本文是健康与社会保障专业的Essay范例，题目是“Canadian Healthcare System Wait Time Health And Social Care Essay（加拿大医疗保健系统等待时间健康与社会保障论文）”，加拿大的卫生保健是通过公共资助的卫生保健系统提供的。它在使用点是免费的，私人机构提供它的大部分服务。加拿大的医疗保健系统受《加拿大卫生法》的要求管辖。加拿大政府通过这项法案，通过联邦规范保证医疗保健的质量。但是，政府不参与日常护理，也不收集有关个人健康的任何细节，这些细节是私人的，只与医生共享。免费医疗制度在加拿大和其他一些国家相对来说是成功的。提供免费医疗服务对一个国家来说是非常重要的(Hatch & Graham, 2004)。在一个国家实行全民免费医疗有明显的好处。
Health care in Canada is offered through a publicly financed health care system. It is without charge at the point of use, and private bodies offer the majority of its services. The Canadian healthcare system is governed by the requirements of the Canada Health Act. The Canadian government, through this act, guarantees the quality of healthcare through federal norms. However, the government does not play a part in daily care or gather any details concerning a person’s health, which is private and only shared to a physician. Free health care is a system has relatively been successful in Canada and a number of other countries. Offering free health care services is very important for a country (Hatch & Graham, 2004). There are explicit benefits to implementing free for all health care in a country.
Another importance of implementing a free health care system is that they can be cost effective when they are administratively simple (Steinbrook, 2006). The free health care system helps to cut administrative Costs in a country’s health system. Since health care will be centralized under one administration, free health care would eliminate competition, and consequently the cost of health care would considerably fall. In the absence of a free health care system, there exist replications in claims and procedures owing to the various, diverse health plans. A free health plan also saves time for the processing of claims; therefore, it could be managed in a smoother and a lot more cost-efficient manner. In addition, employers are, under a free health care system, not required incur many expenses in order to offer health insurance to their workforce. A free health care system, customary under a single administration in a country, eliminates the need, for contract negotiations hence helping in cost cutting. Since there is no need for advertisement, as there is not much competition going on, a free health care system further leads to cost cutting and resources are concentrated on important tasks.
实施免费医疗系统的另一个重要意义是，在行政管理简单的情况下，它们可以具有成本效益(Steinbrook, 2006)。免费医疗系统有助于降低一个国家医疗系统的行政成本。由于保健将集中在一个行政管理之下，免费保健将消除竞争，因此保健费用将大大下降。在没有免费保健制度的情况下，由于各种各样的保健计划，在索赔和程序方面存在重复现象。免费医疗计划还节省处理索赔的时间;因此，它可以以一种更平滑和更有成本效益的方式管理。此外，雇主在免费医疗制度下，不需要花费很多费用来为他们的员工提供健康保险。一个国家的单一行政管理下的免费医疗系统，消除了合同谈判的需要，从而有助于削减成本。由于没有广告的需要，也没有太多的竞争，免费的医疗保健系统进一步导致成本削减和资源集中在重要的任务。
A major criticism concerning the Canadian health care systems, is the amount of time spent as waiting time in health care facilities. Whether it is waiting is for a consultant, key optional surgery e.g. hip replacement, or special procedures, for example, radiation for cancer patients, waiting times in Canada is caused by a myriad of factors (Fradet, Aprikian, Dranitsaris, et al, 2006). In Canada, the waiting time is set in regards the ease of use of medical services in a particular zone and by the comparative need of the patient requiring treatment (Esmail, Walker, & Bank, 2007). There is no solitary cause for longer wait; rather, there are numerous, and complex causes of longer wait times.
对加拿大卫生保健系统的一个主要批评是，在卫生保健设施中等待的时间太长。无论是等待顾问、关键的可选手术(如髋关节置换)，还是特殊的手术(如癌症患者的放疗)，加拿大的等待时间都是由多种因素造成的(Fradet, Aprikian, Dranitsaris, et al, 2006)。在加拿大，等候时间是根据某一地区医疗服务的便利程度和需要治疗的病人的相对需要来确定的(Esmail, Walker， & Bank, 2007年)。更长的等待没有单独的原因;更确切地说，有许多复杂的原因导致较长的等待时间。
A 2008 report issued out by Health Canada in 2008 integrated data on reported wait times for diagnostic services (Health Canada, 2008). The average wait time for diagnostic services, for example, MRI and CAT scans is a fortnight and with 89.5% of operations waiting for less than 3 months (Health Canada, 2008). The same report indicates that the average wait time to consult a physician is a just marginally over a month with 86.4% of patients waiting for a period less than 3 months (Health Canada, 2008). The average wait time for surgical procedures is marginally over 4 weeks with 82.2% of patients having to wait for less than 3 months (Health Canada, 2008).
加拿大卫生部2008年发布的一份2008年报告综合了报告的诊断服务等待时间数据(加拿大卫生部，2008年)。例如，诊断服务的平均等待时间为两周，89.5%的手术等待时间少于3个月(加拿大卫生部，2008年)。同一份报告还指出，平均等待看医生的时间略多于一个月，86.4%的患者等待时间少于3个月(加拿大卫生部，2008年)。外科手术的平均等待时间略高于4周，82.2%的患者等待时间少于3个月(加拿大卫生部，2008年)。
A major cause for long the waiting time in the Canadian health system includes badly organized services. In the Canadian heath system, there is marked inefficiencies evidenced by the acute lack of synchronization amongst all those concerned in service delivery. Poor strategic planning slows down the health system and erects blocks in offering surgeries and additional services. Deficiency of health care workers in Canada is another reason for the long wait times in the health system. At times, patients do not get to see a physician promptly, or at all occasionally, they go to the emergency rooms (ERs), lengthening wait times in ERs. Though the number of physician in the Canadian health system has increased, it has not matched the population increase in the same period. This shortage has been caused by a fall in the sum of foreign physicians coming to Canada, a general aging of the personnel, irregular supply of physicians, a rising proportion of female doctors who are likely to put in fewer hours and the fact that more medical students preferring a specialty over general practice. Unless this problem is solved, the wait time in Canadian health system will continue to increase.
加拿大卫生系统中等待时间过长的一个主要原因是服务组织不良。在加拿大的保健系统中，所有有关方面在提供服务方面严重缺乏同步，这表明存在着明显的低效率。糟糕的战略规划减缓了卫生系统的速度，并阻碍了提供手术和额外服务。加拿大缺乏卫生保健工作者是卫生系统等待时间过长的另一个原因。有时，病人不能及时去看医生，或者只是偶尔去急诊室(er)，从而延长了在急诊室的等待时间。尽管加拿大卫生系统的医生人数有所增加，但与同期的人口增长仍不相称。这种短缺已造成下降的和外国医生来到加拿大,一般人员老化,不规则的医生,女医生的比例上升可能会投入更少的时间和更多的医学生倾向于专业惯例。除非这个问题得到解决，否则加拿大卫生系统的等待时间将继续增加。
In Canadian health system, Physicians do not work as a team. Most physicians’ offices work separately. All arrangements, and measures that precede surgery are administered by each individual office; this leads to waits and inefficiencies at each step. Another possible cause for the long wait times in the Canadian health system is the reduction in hospital services that happened between 1988 and 2002 (Esmail, Walker, & Bank, 2007). For instance, there were sixty four thousand hospital beds cuts in the period. Another cause for the long waits in health systems, in Canada, is the need for additional long-term care and home care. The shortage of funds that lead to under financing of home care and residential long-term care, have augmented wrong and unnecessary hospitalization, and increased strain on emergency rooms in hospitals. Another reason for the increase in the wait times in the health system is the success of the program such that there are better outcomes for medical services. When the services were improved, additional people can now more people can profit from them. For example, numerous patients can now more than ever before have medical operations that normally would have been too risky and perilous a few years ago.
在加拿大的卫生系统中，医生不作为一个团队工作。大多数医生的办公室是分开工作的。所有手术前的安排和措施都由各个办公室管理;这导致了每一步的等待和效率低下。加拿大卫生系统中等待时间过长的另一个可能原因是1988年至2002年期间医院服务的减少(Esmail, Walker， & Bank, 2007)。例如，在此期间削减了64,000个医院床位。在加拿大，卫生系统中出现长时间等待的另一个原因是需要额外的长期护理和家庭护理。资金短缺导致家庭护理和长期住院护理资金不足，增加了错误和不必要的住院治疗，并增加了医院急诊室的压力。卫生系统中等待时间增加的另一个原因是该计划的成功，医疗服务有更好的结果。当这些服务得到改善后，更多的人可以从这些服务中获利。例如，许多病人现在比以往任何时候都更能进行几年前通常太危险的医疗手术。
As such, efforts for reducing wait times will necessitate system-wide improvements. Potential policy measures to reduce the waiting time in the Canadian health system can be centered on either the demand (which includes new technology, patients’ outlook, cost distribution and mechanisms for setting systems) or the furnishing side (includes with the medical center and personnel capacity and the health-sector efficiency). Historically, supply or furnishing side approach has been the overriding strategies that manage long wait times. The health sector can implement the politically correct policy of aiming funding at escalating hospital capacity and workforce. The country ought to put into place a multifaceted assortment of supply-based initiatives that tackle fundamental issues such as the sector’s efficiency and structure revamp. Demand-side approaches should also be developed. The government should start to utilize unequivocal criteria to give precedence to access to surgical procedures. The government should also delegate budgets to general practitioners to parallel specialist-referral conclusions to the monetary cost. Other mechanisms that can be put into place include the demand-side leaning mechanisms such as fresh models of health care, for example, personnel substitution and changing demand from public to private health services providers.
To reduce wait times, the Canadian government needs to implement system-wide expansions in the health care system. The government should fund more pilot projects to find out what goes on in hospitals and regions that are already significantly cutting wait times. The health care system should have systems where common waiting lists are used. For instance, patients with a common problem waiting for a particular practitioner go into the same list. The health care sector should put more efforts into expanding teamwork to eliminate duplication of duties and improve harmony. Modern electronic information system should also be used as well as putting more finds into community care.
为了减少等待时间，加拿大政府需要在卫生保健系统中实施全系统扩展。政府应该资助更多的试点项目，以了解医院和地区的情况，这些地区已经显著缩短了等待时间。医疗保健系统应该有使用普通等候名单的系统。例如，有常见问题的患者在等待特定的医生时，会进入相同的列表。保健部门应更加努力扩大团队合作，消除职责重复，增进和谐。在提高社区医疗服务质量的同时，还应使用现代电子信息系统。
In conclusion, a total eradication of waiting times is not good or ideal. The lists should come up through a process of prioritization founded on the doctor-determined medical necessity and the procedure’s threat as contrasted to patient’s capacity to pay. Waiting lists can help patients. However, the waiting list should be not being so long to put the life of the patients in danger. The government of Canada should put more effort into solving the issue.
总之，完全消除等待时间不是好的或理想的。这些名单应该通过一个优先排序的过程出现，这个过程是基于医生确定的医疗必要性和程序的威胁，而不是病人的支付能力。等候名单可以帮助病人。然而，等候名单不应该太长，以免危及病人的生命。加拿大的政府应该在解决这个问题上付出更多的努力。
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