加国医疗现状 - 见仁见智
万维今日刊登一篇对加拿大医疗体制大有评判的文章:《健康所系 性命相托--不得不说的加国医疗现状》，本来以为我要说话都说完了，可现在又不得已拿起笔，还得再说几句话。
首先说明本人不是加拿大医疗体制的专业辩护者。可是我对此文的片面观点不敢苟同。比如文章里有这一段话：
。。。加拿大一直以优越的全民医保制度自傲于全球，也是吸引我们选择移民的原因之一，然而这一健保体系具有一定的封闭性和“社会主义”色彩，医疗福利过多集中于老幼妇女及残障人士等，故而加拿大可称为"养老天堂"。。。
这话既有“戴着有色眼镜看东西”之嫌，亦有误导的作用。
文章还说：
。。。在所有采用相似医保制度的国家中，加拿大是人均花费最高的。。。
这句话不符合事实。2010年www.visualeconomics.com 发表根据路透社的研究结论(#)已经反驳这个说法。
文章说的家庭医生“包医百病”也不正确。谨慎的FP (Family Doctor) 通常把特殊症状转诊于专科医生。然后专家按症状的严重性给你预约日期。当然那严重性是专家判定，而不是你判定。这是争议的焦点。有钱人可以“判定”自己症状的严重性，掏出钱包去美国即刻买到专家无微不至的照顾，而政府“赞助”的加拿大人只有听从专家指示的选择。
文章里说的那些“怪”现象，本人和家人从来没有遭遇过。对加拿大给我们的医疗，虽然有可以改善之处，大致还是褒多于贬。一般加拿大居民也有同感。根据最新民意调查，85.2% 15岁或以上的加拿大对他们的医疗保障表示满意。(*)
我认为获取高效果的医疗，关键在于和家庭医生和医疗人员（包括诊所的护士和接待小姐们）保持友善和相互尊重的关系。而且病人必须学会成为自己的拥护者(advocate)，这不是说要有对抗性的拥护态度，而是要学好和医生有效地沟通，对这一点英语会话能力甚为重要。
是的，加拿大医疗体制绝不是包治百病的万灵药，其不足之处容易枚举。可是世界上没有一个国家可以说，“我们的医疗体制是完善的”，定义上“单付款人”体制医疗有不完善之内涵意义，可是“用户自付”体制也有其不完善之处。有财富的人可以用金钱买得到最先进的医疗，但在加拿大这不是现实的普世标准。对绝大部分加拿大人来说，当前的体系是最现实，是他们想象和盼望中最能达到，最负担得起的体系。
最后让我引用一位加国报纸读者所说的话做个总结：
“(In your criticism) are you looking for something in particular or just trying to discredit the results? The survey acknowledges a continuous shortage of family doctors and nurses. We all know the service is not perfect, but it does seem to be getting better. There are pockets where it is great and some not so great but you will have that regardless of the type of system in place.
I had the "pleasure" just this last weekend of having to use our health care system and found the quality to be quite acceptable. As a precaution to my condition I was kept under observation for 6 hours after admission and all the tests performed a second time as a precaution. When it didn't turn out to be serious as first thought then I had no problem waiting to consult with my family doctor today. ...(It was my) first visit to emergency in over 23 years so I don't abuse the system by any means.”
下面列出相关资料连接，以供参考：
(#)Health Care Costs Around the World http://www.visualeconomics.com/healthcare-costs-around-the-world_2010-03-01/ (*)Canadians happy with health care, but also want change: survey (March 2010) http://www.nationalpost.com/news/story.html?id=2737354 Health Care: Go Canadian (2008) http://www.businessweek.com/debateroom/archives/2008/06/health_care_go.html Most Canadians are satisfied with overall health-care services(2008) http://www.healthcoalition.ca/index-eng.pdf Healthcare System Ratings: U.S., Great Britain, Canada (March 2003 Survey – Dated) http://www.gallup.com/poll/8056/healthcare-system-ratings-us-great-britain-canada.aspx Canadians satisfied with health care, despite complaints, polls find (2009) http://www.cleveland.com/nation/index.ssf/2009/07/canadians_satisfied_with_healt.html |
