Canadian Healthcare System Flashcards
Canadian healthcare: __ delivered, __ funded
Privately delivered, publicly funded
5 Conditions of Canada Health Act (CHA)
- Public administration
- Comprehensiveness
- Universality
- Portability
- Accessibility
Define Public administration of CHA
Operated non-profit basis by public authority (designated by provincial govt
Not delivery of healthcare itself; just management of insurance plan
Which condition of the Canada Health Act explicitly opposes user fees
Accessibility
Impedes access to care ; if provinces allow user fees for insured services, will lose some or all of federal contribution
What 2 pieces of legislation describe the federal-provincial arrangements for health care
Canada Health Transfer (CHT): sets how much money provincial/territorial governments receive in federal transfers
Canada Health Act (CHA): what conditions need to be met to receive the money
History of racism against indigenous people in Canada
-European settlers brought infectious diseases, such as smallpox and influenza
forced/coerced sterilization of indigenous women
Inuit sanitariums (1940/)
-Brian Sinclair (died in 2008 from urinary infection and blocked catheter)
How history ruined indigenous health
-colonialism took indigenous people off resource rich lands, confined them to reserves that were uninhabitable, lacking in resources
Inter generational trauma of sixties scoop and residential schools
Systemic discrimination against indigenous people: social, employment, healthcare
Health disparities
- health inequities (causes) -> health disparities
disproportionally impacted by disease
Over represented in people in Canada with HIV
Tuberculosis; 26.4x more likely than Canadian born non aboriginal
First Nations; 4x more likely to have type 2 diabetes, resulting in many health implications
Higher rates of suicide than Canadian population
Aboriginal women more likely to experience violence than Canadian non-aboriginal women
Health inequities
Social
Economic
Cultural
Political
Common history of colonialism -> marginalization
Higher unemployment rate
Lower median income
Less likely to have high school diploma
3x as likely as non-indigenous to live in a building in need of repair
Different circumstances, lived experiences if on or off reserve; rural or urban
Disproportionately affected by environmental contamination (esp Inuit, in their food source)
Solutions for racism in healthcare
Cultural sensitivity training for all healthcare works
Healthcare that is collaborative at core; Integrate traditional health knowledge with clinical knowledge; like in new aboriginal centre in CAMH; Canada first hospital based centre focused on indigenous mental health
- indigenous representation at all levels of the healthcare system
Reporting STIs to public health authorities
-if suspected child abuse, child protection act supersedes confidentiality -> release of personal information without consent
- if no child abuse, bound to respect confidentiality of information
- will be reported to authorities only as required by law, but will remain confidential
*identity is protected at all times (unless records are subpoenaed)
-partner notification: sexual partners who may have been exposed are identified, located, assessed, counselled, screened, and treated (benefit: disease surveillance and control); reduces risk of reinfection for original patient
——-by the patient: inform the, refer them to services
——by the HCP: with consent of patient, HCP notified partners of exposure (without naming the person, even if that is their only partner)
———-may be best to prevent physical emotional abuse (also take safety precautions)
——contract referal: compromise, patient must notify within time frame and refer them to services
-honour right of partner to be informed, make decisions about their health
Systemic racism
the processes of racism that are embedded in laws (local, state, and federal), policies, and practices of society and its institutions that provide advantages to racial groups deemed as superior, while differentially oppressing, disadvantaging, or otherwise neglecting racial groups viewed as inferior.
Are Canadian physician allowed to be in both the publicly and privately funded healthcare system?
No, can only be in one or the other
What is the Triple Aim?
Describes what 3 things a quality healthcare system should aim for:
- Improve the health of the population
- Improve the patient experience
- Make the costs per capita low so healthcare system can be sustainable
What outcomes measure how well a healthcare system performs?
Not so much life expectancy (more related to social determinants of health)
Outcomes for diseases we can control (deaths from bacterial infections, diabetes, cardiovascular disease, complications from surgeries)
