Livingston M
State University of New York, College at Old Westbury 11568, USA.
J Public Health Policy. 1998;19(3):267-88.
Americans wanting to understand health care in Canada must take into account three issues: first, what's right about the system, and always has been--it is an accessible system providing universal access to comprehensive medical care. What isn't wrong with the system, that is, the lies promulgated in the United States press about long waiting lines for care and Canadians pouring across the border for care unavailable in Canada, is included. The second issue is what's wrong, and has always been wrong, with the Canadian system: it's a private-practice, fee-for-service medical (some would say "sickness") care system in which the social determinants of health and primary prevention have never been appropriately funded. Finally, for several years there have been, and continue to be, real and ever-escalating threats to the Canadian system in the form of block-granting and serious cuts.
其一,该体系一直以来的优点——它是一个可及的体系,能让民众普遍获得全面的医疗服务。其中还包括该体系没有的问题,即美国媒体所散布的关于就医需长时间排队以及加拿大人越境寻求在加拿大无法获得的医疗服务等不实言论。第二个问题是加拿大医疗体系一直存在的弊端:它是一个私人执业、按服务收费的医疗(有些人会说是“疾病”)护理体系,在这个体系中,健康的社会决定因素和一级预防从未得到过适当的资金投入。最后,多年来,以整笔拨款和大幅削减开支的形式,对加拿大医疗体系的实际威胁一直存在且不断升级。