />
Between the mid-1970s and 2000, capital investment in hospitals declined.<br />
Small hospitals were closed in many parts of <strong>Canada</strong> and acute care services<br />
were consolidated. Despite recent reinvestments in hospital stock by provincial<br />
and territorial governments, in particular in medical equipment, imaging<br />
technologies and ICT, the number of acute care beds per capita has continued<br />
to fall, in part a result of the increase in day surgeries. While most of <strong>Canada</strong>’s<br />
supply of advanced diagnostic technologies is roughly comparable to levels<br />
in other OECD countries, it scores poorly in terms of its effective use of<br />
ICT relative to other high-income countries. However, in recent years, some<br />
advances have been made in this area.<br />
After a lengthy period in the 1990s when the supply of physicians and<br />
nurses, as well as other public health care workers, was reduced because of<br />
government cutbacks, the health work<strong>for</strong>ce has grown since 2000. Private<br />
sector health professionals have seen even more substantial growth during this<br />
period. Medical and nursing faculties have expanded in order to produce more<br />
graduates. At the same time, there has been an increase in the immigration of<br />
<strong>for</strong>eign-educated doctors and nurses and lower emigration to other countries<br />
such as the United States.