Canada Health Act Research Paper

The Canada Health Act (CHA) unmistakably forbids “cherry-picking” of patients, stating “no one may be discriminated against on the basis of such factors as income, age, and health status”. It also sets provisions against charging patients for insured services through user charges or extra-billing, a practice that makes discrimination in favor of wealthier patients unprofitable to physicians (Madore). If met and given universal coverage, these provisions imply that greater patient wealth offers no promise of monetary reward to physicians and should, thus, be unimportant when offering a medical appointment. This conjecture that given these provisions physicians will have no monetary incentive to cherry-pick wealthier patients makes two assumptions:
Given universal coverage, the fee-for-service mechanism that is dominant in Canada seems to provide no incentive for physicians to admit wealthier patients unless a physician takes other factors that would affect use of services, such as the prioritization of one’s health, as being positively correlated with wealth. If, however, physicians are paid through capitation, their selling more services yields no extra profit, and wealthier patients may seem more desirable to enlist if a physician believes the wealthy to be less ill. Admitting healthier patients means less or easier work for the physician with an equal pay, as well as saving physician’s resources and equipment that would be used towards caring for sicker
With a retrospective fee-for-service system of reimbursing physicians I would not be surprised, as the researcher was, to see family doctors offering more appointments to sicker patients – i.e. ones that need costly care. Specifically, patients with chronic health conditions, rather than ones needing a routine check up, need enduring care and therefore present a potential source of long-term income. Further, although it may strike some as unethical to discriminate against patients on basis of health status – a factor included in the CHA’s aforementioned denouncement of cherry-picking, giving privileges to sicker patients portrays a deference of vertical equity and would, I suggest, render health care more equitable. Also, to fulfill their responsibilities as agents, physicians have an “obligation to do everything potentially beneficial to patients”, clearly encompassing granting appointments (Hurley, 362). It could be argued, however, that physician agency entails that they would grant appointments to healthier patient to achieve more positive results and market