Across Country Lines: Part I
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Comparative Analysis of Healthcare Policies and Reforms: Canada and Germany
Expanding a healthcare organization abroad requires a thorough understanding of the policies and reforms in the target country. This paper examines healthcare policies and reforms in Canada and Germany, both of which have universal healthcare systems. Specifically, the focus will be on a common policy area, namely care for the elderly, including assisted living facilities, home care services, physical therapy, and mental health. By comparing the policies and reforms in these two countries, we aim to evaluate their effectiveness, identify similarities and differences, and provide a recommendation on whether our organization should proceed with expanding into one of these countries.
Policy/Reform: Care for the Elderly
The policy/reform pertaining to care for the elderly is crucial for addressing the healthcare needs of aging populations in both Canada and Germany. This policy aims to provide comprehensive and accessible healthcare services, promote healthy aging, and ensure dignified and quality care for the elderly. In Canada, the policy is commonly referred to as the “Seniors Health Care Policy,” while in Germany, it is known as Long-Term Care Insurance (Ridic et al., 2012).
Similarities
In both countries, the care for the elderly policy/reform was enacted due to demographic shifts, increased life expectancy, and the need for sustainable healthcare systems. The policies aim to address the following key objectives:
Accessibility
Both Canada and Germany prioritize ensuring equal access to healthcare services for the elderly. In Canada, the Seniors Health Care Policy focuses on providing accessible care through various initiatives. Assisted living facilities, home care services, and rehabilitation programs are widely available, with the aim of enabling elderly individuals to receive care in their preferred settings. Efforts are made to reduce wait times and improve access to specialized services, such as geriatric assessments and long-term care placements. In Germany, the Pflegeversicherung system also emphasizes accessibility by offering a range of services, including home care, day care centers, and assisted living facilities (Mehdi et al., 2022). The goal is to enable elderly individuals to live independently and receive care according to their specific needs.
Affordability
Mitigating the financial burden on elderly individuals and their families is a crucial aspect of care for the elderly policies in both countries. In Canada, the Seniors Health Care Policy provides insurance coverage for essential healthcare services, reducing out-of-pocket expenses for elderly individuals. Additionally, social support programs, such as the Guaranteed Income Supplement and tax credits, are implemented to provide financial assistance. In Germany, the Pflegeversicherung system operates through mandatory insurance contributions. These contributions help finance the long-term care services for the elderly, ensuring affordability and reducing financial strain (Blankart et al., 2021). However, it is important to note that while the policies aim to alleviate costs, there may still be variations in coverage and potential gaps that require additional private insurance or out-of-pocket payments.
Quality of Care
Improving the quality and standard of care for the elderly is a shared goal in both countries’ policies. In Canada, the Seniors Health Care Policy focuses on person-centered approaches to care, recognizing the unique needs and preferences of elderly individuals. The policy emphasizes prevention, early intervention, and multidisciplinary care, promoting holistic well-being. Efforts are made to integrate mental health services, palliative care, and rehabilitation programs into the continuum of care for the elderly. In Germany, the Pflegeversicherung system places emphasis on maintaining quality standards in long-term care services. Providers must adhere to specific regulations and quality indicators to ensure consistent and high-quality care (Mehdi et al., 2022). The system also encourages family involvement and places importance on the emotional well-being and dignity of elderly individuals.
Differences in Policies and Reforms
Funding Mechanism
The funding mechanisms for care for the elderly differ between Canada and Germany. In Canada, the policy is primarily financed through general tax revenues, which contribute to the overall healthcare budget. These funds are then allocated to various healthcare services, including those for the elderly. The use of tax revenues allows for a more collective approach to funding, with the aim of ensuring equitable access to care. In contrast, Germany operates under a mandatory long-term care insurance system. Contributions are made by individuals and their employers specifically for long-term care services (Dyer et al., 2020). This system establishes a dedicated pool of funds specifically for care for the elderly, allowing for a more targeted and sustainable approach to financing these services.
Coverage Extent
The coverage extent in care for the elderly policies differs between Canada and Germany. Canada’s policy encompasses a broader range of services, including pharmaceuticals, vision care, and medical supplies, in addition to long-term care services. This comprehensive coverage reflects a more holistic approach to elderly care, aiming to address various aspects of their health and well-being. On the other hand, Germany’s policy primarily focuses on long-term care services, such as assistance with activities of daily living, nursing care, and support in assisted living facilities (Dyer et al., 2020). The emphasis on long-term care services highlights the recognition of the specific needs and challenges faced by the elderly population, with an aim to ensure their safety, dignity, and quality of life.
Delivery Systems
Canada and Germany have distinct delivery systems for healthcare, including care for the elderly. Canada’s healthcare system is decentralized, with provincial and territorial variations in the organization and delivery of services. Each province has its own policies and regulations, resulting in some variability in access and delivery of care for the elderly. While the federal government sets the overarching framework, the responsibility for healthcare lies with the provinces, leading to differences in coverage, wait times, and resource allocation. In contrast, Germany has a more centralized healthcare system with standardized benefits and regulations. The federal government plays a more significant role in setting uniform standards and policies, ensuring consistent access and quality of care for the elderly across the country (Osborn et al., 2014). The centralized system facilitates coordination and integration of services, promoting a more standardized approach to elderly care.
Recommendations
Based on the analysis of healthcare policies and reforms in Canada and Germany, it is recommended that our organization consider expanding into Canada. Canada’s healthcare system, with its focus on accessibility, affordability, and quality of care for the elderly, aligns well with our organization’s mission and expertise. The comprehensive coverage offered, encompassing a wide range of services including pharmaceuticals, vision care, and medical supplies, presents an opportunity for our organization to provide holistic care to the elderly population. Moreover, the emphasis on person-centered approaches, prevention, and multidisciplinary care reinforces our commitment to delivering high-quality services.
Also, the decentralized healthcare system in Canada allows for potential collaborations with regional healthcare authorities and service providers. By forging strategic partnerships, we can leverage existing infrastructure, expertise, and resources to ensure a smooth transition and successful integration into the Canadian healthcare landscape. Engaging in dialogue with provincial authorities and healthcare organizations will enable us to navigate the regional variations in licensing, regulations, and funding, ensuring compliance and optimal service delivery.
References
Blankart, C. R., van Gool, K., Papanicolas, I., Bernal‐Delgado, E., Bowden, N., Estupiñán‐Romero, F., … & ICCONIC Collaboration. (2021). International comparison of spending and utilization at the end of life for hip fracture patients. Health Services Research, 56, 1370-1382.
Dyer, S., Valeri, M., Arora, N., Ross, T., & Winsall, M. (2020). Review of international systems of long-term care of older people. Royal Commission into Aged Care Quality and Safety.
Mehdi, Z., Nasser, R., & Theobald, H. (2022). Post-basic education training, age and gender of healthcare workers for elderly patients in Germany and Canada: A comparison. Work, (Preprint), 1-10.
Osborn, R., Moulds, D., Squires, D., Doty, M. M., & Anderson, C. (2014). International survey of older adults finds shortcomings in access, coordination, and patient-centered care. Health Affairs, 33(12), 2247-2255.
Ridic, G., Gleason, S., & Ridic, O. (2012). Comparisons of health care systems in the United States, Germany and Canada. Materia socio-medica, 24(2), 112.
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