DeCoster C A, Brownell M D
Manitoba Centre for Health Policy and Evaluation, Univ. of Manitoba, Winnipeg, Canada.
Public Health Rep. 1997 Jul-Aug;112(4):298-305; discussion 306-7.
In canada, health care is publicly insured and available to all at no charge. Recently, financial pressures have threatened the system and led to considerable debate about how to save it. One proposal is to permit privately funded health care alongside the public system, resulting in what is popularly called a two-tiered system. This paper presents some of the arguments for and against two-tiered health care. Using as an example cataract surgery-a procedure that is available both publicly and privately-the authors look at some common beliefs about private health care in Canada. They conclude that the growth in private sector cataract surgery does not appear to be related to cutbacks or rationing, that private access does not necessarily shorten waiting times, and that, contrary to popular belief, it is not only the well-to-do who pay for private surgery in Canada.
在加拿大，医疗保健由公共保险提供，所有人均可免费享受。最近，财政压力对该体系构成了威胁，并引发了关于如何挽救它的广泛辩论。一项提议是在公共医疗体系之外允许私人资助的医疗保健，从而形成所谓的双层医疗体系。本文呈现了支持和反对双层医疗保健的一些论据。作者以白内障手术为例（该手术在公共和私人领域均可进行），审视了一些关于加拿大私人医疗保健的常见观点。他们得出结论，私营部门白内障手术的增长似乎与削减或配给无关，私人途径不一定能缩短等待时间，而且与普遍看法相反，在加拿大支付私人手术费用的并非只有富人。
