加拿大是否有第三种医疗保健方式?
Katherine Fierlbeck1, Peter Berman2
1McCulloch Professor of Political Science, Department of Political Science, Dalhousie University, Halifax, NS.
HealthcarePapers
|July 31, 2025
概括
加拿大医疗保健法案 (CHA) 建立的加拿大医疗保健系统现在正在努力实现可访问性和公平性. 医疗保健服务的变化意味着CHA (1985) 无意中创建了一个双层系统,限制了基本服务的公共覆盖.
科学领域:
- 公共卫生 公共卫生
- 卫生政策 卫生政策
- 加拿大医疗保健系统加拿大医疗保健系统
背景情况:
- 加拿大医疗保健框架建立于20世纪中叶,并于1985年通过加拿大卫生法 (CHA) 巩固.
- 根据CHA的规定,医疗必要的医院和医生服务必须提供公共保险,目的是提供公平的机会,不论支付能力如何.
- 自CHA成立以来,医疗保健提供和覆盖范围发生了重大变化.
研究的目的:
- 分析当代医疗保健变化如何影响CHA (1985) 的可访问性和公平性目标.
- 检查加拿大两层医疗保健体系起的同时,公共获取减少的悖论.
- 建议对联邦资金和省/地区法规进行重新评估,以改善医疗保健准入和公平.
主要方法:
- 评论和分析加拿大医疗保健政策的演变.
- 根据CHA (1985年) 审查公共保险的"深度但狭窄"范围.
- 分析医疗保健供应的转变,包括药品和精神卫生保健,以及它们对获得医疗服务的影响.
主要成果:
- 为20世纪中叶的医疗保健而设计的CHA (1985) 框架不再完全促进可访问性或公平性.
- 关键的当代医疗保健方面,如药品和精神卫生保健,往往被排除在公共保险之外.
- 服务供应的变化导致了一些人的私人访问增加,创造了一个事实上的双层系统.
结论:
- 矛盾的是,CHA (1985) 严格的结构减少了公共医疗保健的获取,同时实现了双层系统.
- 实现公平和可访问的医疗保健需要从根本上重新考虑联邦资金和省/地区监管框架.
- 重新思考资金和监管之间的相互作用对于解决加拿大的当前医疗保健挑战至关重要.
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