What the future of American health care means for Canada

  • National Newswatch

Will Obamacare impact Canadian health care policy?It's among the many questions that were posed to Trudy Lieberman, past president of the Association of Health Care Journalists and press critic for the Columbia Journalism Review. Lieberman recently completed a cross-Canada public speaking tour, as a Fulbright Scholar and guest of the Evidence Network of Canadian Health Policy, more commonly known as EvidenceNetwork.ca.Lieberman's timely visit happened shortly after the official U.S. government implementation of the Patient Protection and Affordable Care Act (PPACA), also called the Affordable Care Act (ACA) or "Obamacare." Signed into law by President Barack Obama in 2010, PPACA legislation initially inspired some to hope for a more “Canadianized,” equitable version of American health care.But closer analysis reveals this is far from the case.Lieberman is quick to point out that Obamacare builds inequality into the system rather than legislating fundamental reform. Lieberman cites two major differences between attitudes toward health care in Canada and the United States:1.  Equity.Canadian health care ideology dramatically differs from how Americans view health care. Lieberman admits that a market-driven economy and powerful politics from stakeholders, particularly health care providers and insurance companies, are major obstacles to changing cultural attitudes toward equitable health care coverage.“If we (Americans) ever adopt a different system, the impetus would have to come from the business community. It won't come from advocates or academics, or the media,” says Lieberman.  “We have a largely employee-based system with 160 million people covered by their employers. The spark for wholesale reform of the system will have to come from employers.2.  Focus on Aboriginal health care.“I don't recall ever writing about the Indian Health Service,” Lieberman muses. “In Canada, I've heard more discussion of aboriginal health than wait times.Lieberman points out that the results of Obamacare legislation may take years to determine. In the meantime, there are ways our two systems have similarities.3.  Health care costs increasingly shifted to individuals.“We can see a shift in both countries toward making the patient pay for more,” Lieberman notes. “Americans are paying more out of pocket for health care. In Canada, many services are not covered, and depending on the outcome of a court case in British Columbia, Canadians may pay more out of pocket, too.”4.  Quality concerns.“Both countries have various problems with aspects of medical quality and both have to work on improving care, especially long-term care for the elderly,” Lieberman points out.5.  Increasing Demand and Cost for Technology.“We still haven't figured out a way to reign in the cost of technology. Patients want the latest and greatest but the U.S. doesn't have anything like the United Kingdom's National Institute for Health and Care Excellence (NICE), which looks at the cost and efficacy of new treatments before recommending these to NHS doctors.”So, will Obamacare give Canadians a new perspective on our health care system? While both countries have distinct health care policies, the costs for technology, provider services and long-term care, among other items, continue to escalate.  Finding new and improved ways to meet and manage these costs will be the challenge on both sides of the border.Janna Stam is a Toronto-based freelance writer and communications professional in Canada. She has written for diverse audiences, including health care IT users, non-profit organizations, and political campaigns. She holds a Master of Arts in English Literature from Queen's University. For more information, visit jstam.ca