06 - The Canadian Healthcare System Flashcards
Canada has a unified healthcare system and it is directly administered by a federal department. True or False
False, the Canadian health care system is predominately a public funded, privately delivered system of 13 interlocking but independent health care systems each operated by the provinces or territories.
What are the macro-components of any health care system?
Hospitals and other Health Facilities
Health Care Providers
Drugs
Funding
What percentage of hospitals operate as not-for-profit entities?
95% of hospitals are funded primarily by provincial or regional health authorities based on a global spending budget
What is the role of physicians in the healthcare system?
They are the traditional arbiters of legitimate sickness and resource utilization. They drive up to 70% of health care costs. Half of physicians work as general practitioners or family physicians.
How are physicians payed?
They generally operate as contractors that receive reimbursement from public-funded sources based upon number serviced provided rather than quality.
Are longer wait times for physicians due to fewer doctors today than 40 years ago?
No, in fact there are more doctors today per-capita than ever before. The wait times are attributed to people now care more about their health, people are living longer with more complex needs, the widening rural/urban divide, and physicians are working less
What is the role of nurses in the health care system?
Nurses are primarily employed in the formal health care system (hospitals, home care and public health services). They also work in private clinics in a variety of settings. Most nurses are salaried employees and unlike doctors, are paid for time spent on the job rather than services provided.
What are some other health professionals?
Nutritionists
Physical Therapists
Occupational Therapists
Massage Therapists
Psychology
Chiropractors
Dentists
How are community-based health care provides paid?
They are generally paid through private or work-related insurance or out-of-pocket, Certain individuals receive support from public payer programs depending on age or need-based.
How many pharmacists practice in Canada and Saskatchewan?
About 44,000 pharmacists practice in Canada and 1,600 of them are in Saskatchewan. 75% of Sask pharmacists are in community practice.
How are the duties of pharmacists changing?
There is push for the ability to provide nd to be paid for more cognitive services, This means that there needs to be less emphasis on dispensing, both as a way to reimburse pharmacists and as a way to redefine their role in health care.
How do Canadians pay for drugs?
Most Canadians have some form og coverage through a variety of payers. This includes federal drug programs(NIHB, Vet Affairs, RCMP), Provincial Drug Plans, WCB coverage, and private insurance
Unfortunately the working poor has the least amount of coverage through these different programs and are less likely to pay out-of-pocket expenses for drugs.
What is the breakdown of prescribed drug expenditure in Canada
42.5% is funded by the public sector, 36.5% is by private insurers, and the remaining 21% is out of pocket
What are the details of the Senior’s Drug Plan?
Eligible individuals whose net annual income is lesser than $68,000 and under the age of 65 will pay $25 for drugs listed on the Saskatchewan Formulary
What are the details of the Children’s Drug Plan?
Families that have children who are younger than 15 years old will pay $25 for drugs listed on the Saskatchewan Formulary
What are the details of the Special Support Program?
This is an income-based program designed to help those with high drug costs (exceed 3.4% of income). Recipients are not automatically enrolled, this is something they have to apply for.
What are the details for the Guaranteed Income Supplement (GIS)?
Individuals that receive the GIS, families have a deductible of $200 two times a year. Once this amount of drugs has been payed, families only have to pay 35% of prescription costs.
What are the details for Family Health Benefits (FHB)
Families have a deductible of $100 that they have to pay two times a year. Once this amount has been reached, families only have to pay 35% of their children’s prescription costs
What is Supplementary Health?
There are three plans under supplementary health
Plan 1: Pay $2 for each prescription
Plan 2: All prescriptions are free
Plan 3: In addition to Plan 2 benefits, no charge for certain additional prescribed drugs. This is geared towards seniors that receive SIP or live in special-care homes
Under all plans, children under 18 receive prescriptions for free. Insulin, oral diabetes medications, and oral birth control are all free
What healthcare services are available in Saskatchewan?
EMS
Acute Care (primary, secondary, and tertiary)
Rehabilitative
Mental Health
Long-term care
Community Support
Public Health
What are some EMS services?
They are stabilization and observation centers which help manage minor emergencies, or to prepare more serious cases for transport
What are some duties assigned to primary care?
They are generally the first contact people have with the health care system. This type of service is provided by a variety if healthcare practitioners.
What are some duties assigned to secondary care?
Obstetrical and peri-natal care, pediatric medicine and surgery, and more specialized psychiatric, medical, and surgical care. These services are provided in major and minor centers like Saskatoon and North Battleford respectively.
What are some duties assigned to tertiary care?
These are highly sophisticated diagnostic and treatment services that are generally provided only after referral from a specialist working in a secondary centre. Neurosurgery, plastic surgery, and oncology are some examples
How is rehabilitation delivered to patients?
It includes services provided by physiotherapists, occupational therapists, and speech and language pathologists. These services are provided in a multidisciplinary setting with strong emphasis on teamwork and case management
Who pays for rehabilitation care?
Both public and private funding pays for this type of care.
Medicare only pays for rehab services in hospitals
private insurance in community clinic, and
WCB/SGI in both hospital and community clinics.
What mental health programs are available in Saskatchewan?
- Adult Community Mental Health
- Psychiatric Rehabilitation Community Mental Health
- Child and Youth Community Mental Health
- Inpatient Mental Health
What are some options for long-term care?
Individuals who have lighter care needs may opt to live in a personal care home as a way to help them manage their condition. These people are responsible for footing the bill as Medicare will not cover this type of care.
Individuals that need more care than what personal care homes can provide, may opt in to special-care homes. These facility provide long-term services to those with heavy care needs.
What is palliative care?
It is active compassionate care to the terminally ill person. The aim is to enhance quality of life by meeting physical, emotional, and spiritual needs.
What are some community supports services available under the healthcare system?
Respite Care: To provide relief to family and other primary caregivers. This can be a few hours to a month.
Adult Day/Night Programs:
Provide health and social services to those wishing to remain in their homes. This coverage allows primary caregivers(family) the opportunity to sleep at night.
Crisis Intervention: Temporary shelters for victims of violence and sexual abuse. They also provide suicide intervention and counselling.
Home-maintenance Services
These include meal programs, home management, personal care (ADL), nursing and other health care services
How does the health care system learn more about public health?
Population Health Assessment:
Measure health performance and opportunities for quality improvement
Health Promotion, Monitoring, and Surveillance:
Monitor population health levels and public health risks
Prevention and Protection:
Prevention of disease, illness and injury, and protection from public health risks
