|Implemented in this survey?|
A Health Care Guarantee would specify maximum waiting times for procedures and treatments. Once a patient has waited the maximum time, he or she would be entitled to immediate care in another jurisdiction to be paid for by her insurer (essentially, the government of the province in question). The rationale is that this would provide governments with the incentive to build capacity, develop treatment standards and enhance information systems to bring waiting times in line with these standards.
|Medienpräsenz||sehr gering||sehr hoch|
|Implemented in this survey?|
The idea of Health Care Guarantee has not been prominent in health policy discussions in the time since we last reported on this reform (see survey round 03/2004). There have been few
new statements of stakeholder positions on this issue.
This is notable given that the broader issue of waiting times has been a major focus in recent months. Waiting times was the priority health care issue in both the June federal election and the First Ministers' Meeting in September. A report on health care waiting times published by Statistics Canada in July showed that there is wide variation across Canada in how long people wait, for what services and at what cost to their mental and physical health.
In their announced accord following the September meeting, the First Ministers described the need to improve timely access to quality care as a top priority and agreed to allocate funding to reducing waits for certain health services. Performance reporting will be the dominant mechanism to show the impact of the new funding. As part of this mechanism, the First Ministers agreed to develop "evidence-based benchmarks for medically acceptable waiting times" by the end of 2005 with cancer, heart, diagnostic imaging, joint replacements and sight restoration named as the priority clinical areas. The process for coming up with these benchmarks is yet to be determined.
So while waiting times are in the health policy spotlight and there is renewed emphasis on publishing medically acceptable benchmarks, there has been little recent discussion about using a Health Care Guarantee to enforce these benchmarks.
While a Health Care Guarantee is not currently being implemented in Canada, there is continued action in three related areas.
First, individual wait list initiatives reported in previous surveys, like the Western Canada Waiting List Project and the Ontario Cardiac Care Network continue to develop and recieve attention for their advances in measuring and managing waiting times.
Second, there is a growing list of provincial government websites that allow patients to view waiting times for particular services for health care providers in their local area.
Third, as reported in an earlier survey, there is a high profile case before the Supreme Court of Canada related to waiting times in Canada's publicly financed health care systems. A patient-doctor team are arguing to allow the purchase of private insurance for services currently covered by the public system. This case went before the Supreme Court in June. If successful, this case could open the door to a parallel private tier of health care. Though it is unclear what effect this would have on waiting times in the public tier.
The increased attention on waiting times in the Canadian health care system shows no signs of abating. Supported by the outcome of the most recent First Ministers meeting on health
care, initiatives to develop wait time benchmarks based on medical evidence look set to expand. Despite this attention, the idea of a Health Care Guarantee is receiving very little
However, with the new injection of federal funds for Canada's health care system and continued efforts to report progress on tackling waiting times, there are encouraging signs that the measurement and management of waiting times will improve. So the ultimate goal of a Health Care Guarantee may be achieved by other means.
Access to Health Care Services in Canada, 2003, Statistics Canada: www.statcan.ca/english/freepub/82-575-XIE/2003001/report.htm
Western Canada Wait List Project: www.wcwl.org
Ontario Cardiac Care Network: www.ccn.on.ca/access.html
Report on Wait Times Colloquium by CPRN: www.cprn.org/en/doc.cfm?doc=588
Provincial Wait List Registries: