Canadian Healthcare System

Question 1

Describe the BNA act of 1867

Answer 1

-British North America Act
-explained how the new Canadian government would work under the new confederation
-decided the federal would be an umbrella over the provincial governments

Question 2

What was the division of responsibilities under the BNA act of 1867?

Answer 2

Federal responsibilities:
-health of indigenous people
-health policy and contagious diseases
-pharmaceutical and food safety (Health Canada)

Provincial and Territorial responsibilities:
-public health (hospitals, mental health facilities, education)
-passed “Insanity Act” which is now the mental health act

Question 3

What is the early history of mental health?

Answer 3

-demonic possession, sin, or biological causes
-early asylum care included inhumane treatments
-humane treatment started in the 1700s by Philippe Pinel

Question 4

What does Moral theory refer to?

Answer 4

-talking to patients and creating a calm environment
-started with more humane treatment due to Philippe Pinel

Question 5

Describe the Canadian Asylums

Answer 5

-began in Quebec and the Maritimes
-eventually each province opened an asylum
-moral theory lacked success
-Dorothea Dix advocated for humane treatment and visited the Pope to spread the word
-in the 1900s began radical theories, ex. shock therapy, lobotomies, and psychotherapy

Question 6

When were psychotropic drugs introduced?

Answer 6

late 1950s to 1960s

Question 7

Describe the deinstitutionalization of Canada’s asylums

Answer 7

-1950s to 1980s
-Canadian Mental Health Association (CMHA) published a framework for mental health reform (1963)
-said the mental illness should be treated with the same level of professionalism and organization as physical illness
-less hospitalization
-less expensive
-community based service
-community housing

Question 8

Was deinstitutionalization successful?

Answer 8

Not as much as planned
-resulted in a lot of homelessness
-trans-institutionalization (redistribution of patients)

Question 9

What was the first hospital in Canada?

Answer 9

Hospital-Hotel-Dieu de Quebec
-relied on financing from the wealthy and organizations
-in 1900 the government started providing some funds for hospitals
-religious and charitable agencies

Question 10

What are some of the major volunteer agencies that worked in health services?

Answer 10

-Order of St John (St. John’s Ambulance)
-the Canadian Red Cross
-Victorian Order of Nurses VON
-Children’s Aid society
-Canadian Mental Health Association

Question 11

What are the 4 sacred medicines?

Answer 11

tobacco, cedar, sage, and sweet grass

Question 12

What influence did the world wars have on medicine?

Answer 12

-improved techniques and technology
-triage was introduced
-traumatic injuries required advanced anesthesia, infection control, and surgery
-plastic surgery
-stored blood
-x-ray machines improved
-electron microscopes
-oximetry
-penicillin

Question 13

What are the important Canadian medical discoveries?

Answer 13

-insulin
-Hans Selye, father of the field of stress research
-first artificial kidney machine
-introduction of lumpectomy for tx of breast cancer
-first device to deliver radiation in the tx of cancer
-discovery of blood forming stem cells
-first artificial knee joint

Question 14

Describe the evolution of the Social Safety Net

Answer 14

-the great depression left a lot of people without work
-determined that the government should insure a standard of living and access to services for all

Question 15

What is the Nationally Legislated Social Safety Net?

Answer 15

-services for when you need it

1942- M. King (PM) unemployment insurance
1944- Family allowance (now child tax benefit)
1948- National Health Grants program
1952- Old age security (70+ yrs)

Question 16

What was the situation prior to medicare?

Answer 16

-before WW2, healthcare in Canada was privately delivered
-doctors often went without payment
-People suffered and or died without medical care
-financial ruin

Question 17

Describe Tommy Douglas

Answer 17

-believed healthcare was a basic human right
-leader of first socialist party in North America
-Premier of Saskatchewan
-introduced government insurance for hospitalization and later, medical doctor visits
-led the way for social reforms in the rest of Canada

Question 18

What are the 5 pillars of healthcare?

Answer 18

1) universality
2) portability
3) comprehensive coverage
4) public administration
5) accessibility

Question 19

What is the Established Programs Financing Act?

Answer 19

-replaced the 50/50 funding for medical care
-allowed provinces greater freedom in setting policies and allowing the federal government to control its share of the costs
-reallocation of funding to community, long term care, ambulatory care, etc.

Question 20

What was determined by the Hall Report #2 (1980)?

Answer 20

Was Canada’s national-provincial health program report for the 80s
-extra billing violated medicare
-was a movement towards the 2-tiered health system
-recommendations: doctors could bill outside of medicare
-national standards be set
-accessibility be added
-form a national health council