When looking at healthcare with medical/diagnostic imaging in mind, procedures such as x-rays, CTs, MRIs, Ultrasounds, etc. are at no cost to Canadians, as per the Canadian Health Act. This may have a contributing factor to the high wait times for such exams. Based on a patient's underlying health issues, it can be argued that some imaging exams are a gold standard for diagnosis, versus others being beneficial and not necessary. With that in mind, it is no surprise to any that when a patient has a better relationship with their physician, they may have an imaging procedure ordered that others may not have. For example, for lower back pain, one patient may solely have x-ray requests ordered, whereas another patient (who has a close relationship with their physician; ie: friend, colleague, etc) may have the benefit of having x-rays, MRIs, and other imaging tests ordered. This may be harder to regulate under the Canada Health Act, as technically, it all falls under the appropriate guidelines of being a medically necessary procedure. One way in which the Canadian Health Act can be modernized is to only have additional imaging procedures ordered if the initial procedure is undiagnostic or did not provide the means of diagnosing the patients' area of concern. This would not only regulate the number of diagnostic tests patients are obtaining, but also help reduce overall wait times to those patients who urgently need them, such as a patient awaiting CT imaging results for oncological planning.
In review of the article by Flood and Thomas (2016), having the Canadian Health Act revised so that each patient's care is reviewed on an individual basis would be more appropriate. "A modern system will rationally evaluate the evidence and impact of a broad range of services that can advance human health and decide which of these services should be insured for the community at that time". (Flood et al., 2016, p. 411). Currently, the Ca
nada Health Act treats Canadians from an equitable standpoint, whereas a healthcare system should treat them with equality in mind. This would allow for a patients' health issues to be looked at as a whole, and thus determine what "medically necessary" means to them. With that being said, for the above example, having additional imaging should be considered medically necessary due to chronic, ongoing back pain that could be affecting a patient's overall mental health and quality of life.
Reference:
Flood, C. M., & Thomas, B. P. (2017, January 28). Modernizing the Canada Health Act. Ottawa Faculty of Law Working Paper No. 2017-18. Retrieved January 22, 2022, from https://papers.ssrn.com/sol3/papers.cfm?abstract_id=2907029
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