Canada’s Medicare system is progressively deteriorating. It faces recurrent crises in its present form despite a continuous, decades-long allocation of more tax resources. At the same time, Canadians clearly want to assure guaranteed, universal access to medical services. A new Medicare model has the potential to retain universality, restore service levels, control costs and introduce transparency and accountability to the system. That model, Universal Medical Savings Accounts (UMSAs), allocates existing public funding directly to individual citizen-consumers of health-care services.
Currently, federal and provincial governments underwrite Medicare budgets through a complex system of block grants to medical authorities. With UMSAs, the same money would be divided up among individual health-care consumers, each of whom would receive it in the form of credits deposited to a dedicated health-care account. With the exception of a mandatory requirement to purchase insurance coverage for long-term and catastrophic care, spending from the account would be controlled by the account-holder. Hospitals, clinics and doctors would charge patients for services rendered, with payments made from individual UMSAs. Any money left in the UMSA would remain the property of the account-holder.