U.S. and Canada's Health Care Systems Compared

Under BCBS, insureds seek make do from hospitals and doctors of their choice and be charged on a fee-for-service basis. BCBS because reimburses from 80 to 100 percent of the charges if they are not classify as preventive care and the insured's deductible has been paid. In addition, two usually establish lifetime and/or annual reimbursement limits (Weitz 329).

mercantile insurers also charge on a fee-for-service plan merely can offer lower premiums than BCBS because they use actuarial riskiness ratings. That is, they identify and insure only persons with low health risks or charge high-risk persons higher premiums (Weitz 330). Now that both BCBS and mercantile insurers use this brass, many persons with chronic illnesses are unable to reign or keep reporting.

health maintenance organizations used to pay doctors a net profit and c all over the full cost of preventive care. Initially, patients paid no costs beyond their insurance premiums if they used doctors affiliated with the HMO and saw specialists only when referred by their pristine care doctor. However, to monish unnecessary doctors' visits, HMOs put one over begun to charge co-payments and have moved away(p) from their own salaried doctors to contracting with group medical practices to stick out services.

Finally, those who cannot afford the above forms of insurance coverage or are over the age of 65 may seek coverage through the federal programs M

In Canada, on the other hand, the national health insurance establishment pays all costs for everyone of medical, hospital, and spacious-term care, mental health services, and, for those over 65, the cost of prescription drugs (Weitz 375). These costs are paid for by federal and provincial taxes. Canadians can choose any primary care doctor they want. Hospitals in Canada receive an annual operating(a) budget from the insurance system and can spend their budgets as they like, with no controls imposed by the government so long as they provide care to anyone in their region who inescapably services (Weitz 375).

Thus, there is far less likelihood in Canada that someone who needs medical services will be unable to obtain them.

A Critical Approach. New York: Wadsworth, 1996.

The Canadian system is not free of problems. Paying doctors on a fee-for-service basis makes it hard to control medical costs (Weitz 379). Also, the provinces have instituted utilization review boards to identify doctors who perform medically unjustified tests and procedures but have given the boards little power of enforcement. Also, backup hospitals through annual global budgets causes problems such as providing hospitals with an bonus to retain as long as possible affordable patients in the attempt to avoid higher-cost patients (Weitz 379).

edicare and Medicaid. Medicare covers almost all American over age 65 and some permanently disable persons for hospital and medical bills. Medicaid covers persons based on income and physical photo (Weitz 336).

Weitz, Rose. The Sociology of Health, Illness, and Health Care:

In addition to improving glide slope while maintaining the quality of care, the Canadian health care system has also managed to restrain health care costs (Weitz 378). Generally, doctors in Canada order fewer tests,
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