Medical prescriptions were filled by pharmacies at no cost, and people opened their homes to passengers in need of a coffee or a shower. They took us to their homes, made sure we wanted for nothing, treated us as part of the family. Shirley Brook-Jones and the passengers from her flight were cared for in the nearby community of Lewisporte , Newfoundland.
On their flight home six days later, Brook-Jones suggested to passengers that they should start a scholarship for local students as a way to thank the community. Word spread and the fund grew. Among those killed:.
The couple had been married for 18 months. Christine Egan, 55, a nurse from Winnipeg , was visiting her brother Michael, 51, at his office on the th floor of the World Trade Center. Both were killed. Following his death, his widow, Maureen, started the Canadian Coalition Against Terror, an organization that successfully lobbied the federal government to enact legislation allowing Canadian victims to sue countries or groups that support terrorism.
As he headed to the elevators, DiFrancesco was thrown against the wall as United Flight struck the building between the 77th and 85th floors.
As DiFrancesco and his colleagues started down one of the emergency stairwells, there was smoke, fire, debris and confusion.
By the time he made it to the 79th floor, the stairwell was blocked by a collapsed wall. He found a hole in the wall and ran through flames and burning debris for the next three stories. In October , Canadian naval ships were dispatched to the Arabian Sea off southwest Asia to patrol the seas for vessels engaged in illegal activity. More soldiers soon followed and Canada would stay in the region until By the time the operation ended, 40, Canadian Armed Forces members had served in Afghanistan and soldiers had lost their lives.
The Canadian government enacted a number of new security measures to combat terrorism at home, increasing security at airports, ports and border crossings, as well as enacting new in-flight security rules for airlines.
In , the Liberal government passed controversial legislation called the Anti-Terrorism Act. The law's "preventative arrest" provision allowed police to bring a person suspected of terrorist activity before a judge, who could curtail their freedom — for example, forbidding them from communicating with specific individuals.
The law also created "investigative hearings" in which suspected terrorists who had not yet been charged with any crime could be compelled to testify at secret judicial hearings. These two elements of the legislation had a sunset clause of five years; the rest of the Anti-Terrorism Act remained. The Conservative government of Prime Minister Stephen Harper tried four times to resurrect the two provisions, finally succeeding in with the Combating Terrorism Act.
That law renewed preventative arrests and investigative hearings for five years. It also made it a crime to leave Canada to engage in terrorist activities and included stiffer penalties for harboring a person involved in terrorism. Michael Arcynski, 45, married with six children. A seventh child was born after the attack. Ken Basnicki, 48, married with two children. Review the details of this process for getting a family- or employment-based visa.
Another way to seek an immigrant visa is through the Diversity Visa Lottery program. This program lets people from countries with low U. You will get a sealed packet of documents to give officials at the U.
You will be admitted to the U. You will not have to return to your home country. You will still have to go through steps like those required for an immigrant visa application:. Wait until the petition is approved and there is a visa available in your category. Then apply for a Green Card from within the U. You will still need to get a medical examination, go to an interview, and wait for a decision on your application. Refugees are people who fled their homes for a variety of reasons, including persecution or the fear of persecution and war, to find protection elsewhere.
If these organizations are unavailable to you, contact the nearest U. Embassy or consulate. These exports support more than , American jobs. Since the original NAFTA did not eliminate all tariffs on agricultural trade between the United States and Canada, the USMCA will create new market access opportunities for United States exports to Canada of dairy, poultry, and eggs, and in exchange the United States will provide new access to Canada for dairy, peanuts, processed peanut products, and a limited amount of sugar and sugar containing products.
The agreement includes market access gains for the following American products:. Fluid Milk : 50, metric tons MT by year six of the agreement, growing one percent for an additional 13 years. Eighty-five percent of the quota will be reserved for further processing. Cheese : 12, MT by year six of the agreement, growing one percent for an additional 13 years. Fifty percent of that amount will be available for any kind of cheese, while the remainder will be for industrial cheeses.
Cream : 10, MT by year six of the agreement, growing one percent for an additional 13 years. Eighty-five percent of the volume in year one will be reserved for further processing.
Skim Milk Powder : 7, MT by year six of the agreement, growing one percent for an additional 13 years. Butter and Cream Powder: 4, MT by year six of the agreement, growing one percent for an additional 13 years.
Eliminating the weaknesses while maintaining the strengths is a challenge faced by any plan for changing the U. Empirical Evidence and International Comparisons. From the table we can see that the United States has the largest GDP per capita and the largest health care spending per capita. The number of physicians per , number of hospital beds per and average length of stay days are largest in Germany.
The United States is ranked at the bottom of the list in terms of hospital beds per at 3. Medical care spending in the U. Comparative Health Care System statistics for these three countries show that the United States has the highest infant mortality 7.
The mortality rate in Canada is 5. The percent of population greater than 65 years according to data is One interesting question is whether people in various nations are satisfied with their current health care system.
From the data several conclusions are worth mentioning. The first is that Canadians are most satisfied with their health care system. The Canadian health care system offers national health insurance financed by taxes, private production of health care services, and regulated budgets and fees for health care providers.
The second conclusion to be drawn is that people in the United States are the least satisfied with their current health care system. In addition, 3 out of every 10 respondents in the United States believed the health care system requires a complete restructuring. The surveyors speculated that the dissatisfaction with the present U. The third conclusion is that the presence of a national health care or socialized medicine plan does not guarantee high levels of consumer satisfaction.
Source: Robert J. The data suggests that the Canadian and German systems appear to be more effective than the U. Costs are lower, more services are provided, financial barriers do not exist, and health status as measured by mortality rates is superior. Canadians and Germans have longer life expectancies and lower infant mortality rates than do U. However, the comparisons do not tell the whole story, nor do they necessarily imply that the United States should adopt the Canadian or German approach.
Some have argued that a system that is manageable for a population of 30 or 80 million people cannot easily be adapted to a more pluralistic, heterogeneous country with a population of nearly million. Many Canadians are no longer confident that the provinces will be able to afford their current systems.
As a result of unprecedented federal deficits the Canadian government has reduced substantially its cash transfers to the provinces. A recent government study indicated that 4. Overworked technology is one reason for the long lines; others include a shortage of nurses and inefficient management of hospital and other health care facilities, according to several studies Krauss 3. Waiting times have also increased because an aging population has put more demands on the system, while the current generation of doctors is working fewer hours than the last.
Waiting can occur at every step of treatment. A study by the conservative Fraser Institute concluded that patients across Canada experienced average waiting times of In an effort to reduce waiting lists, some Canadian provinces Alberta, Nova Scotia and Ontario have established about 30 private MRI and CT clinics, some of which offer non emergency services to be paid for by private insurance.
But in the context of slower economic growth, stagnant incomes, and a consensus that labor costs cannot rise much more without disastrous effects on competitiveness and employment, payroll based financing is not a sufficient revenue based Giaimo Even if payroll taxes were permitted to rise, the resultant unemployment and inactivity could, in the end, lead to a financing crisis of the social insurance system.
A number of proposals aimed at putting health care financing on a sounder and more equitable footing were presented in the late s. These included raising the income ceiling for contributions, bringing civil servants and the self employed into statutory health insurance, and bringing non—wage income and assets under the contribution levy.
Other proposals would have simply shifted costs from employers to employees. However, there was no real political support for this proposal and the immediate outcome was political paralysis. Future German governments face difficult choices in continuing to ensure that all individuals have access to high quality care at an affordable cost.
Thus far, however, the political and sectoral configurations underlying German health politics have impeded radical changes in governance or financing. Most stakeholders still want to maintain the status quo. However, the situation is dynamic, not set in stone. The power of preferences of politicians could change in the future in ways that would tolerate a bolder departure from the present governance system or radical changes in financing. Such changes could either expand or undermine solidarity — or they might prompt a search to redefine it.
Given the presence of powerful countervailing forces in the health sector and in the political arena, successful adjustment will likely hinge on forging a consensus with these stakeholders over a new conception of solidarity that continues to ensure broad provision, spreads the burden of adjustment fairly, and shelters the most vulnerable from harm Giaimo From the discussions that were presented above we can see that the prices and expenditures on various medical services continue to rise in the US, although at a slower rate than in the past.
The transition to managed care health care system has helped to promote some cost savings in various medical care markets but has also resulted in some rationing of care. Choice of physician, physician autonomy and income, hospital inpatient admissions, and selection among pharmaceutical products have all been greatly limited by the movement to a managed care health care system in the United States. These limitations pertain not only to private managed care insurance plans but also to managed care plans under the auspices of the Medicare and Medicaid programs.
Moreover, it seems that competition in the health care sector may have sown the seeds of its own destruction. For instance, benefit denial and cherry picking behavior take place in the private health insurance industry because of competition. Induced demand in the physician services industry and the medical arms race in the hospital industry are argued to occur because of competition Santerre and Neun 9.
In the discussion, it is important to compare the US health care system with health care systems in other advanced industrialized countries. Canada and Germany involve a single payer system rather than a multiple payer system like that of the US.
Their health care systems provide nearly universal access to medical care services and involve a greater financing and regulatory role for the federal government and less reliance on competition in health care matters. The available data suggests that the US spends more on medical care as a fraction of GDP than to the other two countries. Comparatively high health care expenditures coupled with low medical utilization rates have led some to believe that medical prices must be significantly higher in the US than in the other two countries.
The quality of medical services may be higher in the US and account for the alleged higher medical prices. Evidence suggests that waiting times are shorter for most medical services in the United States. Many analysts have concluded that health care costs and infant mortality are lower in other countries because a government plays a more dominant role in the health care sector and because there is universal access to health insurance.
Many health care policy analysts believe that a similar approach can produce better results in the US. Many people in the US are dissatisfied with the performance of the health care system. The cost of health care in the United States is alleged to be rising faster than in any other country. Many worry that the health care monster will continue to devour an increasingly large slice of the economic pie. Moreover, at any one point in time, critics note that one out of every six non—elderly citizens lacks insurance coverage for acute care.
Many others in the US are seriously underinsured or lack proper long-term care insurance coverage. A number of health care analysts and policy makers are searching for ways to improve the American health care system. Various groups have advanced a large number of health care reform plans.
The plans differ in a number of respects, especially concerning the role the individual, employer and government play in the financing of medical insurance and the functions the government and marketplace serve in the allocation of health care resources. Several distinctive new approaches and plans have been proposed to improve and reform the US health care system. Four different approaches have surfaced in recent times; those include medical savings accounts, individual mandates, managed competition and national health insurance Santerre and Neun Medical savings accounts programs are not designed to achieve universal coverage.
However, health insurance premiums should become more affordable when they become tax deductible and apply mainly to catastrophic plans. Tax credits and subsidies are used to make health insurance more affordable for poor individuals. The plan is financed primarily out of individual contributions to medical savings accounts.
The government expenditures on Medicare and Medicaid would end and the deficit should diminish accordingly. A reduction in administrative expenses also translates into cost savings The individual mandates plan is implemented through mandated insurance coverage and a guarantee by the government that basic medical coverage is available across the country.
Tax credits and subsidies are available to make coverage affordable to all. Under this plan near universal coverage would be attainable. The plan is financed largely by premium payments by consumers either directly or through employers. A tax increase is necessary which negatively affects the budget deficit. Under this plan, both Medicare and Medicaid would be eliminated. Costs are contained through the maintenance of a highly competitive medical insurance market.
Private insurance vendors are disciplined by the market place to provide competitive prices to consumers. Under managed competition plan employers are required to provide medical coverage to all full time workers.
Subsidies are provided to make it possible for low-income families to purchase medical insurance. Medicaid and Medicare are maintained and almost universal coverage should be possible. Medical coverage is financed primarily through employer mandates so employees most likely pay through foregone wages. Government expenditures are paid through a payroll tax.
The impact on the deficit should not be too significant. Cost containments results from the maintenance of a highly competitive private insurance market. This plan would likely have a significant effect on employment because employer mandates may create substantial distortions in labor markets, especially among low — wage workers. Finally, a national health insurance system would provide universal coverage for all citizens. Medical coverage is financed out of an income tax.
In addition, funds for Medicare and Medicaid are diverted to partially offset the cost of the plan. An employer tax equal to the cost of employer — financed medical insurance is levied.
0コメント