Horizontal and vertical healthcare integration: lessons learned from the United States

Leatt, Pink and Guerriere provide a very rational argument for moving the Canadian healthcare system towards a more integrated model. They suggest that the current system in Canada is a hodge-podge of disconnected parts. The current system is viewed as providing uncoordinated care, with inadequate use of non-medical practitioners, perverse payment incentives for providers, too much focus on treatment of disease, unacceptable wait times for services and related other problems. The authors provide extensive documentation of vital components of a system they envision for Canada, the rationale for adopting an integrated system of services, and conclude by suggesting strategies for achieving integrated healthcare. Change towards the new system would concentrate initially on primary care, using virtual coordination networks at the local level. Innovative needs-based funding methods would ensure that individuals throughout Canada receive necessary services for keeping them healthy.