HEALTH CARE SYSTEM IN CANADA

The Sustainable Development Goals (SDGs) also referred to as the Global Goals are a universal agreement towards ending poverty, protect the natural resources in the world and make sure that people enjoy peace and prosperity. The goals emerged from the successes of Millennium Development Goals but expanded to cover emerging elements such as climate change, economic inequality, innovation, sustainable resource use, peace and justice (UNDP, 2017). The goals are interlinked and they cannot be fully achieved in isolation.

The SDGs works aim at improving the spirit of partnership and pragmatism in effort of making the most appropriate choices to improve life, in a sustainable manner and for posterity. They offer clear guidelines and target that needs to be put in place while being adopted in the context of every nation in terms to priorities and challenges faced. They offer an all-inclusive agenda that presents a unique chance of ensuring that the whole world is successful and following a sustainable path (UNDP, 2017).

The SDG goal include:

1. End poverty in all its forms everywhere
2. End hunger, achieve food security and improved nutrition and promote sustainable agriculture
3. Ensure healthy lives and promote well-being for all at all ages
4. Ensure inclusive and equitable quality education and promote lifelong learning opportunities for all.
5. Achieve gender equality and empower all women and girls
6. Ensure availability and sustainable management of water and sanitation for all
7. Ensure access to affordable, reliable, and sustainable and modern energy for all
8. Promote sustained, inclusive and sustainable economic growth, full and productive employment and decent work for all
9. Build resilient infrastructure,  promote inclusive and sustainable industrialization and foster innovation
10. Reduce inequality within and among countries
11. Make cities and human settlements inclusive, safe, resilient and sustainable
12. Ensure sustainable  consumption and production patterns
13. Take urgent action to deal with climate change and its impacts
14. Conserve and sustainably use water resources
15. Protect, restore and promote sustainable use of terrestrial ecosystems, sustainably manage forest, deal with desertification
16. Promote peaceful and inclusive societies for sustainable development, provide access to justice for all and build effective, accountable and inclusive institutions
17. Strengthen the means of implementation and revitalize the global partnership for sustainable development

The goal that is directly linked to health is the SDG 3 that talks about ensuring health lives and promoting the well-being of the population at all ages. The specific target set for this include reducing global maternal ratio to less than 70 per 100000 live births, end preventable deaths of newborns and children under 5 years, bring to an end the epidemics of AIDS, tuberculosis, malaria and other diseases. Strengthen the prevention and treatment of substance abuse, reduce death due to road accidents increase access to sexual and reproductive health-care services, achieve universal health coverage, and reduce deaths due to poisonous and hazardous substances (United Nations , 2015).

The healthcare System in Canada

In Canada, the respective provinces and territories operate their own health insurance programs that covers all provincial and territorial residents. The federal government offers support to these programs by allocating finances subject to the condition of meeting the five criteria set out in the Canada Health Act.  Each province is charged with the task of coming up with specific requirements, undocumented immigrants which covers even the denied refugee claimants. Coverage of other health services is availed through a mix of public programs and private health insurance or self-payment. The central government offers extra health care benefits for the providers and hospital services provided to First Nations and Inuit, the Royal Canadian Mounted Police and the Canadian Forces, veterans, refugee claimant and inmates in federal holdings. It has been noted that only two thirds of the Canadians have private health insurance that caters for services not comprehensively addressed by the public programs (The Commonwealth Fund, 2017).

The total health expenditure in Canada was noted to reach approximately $6604 per person which higher by $200 per person for than the amount in 2016. The expenditure per person was however found to be different for different part of the country with Newfoundland and Labrador having $7378, $7329 in Alberta, $6367 in Ontario and $ 6231 in British Columbia. While compare with other international healthcare systems, the health expenditure in 2015 was $5782 per person which was similar to nations like France with $5677, Australia $ 5631, and United Kingdom with $57170. The distribution of the finances in 2017 across the sector saw the hospital take 28.3%, drugs 16.4%, physician services taking 15.4%. For the last 10 years, hospitals have continued to take the largest share of spending (Canadian Institute for Health Information, 2017).

Systems-Level Challenges Facing the Healthcare System In Canada

One of the key challenges that face the healthcare system in Canada is delivered from a recent report on demographics that indicated that the number of seniors in the country was  higher than the number of children. This introduces a unique challenge to the healthcare system regarding sustainability. The situation is bound to have implications for the public expenditure, the labor market, housing and institutional infrastructure (The Conference Board of Canada, 2017, p. 1). The estimated expenditure in 2016 for the health care system was estimated to be about $228 billion which was equivalent to more than 11% of the GDP. With the recent demographic changes as well as unmet needs in Canada’s health care system, the pressure to the system will continue to increase.

In the quest for meeting the demand for a universal health insurance model, some issue affecting the quality of healthcare has arisen. In a rank offered by the Commonwealth Fund that is the US. Based, Canada’s healthcare system has been ranked 9th and 10th for a couple of years running. A major concern with the healthcare system in Canada has been linked to access. It has been established that in Canada, the citizens have timely access to high-quality care for urgent and emergent problems which includes heart attacks, strokes, and cancer. However, access to less demanding health issues requires a longer wait, and in some cases, this even extends to a month or even years. Examples of such services have been noted to be hip and knee replacements, shoulder and cataract surgery, a consultation visit to a specialist (Simpson, Walker, Drummond, Sinclair, & Wilson, 2017, p. 3). These wait period for their services have been found to be beyond the recommended amount. The aged citizens without acute illnesses also find themselves waiting for a long period before they can access the long-term care facility.

Another challenge that poses problems to the healthcare system in Canada is the increasing costs of the universal health insurance scheme. These costs have been affected by the changes in the economic growth in the country. The government continues to receive pressure to increase the spending on the healthcare system. The estimated expenditure per citizen in Canada averages at around $ 4790 per citizen (Sampson, et al. 2017, p.4). About other systems in the developed world, this is considered as expensive. The increase life expectancy among the Canadian comes with economic implications to the system.

Experts have termed the major challenge facing Canada’s healthcare as “code gridlock.” This means that the care is provided in what appears to be glacial rhythm as a result of clogs in the system. In the long-term care and nursing home, the capacity has been fully saturated. There are limited home care hours causing a huge number of patients who could have been treated at home to remain in hospital. This presents a situation referred to as the alternate level of care. This is characterized by patients being held up in facilities, scarce bed capacity, cancellation of elective surgeries, and long wait period for admission. The number of a physician also limits the capacity of the healthcare system. In Canada, it is estimated that there are 2.2 physicians for every 1000 citizens which is lower than in other developed countries.

How the SDGs can address the Challenges to Canada’s Healthcare System

The SDGs adopted by the United Nations tackles issues in the social, political, economic and environment perspectives. These perspectives affect the healthcare sector either directly or indirectly. SDG 3 is the explicit goal regarding health matters. SDG 3 aims at ensuring health lives and promoting well-being for everybody at all ages. This echoes the need of every individual to receive the highest attainable quality of physical and mental health.

The SDG 3 on improved healthcare indicates the need of increasing the number of health workers by 2030 and ensuring that all are covered under a universal health coverage. This indicator to the SDG 3 addresses the challenge of delayed access to the health care serviced due to a limited number of physicians. Meeting this indicator would imply that the issue of long delays due to a limited number of providers would need to increase.

The call to ensure that all people are covered under the universal health coverage justifies the need of increasing healthcare expenditure. The call to achieve this SDG prompts the need of manager in charge of the healthcare system to ensure that substantive and strategic investments are made to improve the general condition of the healthcare system.

The sustainable development goals are structured in such a way that they can be are relevant in all countries despite their income levels. This implies that even in Canada, they can be used in the health sector but in a manner that focuses on the specific needs of the country. One of the common goals for all income level countries is to have a shared health information and using this as a means of coming up with new and promising opportunities to learn from others (Bennett, 2015, p. 2). In this, light, Canada can borrow from the low-income countries on how to shift simple tasks to less qualified but properly skilled health workers and on having an elaborate community support services for health services. This will help address the challenge of the hospital being clogged with people who would have received home care are still engaged in the facilities.

While only one SDG specifically addresses the issue of health, other SDG goals touch on social, political and environmental factors whose effects trickle down to affecting the health sector and the health care system. There are common connections of ending poverty and hunger, improving education level, enhancing the water and sanitation, as well as promoting gender equality (Bennett, 2015, p. 2). These factors affect the social set up of the healthcare system. Achieving this will ensure the health care system is all-inclusive and catering for even the increasing senior group in Canada. In most cases, the senior groups are left out in economic matters and affected by social and economic factors which end up affecting their health status. Thus by addressing various SDGs, the healthcare sector in Canada will have most challenges related to access to services addressed.

It should be noted that in the Alma Ata Declaration, health sector was defined to mean, “A state of complete physical, mental and social well-being.” With this in mind, the healthcare system challenges will be addressed through attainment of different SDG goals such as SDG 8 on providing decent work for all, SDG 11 on ensuring that cities and human settlements are safer and sustainable, SDG 13 on dealing with climate change, SDG 16 that aims to promote peaceful and inclusive communities, and SDG 10 on reducing inequality (Bennett, 2015, p. 2). These goals will help deal with the challenge of sustainability of the healthcare system. This is because by addressing these social, political, and environmental factors, the prevalence and incidences of diseases will reduce thereby putting less pressure on the healthcare system. This will be effective in improving its effectiveness.  

References

Bennett, S. (2015). How the SDGs can Help Address Global Health Challenges. World Economic Forum.

Canadian Institute for Health Information. (2017). Natioanal Health Expenditure Trends. Retrieved from https://www.cihi.ca/en/national-health-expenditure-trends

Simpson, C., Walker, D., Drummond, D., Sinclair, & Wilson, R. (2017). How Healthy is the Canadian Health-care System? The Conservation .

The Commonwealth Fund. (2017). Health Care in Canada. Retrieved from http://www.commonwealthfund.org/topics/international-health-policy/countries/canada

The Conference Board of Canada. (2017). Health Care System Sustainability a Key Concern as Canadians Get Older.

UNDP. (2015). “Transforming our world: the 2030 Agenda for Sustainable Development” . Retrieved from https://sustainabledevelopment.un.org/post2015/transformingourworld/publication

UNDP. (2017). Sustainabel Development Goals. Retrieved from http://www.undp.org/content/undp/en/home/sustainable-development-goals.html