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    Challenges facing vision rehabilitation services

    Boston—Vision rehabilitation services in the United States and Canada exist on a background of different medical systems.

    In each country, there is a patchwork of vision rehabilitation national services and regional services, and each has individual and common challenges. 

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    “Canada has a single-payer system and funds each province to provide health care as long as the province does not charge patients for any services provided by health insurance,” explained Mary Lou Jackson, MD, said. “The United States has both significant payment for health care by the national government, and also payment for health-care services by private insurers.

    “Sixty percent of services are publically funded by Medicare and the Veterans’ Administration, and most working-age individuals have insurance through an employer,” said Dr. Jackson, director, Visual Rehabilitation, Massachusetts Eye and Ear Institute, Department of Ophthalmology, Harvard Medical School, Boston.

    The difference between the two systems is substantial, she said.

    “Canada’s system is predicated on universal access for all Canadians, whereas a proportion of the U.S. population does not have health-care insurance,” Dr. Jackson said. “In January 2014, 16% of the U.S. population had no insurance, an issue currently being addressed by changes in the American health-care system.

    “However, health-care-related costs including co-payments and insurance premiums, can cause financial hardship for some in the United States,” she added.

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