Taylor D Wayne
Michael G. DeGroote School of Business, McMaster University.
Healthc Manage Forum. 2003 Spring;16(1):6-10, 44-9. doi: 10.1016/S0840-4704(10)60606-0.
The Commission on the Future of Health Care in Canada asked whether Medicare is sustainable in its present form. Well, Medicare is not sustainable for at least six reasons. Given a long list of factors, such as Canada's changing dependency ratio, the phenomenon of diminishing returns from increased taxation, competing provincial expenditure needs, low labour and technological productivity in government-funded healthcare, the expectations held by baby boomers, and the evolving value sets of Canadians--Medicare will impoverish Canada within the next couple of decades if not seriously recast. As distasteful as parallel private-pay, private-choice healthcare may be to some policy makers and providers who grew up in the 1960s, the reality of the 2020s will dictate its necessity as a pragmatic solution to a systemic problem.
加拿大医疗保健未来委员会曾询问，现行形式的加拿大医疗保险制度是否可持续。嗯，医疗保险制度至少出于六个原因而不可持续。考虑到一系列因素，比如加拿大不断变化的抚养比、税收增加带来的收益递减现象、各省相互竞争的支出需求、政府资助医疗保健领域低下的劳动力和技术生产率、婴儿潮一代的期望以及加拿大人不断演变的价值观——如果不进行重大重塑，医疗保险制度将在未来几十年内使加拿大陷入贫困。尽管对于一些在20世纪60年代成长起来的政策制定者和医疗服务提供者来说，平行的自费、私立选择医疗保健可能令人反感，但21世纪20年代的现实将决定其作为解决系统性问题的务实方案的必要性。
