A Critical Evaluation Of Canadas Healthcare System Sample

Introduction :A Critical Evaluation Of Canada’s Healthcare System

The publicly funded health care system in Canada is dynamic; modifications have been implemented during the last 40 years and will persist in response to advancements in both medical and society. Universal coverage for medically necessary health care services that are offered based on need rather than ability to pay, however, nevertheless remains the fundamentals (Schrewe, 2023). The basis of Canadian healthcare is the “Canada Health Act of 1984” that has been providing access to physician and hospital services without direct payments at the point of care. The federal government's financial support for health care from 1957 to 1977 was calculated as a percentage (one-half) of the amount that provinces and territories spent on hospital and physician services that were covered. The Federal-Provincial Fiscal Arrangements and Established Programmes Financing Act superseded cost sharing in 1977 by a block fund, which in this case consisted of a mix of tax points and cash payments (Mosadeghrad, 2014). 

Health Status of That Country 

It is identified that the ageing population of the Canada has been facing different kind of issues due to illness and other aspects. By 2030 almost 25% of Canadians will be 65 or older placing additional pressure on the healthcare system and they will be facing chronic conditions. In the Healthcare Access and Quality Index, Canada was in the top 10% of 195 countries analysed, surpassing several nations with higher scores in the Commonwealth Fund Report, according to a new analysis from the Global Burden of Disease Study. Furthermore, there is a growing pressure on mental health service accessibility (Singh, Kumar and Gupta, 2022). Obesity rates have been rising and there is a greater chance of developing a number of chronic illnesses.

With an average life expectancy of 82 years at birth, Canada boasts one of the longest life expectancies in the world. This demonstrates the nation's dedication to providing healthcare and public health initiatives (Tulchinsky and Varavikova, 2014). The infant mortality rate is about 4.5 per 1,000 live births, which is a low rate. The low rate of maternal mortality further emphasizes the efficacy of programmes related to maternity and child health.

A great standard of living is maintained by many Canadians far into old age due to effective healthcare interventions. However, the years of life lost due to early deaths from diseases like coronary artery disease, cancer, and accidents are still reasons for concern. Prioritization is given to preventive care and health promotion with a focus on improving the quality of life during those years as well as increasing life expectancy. Financial Situation and Health Care Spending: Canada is among the top ten economies in the world due to its strong GDP (European Observatory on Health Systems and Policies et al., 2020).

About 11% of the nation's GDP is allocated to healthcare. All residents and citizens of Canada will have universal access to hospital and physician services because of this investment (Canadian Institute for Health Information, 2022).

Public Health Difficulties:

Wait Times: The length of time patients must wait for specific medical procedures, diagnostic testing, and specialist visits is one of the major problems with the Canadian healthcare system (Rankin, 2021).

Native American Health There are differences in health between Indigenous and non-Indigenous communities; the former have lower life expectancies, higher incidence of mental health problems, and chronic disease.

Health Indicators:

Fertility Rate: 1.5 live births per woman

Life Expectancy (Female, Male): 85, 81

Infant Mortality Rate: 3.9 deaths per 1,000 live births

Child Mortality Rate: 4.8 per 1,000 live births

Maternal Mortality Rate: 8.3 deaths per 100,000 live births

Prevalence of Obesity: 26.3%

Racial/Ethnic Demographics:

White NH: 75%

Asian: 14%

Native: 5%

Black NH: 3%

Hispanic/Latino: 2%

Other: 1%

Age Structure:

0-14 years: 15.4%

15-24 years: 11.6%

25-54 years: 39.6%

55-64 years: 14.2%

65 years and over: 19.1%

Healthcare Structure 

It can be stated that the government has been playing an adequate role in the promotion of healthcare services. Canada Health Transfer (CHT) has been promoted through the federal government (Canada, 2023). This money which is distributed in accordance with per capita income focuses towards supporting the delivery of healthcare services. Each province and territory is responsible for managing its own healthcare system and they have been focusing on the determining the treatments that are covered the amount of funding allocated and the format in which healthcare is delivered. They are in charge of overseeing and funding their healthcare insurance plans that offer coverage for the majority of resident medical services (Tikkanen et al., 2020).

Canadian citizens and permanent residents have been adequately getting the healthcare treatment through which appropriate services can be provided. Furthermore, it is also to be stated that healthcare funding and financing are the appropriate system that is to be publicly administrated (Internationalinsurance, 2023). On the other hand, it is necessary to focus on the Canadian medical practioners and nurses to take public insurance policies. It is also necessary for them to focus on the aspects related to income and other sources through which medicare services can be provided adequately. 

In the Canada, it is identified that private and public healthcare organisations and providers have been offering the appropriate healthcare services (European Observatory on Health Systems and Policies et al., 2020b). Furthermore, it is identified that healthcare system also depends heavily on other healthcare personnel, including nurses, chemists, and allied health specialists. The Many Canadians has been focusing on to obtain private supplemental health insurance to cover treatments not covered by the public system even though Medicare covers essential healthcare services. Prescription medications, dental treatment, vision care, and other services are crucial for the government to consider (Pacific, 2020). Within their borders, healthcare provider licencing and delivery are governed and monitored by provincial and territorial administrations.

To guarantee that the values of the Canada Health Act are respected, the federal government, through organisations such as Health Canada, offers national supervision, direction, and financial support. The Canadian healthcare system must deal with issues like controlling costs, reducing wait times for certain services, and guaranteeing effectiveness and coordination between healthcare services and providers (Youn, Geismar and Pinedo, 2022).

Figure 1: Health Market of Canadians 

(Source: Insights, 2022)

In 2022 the projected value of Canada's connected healthcare market was $5.309 billion. Furthermore, the Canadian healthcare industry is also predicted that by 2027 there will be an increase at a “compound annual growth rate” of 10.19%, from $1,638.00 million in 2023 to $2,415.00 million (Statista, 2022). By 20230, it is also been predicted that a CAGR of 28.4% will develop significantly and reach an estimated market size of $39.221 billion.

As one of the biggest countries in the world, Canada holds a strong free-market economy that supports a variety of industries, including tiny owner-managed businesses to giant international conglomerates (Thanthong-Knight, 2023). Furthermore, in the old times, to support the Canada’s economy the export of agricultural staples and particularly grain, as well as the creation and marketing of exports of natural resources, such as oil, gas, and forest products has played a crucial role.

A mixed public-private paradigm characterises the healthcare system in Canada. In addition, with help from the state sector, healthcare services are provided by the private sector. Most Canadians have adequate opinions about how technology has been affecting the healthcare sector. They believe that technology will improve their ability to communicate with healthcare professionals and will improve their own experiences receiving care. Furthermore, there are regional variations in Canada's national healthcare service procurement scheme. The out-of-pocket cost as a percentage of current healthcare spending is approximately 14.91%, demonstrating that personal contributions pay a portion of healthcare costs (WHSF, 2022b). 

The Canadian healthcare industry is expanding and changing in sectors like digital health and connected healthcare (Li and Carayon, 2021). The nation's healthcare system varies by province incorporates aspects of the public and private sectors. On the other hand, Regulations are specific to each province and might differ greatly between areas and service providers. Approximately 10.84% of Canada's GDP was allocated to healthcare in 2019 indicating a substantial commitment in this area (WHSF, 2022a). In the country's economy, the Canadian healthcare industry plays a vital role and it is always changing to meet the demands and expectations of the populace (Marcu, 2021).

Healthcare Funding 

The Canadian healthcare system is frequently praised as an example of easily available healthcare for everybody. This approach is based on a combination of public and private finance. Healthcare in Canada is mostly funded by the commercial sector despite the majority of money coming from the public sector (Dutescu and Hillier, 2021). In terms of medicare, it is a prominent of the nation's social structure. Canadians can receive medically necessary care without having to bear crippling out-of-pocket expenses.

Four main sources of funding are used to support the healthcare system general tax revenue from provinces and territories federal transfers the Canada Health Transfer (CHT) and additional fiscal transfers (Naylor, Boozary and Adams, 2020). The equal distribution of resources across the country and their sustainability are guaranteed by this diverse funding method.

The public sector provides around 70% of healthcare funding, highlighting the government's crucial role in delivering necessary care. The private sector contributes the remaining thirty percent, which covers employer-sponsored healthcare coverage, out-of-pocket costs, and additional insurance. The optimisation of healthcare services is made possible by this balance between public and private resources.

Medicare provides hospital and physician services, which are the foundation of the healthcare system with guaranteed coverage. Despite the breadth of this universal coverage, some treatments are excluded including prescription medication, dental care, and vision care. This has caused a large number of Canadians to add private insurance to their healthcare.

The Canadian healthcare system is distinguished by its dedication to universality. Regardless of their financial situation all Canadian citizens and permanent residents are entitled to obtain medically essential care. This dedication to universality guarantees that everyone has access to necessary treatment, enhancing Canada's standing as a nation that provides fair healthcare.

Even though they vary, prescription medication costs in Canada are still reasonably low when compared to some other nations. For general health, having access to essential pharmaceuticals is essential, and the Canadian government actively works to strike a balance between drug availability and innovation and price (Lohman et al., 2022).

The advancement of healthcare in the nation is greatly aided by the “Canadian Institutes of Health Research” (CIHR). Working with partners and researchers, CIHR, Canada's government funding agency for health research, supports discoveries and innovations that improve the country's healthcare system. Furthermore, Canada also aims to enhance its healthcare outcomes by funding research.

The healthcare system in Canada is not without its difficulties, despite its numerous advantages. Notable problems include the need for more medical personnel, the difficulty of guaranteeing prompt access to care, the ageing population's rising burden on the system, and worries about bureaucratic procedures that may compromise accessibility and efficiency. Canada’s healthcare system is mainly supported by the citizen taxes and thereafter it contributes to private and public sectors. This strategy ensures that Canadians can access essential medical care without worrying about bankrupting costs. 

Furthermore, the healthcare system of Canada is extensive however there are some significant amount of issues encountered by the citizens as well. In addition, these issues are adequately supported by the various institutions according to the needs of Canadian citizens.A vital part of Canada's social fabric, the public-private collaboration in funding ensures the accessibility and sustainability of healthcare services.

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Models For Healthcare Funding

Canada's healthcare system receives around 11% of the country’s GDP as funding, in addition, it is a vital component of the country's effort to guarantee that everyone has access to high-quality healthcare (Valle, 2021). Canada also commitment to providing healthcare to all is reflected in the present funding mechanism, which is mostly based on a worldwide budget system. Even if the global budget system upholds the values of accessibility and universality, it is crucial to recognise the difficulties it presents and the continuous attempts to overcome them. This paradigm guarantees that healthcare providers receive a fixed amount of funding, regardless of the number of patients treated or the calibre of care provided (CHSPR, 2023). 

The budget model of Canada is mainly based on the principles of equity and inclusivity additionally, it also distributes a fixed sum of money to healthcare providers. Furthermore, it also ensures that everyone in Canada, regardless of financial situation, can access the basic healthcare services. It does, however, have some difficulties, just like any other system. The main obstacle is financial limitations. Under the global budget model, fixed financing may result in resource constraints that frequently cause a scarcity of medical personnel, protracted treatment wait times, and strain on the healthcare system (Valle, 2021). These limitations may make it more difficult for the system to adapt to changing patient needs and rising healthcare demands.

The absence of efficiency has developed a significant amount of concerns among Canadian citizens in addition, it also developed a system where healthcare service providers are not motivated enough as well. On the other hand, there can be less motivation to raise the standard of care, optimise workflow, or enhance patient experiences in the absence of monetary rewards linked to performance. Additionally, the distribution of funding under the global budget model would not always be in line with the particular healthcare requirements of Canada's various populations or regions (Tikkanen et al., 2020). This may lead to differences in the way healthcare is delivered, with certain regions having more difficulty than others in providing quality care because of resource constraints.

Accountability concerns are another issue raised by the global budget approach. Because financing is not correlated with patient outcomes or performance measures, it gets harder to guarantee high-quality care is provided (Eriksson, Levin and Nedlund, 2022). In certain cases, the lack of clear financial penalties for poor performance can lessen the motivation to reach quality standards.

ABF bundled payments and integrated financing models are a few of the alternative funding models that several Canadian governments have investigated in response to these difficulties (Barber, Lorenzoni and Ong, 2019). Funds are distributed by ABF to healthcare providers according to the kinds and amounts of services they offer as well as the complexity of the patient populations they serve. This approach may raise the standard of service and provide financial incentives for effectiveness. A more modern funding model called "bundled payments" uses a single payment to cover all medical care associated with a particular ailment or medical event within a predetermined period (Canadian Institute for Health Information, 2022). This improves patient continuity of care and fosters more coordination among healthcare providers. In order to provide a more comprehensive approach to patient care, integrated funding models seek to improve coordination and integration across many healthcare sectors, including primary care, acute care, mental health, and pharmaceuticals. Both patients and policymakers place a high value on service quality while seeking high-quality medical care. This includes how well healthcare services support evidence-based treatment and improve intended health outcomes (Laberge et al., 2022). The healthcare landscape is greatly influenced by funding methods, yet in order to maintain the greatest level of treatment, quality assurance procedures, strict standards, and accountability frameworks must be added (CHSPR, 2023).

Systems For Procuring Healthcare Services

Figure 2: Planned procurement summary: assets and acquired services

(Source: Canada, 2020)

The department's proactive disclosure efforts are greatly aided by Health Canada's Procurement Plan for the 2019–2020 fiscal years. It has been a high-level overview of the department's planned procurement activities for the year and openness about the distribution of public funds for the purchase of goods and services (Canada, 2020). It is imperative to acknowledge that this plan does not constitute an invitation to tender or request for proposals, nor does it imply an official government commitment to buy any particular assets or services (Barber, Lorenzoni and Ong, 2019). Rather, it serves as a strategic overview of Health Canada's procurement goals.

During the purchase process, a set of general guidelines must be followed. In addition, these guidelines are implemented to ensure that government contracting is carried out in a way that is honest and prudent enough to stand up to public scrutiny (OECD, 2021). They represent equity in the use of public money and facilitate access and competitiveness. Government procurement should also assist long-term industrial and regional development, give priority to operational needs, and be in line with a number of national goals, including the economic development of Aboriginal people. Government procurement must also adhere to international trade accords including the CPTPP, WTO-AGP, CFTA, and NAFTA (Government of Canada, 2022).

In order to guarantee that Canadians have access to adequate and efficient medical treatment, Health Canada assumes a leading role in advocating for sustainable healthcare systems. It works with the governments of the provinces and territories and provides financial agreements to important health partners who are enhancing the health system (Nguyen et al., 2020).

The department manages, evaluates, and disseminates health and safety risks related to a range of factors, including chemicals, pesticides, food, tobacco, environmental factors, consumer goods, and controlled substances. It collaborates closely with both domestic and foreign partners in this endeavour (Laberge et al., 2022). The initial goal is to ensure that Canadians are developing the necessary knowledge regarding their well-being and health. 

The department uses the internet platform Buyandsell.gc.ca to notify prospective bidders about government contracting opportunities. Through this platform, it notifies vendors of its intention to award a contract directly to a supplier and requests qualification statements from qualified suppliers. These notices are known as Advanced Contract Award Notices (ACAN) (Government of Canada, 2021). Planned Procurement Volumes: By consolidating buys, Health Canada hopes to find economies of scale through its procurement planning process. As a result, standing offer agreements are used more effectively and with greater flexibility. Additionally, the department finds ways to improve service delivery. Planned expenditures totalling $227.1 million for purchased services and other assets were indicated for the 2019–20 fiscal year (Sec.gov, 2022).

Economic Evaluation of Certain Interventions Including Mental Health

In Canada's healthcare system, the economic assessment of healthcare interventions including mental health interventions is crucial. In order to achieve the greatest potential health outcomes for the population, policymakers, and healthcare practitioners may make well-informed decisions about where to direct resources thanks to its crucial role as a tool for healthcare planning and resource allocation (Shah et al., 2023). Due to the limited resources available to Canada's publicly financed healthcare system, it is crucial to give priority to interventions that provide the best return on investment in order to ensure that resources are spent effectively. These assessments help to raise the general standard of healthcare services by pinpointing opportunities for efficiency gains and quality improvement (Li and Carayon, 2021). Mental health intervention in Canada’s healthcare system is one of the most essential aspects. Therefore it is essential to ensure the proper implementation process of the healthcare strategies, healthcare practices and healthcare resources. Furthermore, it is also crucial for an effective decision-making process as well. However, the limited resources available for Canada’s healthcare sectors are developing a significant amount of challenges. Therefore, it is essential to allocate the resources more effectively to develop a successful framework for the mental health sector of Canada. For this evidence-based method has been used to evaluate the costs and advantages of interventions, empirical data guarantees that healthcare decisions are supported by facts and research.

 Profitable evaluation in Canada includes a range of analyses, including “ budget impact analysis ”( BIA), “ cost- effectiveness analysis ”( CEA), “ cost- mileage analysis ”( CUA), and cost- benefit analysis( CBA). These studies aid in calculating the fiscal advantages of an intervention as well as the cost per unit of health gain and “ quality- acclimated life time ”( QALY)( Brent, 2023). When it comes to internal health interventions, these evaluations constantly number assessing the fiscal viability of programmes or curatives in relation to increased quality of life, dropped impairment, and more well- being. 

There are particular difficulties when doing profitable assessments in the environment of internal health interventions, including quantifying health issues, taking long- term goods into account, and dealing with smirch and access restrictions. likewise, because internal health is complex and requires cooperation between internal health professionals, economists, and healthcare providers, an interdisciplinary approach is needed to completely assess the impact of the intervention( Canada, 2023). The vacuity of data is also essential to guaranteeing the validity of these assessments, especially patient- reported issues and long- term follow- up data. 

In summary, the profitable valuation of healthcare interventions especially those pertaining to internal health is essential to maximising resource allocation in Canada's healthcare system. It guarantees that the population's advantages are optimised through the instruction of healthcare spending, all the bit maintaining responsibility and substantiation- grounded resolution- timber. Notwithstanding the personal difficulties offered by internal health interventions, nonstop cracks to ameliorate data collecting and valuation ways are necessary to gain a better understanding of and enhance the profitable valuation of these pivotal services, which will ultimately ameliorate Canadians' quality of life (Canadian Institute for Health Information, 2022). 

Healthcare Distribution and Equity

The distribution and fairness of healthcare are fundamental tenets of Canada's healthcare system, which strives to guarantee that healthcare services are equitable and available to all residents of the large and diverse country. Geographic allocation plays a role in healthcare distribution, with the goal of reaching both urban and rural areas with medical experts and infrastructure. Overcoming the difficulties of providing primary care and specialised services, such as mental health, in rural places is crucial (Laberge et al., 2022). Technological advancements such as telehealth serve to increase accessibility by bridging geographical divides and providing virtual healthcare services, which are particularly helpful in remote areas.

Beyond geographic differences, healthcare equity addresses inequalities based on age, gender, ethnicity, and socioeconomic position. In order to ensure that everyone has an equal chance to reach their utmost level of health, Canada is committed to eradicating gaps in health outcomes (OECD, 2021). This entails making certain that socioeconomic background and income do not restrict access to high-quality healthcare, offering varied populations culturally competent treatment, and guaranteeing that healthcare is age- and gender-appropriate. In Canada, encouraging health and prevention, lowering access obstacles, training healthcare professionals in cultural competency, and gathering and analysing data to spot inequities are some of the strategies for attaining healthcare equity (Zghal et al., 2020). The abecedarian tenets of healthcare division in Canada are adaptable access and addition, guaranteeing that all subjects, regardless of where they reside or come from, have access to high-quality healthcare. 

Health Outcomes and Performance

A fundamental tenet of health systems around the globe is equity in the distribution of healthcare resources. The proper allocation of medical supplies and equipment highlights the need to allocate these essential resources in accordance with each person's healthcare needs, fostering equity and fair access among demographic groups that are determined by geography (WHSF, 2022a).

The unequal distribution of health resources is not only limited to the specific country it is also noticeable in emerging and developed countries such as Vietnam, Bangladesh, India, and Thailand. Furthermore, different factors such as economic value and income and locality also influence the distribution of health services. These disparities add to the more general notion of health inequality, which also includes differences in access to medical care (WHSF, 2022b). These unjust allocations, which are the outcome of institutional defects, lead to injustice in the healthcare system.

The World Health Organisation (WHO) emphasises how crucial the fairness concept is for dividing up and allocating resources for health care. In order to enhance the effectiveness of the healthcare system it is essential to ensure the mitigation process of the unequal distribution of healthcare resources. Furthermore, so many countries have implemented institutional frameworks that recognise the right to healthcare and medical treatment as a basic human right. Although this right is acknowledged everywhere, obtaining equitable access is significantly hampered by the uneven regional distribution of health resources. The lack of planning, data, and healthcare professionals in developing nations frequently results in the unequal distribution of resources. Disparities in health outcomes may result from people's limited access to necessary healthcare services due to this inequality (Thanthong-Knight, 2023).

To summarise, sharing resources equally is a vital part of healthcare syste­ms. It helps make healthcare­ services more just and fair (Shah e­t al., 2023). To make sure eve­ryone has the same access to healthcare, no matter whe­re they live, their ethnicity, or income, it’s really important to tackle­ the global problem of not sharing resources equally.

Recommendations 

Needs-Based Resource Allocation: Changing to a needs-based approach is one of the most important stages towards attaining equitable resource allocation in healthcare. This method requires a data-driven evaluation of the healthcare requirements of various populations or regions, accounting for variables including disease prevalence, demography, and social determinants of health. Establishing clear criteria and rules for resource distribution is crucial to the efficient implementation of this advice. It also ensures that the process is open to the public and grounded in actual evidence. In addition, it is crucial to conduct frequent assessments and modify resource allocations in order to adapt to evolving healthcare requirements (OECD, 2021). In order to guarantee that underprivileged populations receive the healthcare services they require, needs-based resource allocation is a crucial first step in allocating resources where they are most urgently needed.

Equity-Oriented Policies: It is imperative that governments and healthcare institutions proactively implement strategies and policies that give equity first priority when allocating resources for healthcare (Government of Canada, 2022a). This can be accomplished by creating moral frameworks that specifically highlight fair resource distribution as a fundamental idea that directs decision-making at all healthcare management levels. Identifying possible inequities and creating mitigation strategies are made easier with the implementation of equity impact assessments for healthcare policies and treatments. Incorporating communities and stakeholders into the decision-making process additionally guarantees that the distinct requirements and inclinations of impacted groups are taken into account (Nguyen et al., 2020). Policies that prioritise equity play a crucial role in mitigating healthcare inequalities and cultivating a perception of impartiality and social justice in the distribution of resources.

Capacity Building and Investment: The healthcare system needs to be heavily invested in in order to address the issue of unequal resource allocation in healthcare. This includes providing incentives to healthcare professionals to work in places where there is a shortage in order to assist in the development of the healthcare workforce, especially in neglected areas. Infrastructure investment is also essential; it includes building and maintaining medical facilities in underprivileged areas and using telemedicine and mobile clinics to fill up gaps in coverage. Furthermore, evidence-based resource allocation is made possible by investments in technology and data collection, which are necessary for accurate and accessible data (Mosadeghrad, 2021). Building a robust and responsive healthcare system that can adjust to changing healthcare requirements and successfully address inequities depends heavily on capacity building and investment.

Conclusion 

In conclusion, the total spending of the healthcare system almost 70% are generated from taxes. Furthermore, the rest of the cost also has been collected through the healthcare insurance and private insurance. In addition, the backbone of the healthcare system such as Medicare also pays for doctor and hospital treatments at no cost to the patient at the time of service. The global budget system, which gives healthcare providers a set amount of money regardless of the number of people they treat or the calibre of treatment they deliver, is the most common funding model in Canada. The global budget system confronts difficulties because of limited resources, insufficient incentives for efficiency, and possible disparities in resource allocation, even while it supports the principles of accessibility and universality.

The governments of Canada have looked into alternative funding models such bundled payments, integrated finance models, and activity-based funding (ABF) to solve these issues. Funds are distributed by ABF in accordance with the kinds and quantities of services rendered as well as the complexity of patient populations. Bundled payments combine financing for all medical services associated with a certain ailment over a predetermined period of time. The goal of integrated finance models is to improve collaboration between different healthcare sectors.

Systems for Purchasing Healthcare Services: The department's planned procurement operations are outlined in Health Canada's procurement strategy for the 2019–2020 budget year. The strategy places a strong emphasis on accountability and openness when allocating public monies to pay for the acquisition of products and services. To guarantee that government contracting is carried out in a way that is responsible, truthful, and compliant with trade agreements, national objectives, and economic development goals, Health Canada adheres to a set of broad criteria. Canada's healthcare system, which is mostly funded by taxes, is an excellent example of the country's dedication to universal healthcare because it combines funding from the public and private sectors. Canada is not one to let obstacles like long wait times and unequal resource distribution stop it from innovating and exploring new finance models to enhance healthcare delivery. 

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