Within the context of the Canadian health care system, two-tiered system means a system in which those with the means are allowed to buy healthcare insurance from the private, for profit insurers while those who are unable can still access basic publically funded health care (Beach, Chaykowski, Shortt, St-Hilaire, & Sweetman, 2006). This system might lead to a situation where the rich access better and faster care while the poor access care with long waiting.
Proponents of the two-tiered system argue that the system will reduce waiting times in public health facilities because the rich will be removed from the waiting lists, as they go to pay their healthcare in private clinics. Those against the two-tier system argue that the system will also remove healthcare providers from the public system, which will create shortage of health care professionals. The result is that the situation will lengthen wait for poor Canadians who will be unable to afford private insurance (Beach et al., 2006).
The principle of egalitarianism demand equality in the provision of health. Universal coverage in Canada ensures that every individual citizen is provided with health care services. Every Canadian qualifies for health coverage regardless of their income, standard of living, or medical history. The introduction of the two-tiered system might compromise the spirit of egalitarianism and universal coverage in Canada. There are concerns that privatizing health care through the two-tiered system would bring about inequalities in the health care system, since only the wealthy will be able to get certain treatments. This would be in violation of the Canadian law. According to the Canada Health Act principle of universality, all insured Canadians are supposed to get the same level of care. Contrary to this, the two-tiered system will mean that the poor and the rich do not receive the same level of care. The private and the public findings might be complementary to each other. The government pays for those who cannot afford private insurance. Those who are financially able are required to take health insurance with private insurance firms.
In the US, the Institute for Healthcare Improvement Triple Aim was intended to optimize the performance of the US health system (Institute for Healthcare Improvement, 2012). It seeks to focus health improvement efforts on three dimensions, namely, improvement in the patient experience of care, improvement of the health of populations, and reduction of the per capita cost of health care. To achieve these aims, they developed a concept design with five elements. These elements include focus on individuals and families, redesigning of the primary care services and structures, population health management, cost control platform, and system integration and execution. The Triple Aim objectives enhance the egalitarian principles by ensuring that every American is guaranteed the three aims (Institute for Healthcare Improvement, 2012).
The Institute for Health Improvement suggests that target populations in need should be identified. Practices should be modified to meet the health care needs and conditions at the local level. The system will enhance health of the populations because it will be possible to identify problems more effectively before they even reach the acute care. The health care will be simple and well-coordinated, meaning that the burden of illnesses will reliably decrease. It will also enhance competition among businesses, relieve the public expenditure on healthcare, and allow societies to invest in other areas such as schools and the lived environment (Institute for Healthcare Improvement, 2012). This will result in the improvement of the quality for all, thus enhancing the egalitarian aspect of health care in the country.
References
Beach, C. M., Chaykowski, R. P., Shortt, S., St-Hilaire, F., & Sweetman, A. (2006).Health services restructuring in Canada: New evidence and new directions. Montreal, Canada: McGill-Queens Universit
