Ch 4,7 Flashcards
When did China’s latest healthcare reform effort take place and how long did it take to complete?
2005, 4 years
What document came out of the culmination of China’s healthcare reform?
Opinions on deepening the reform of the health care system 2009
The WHO is composed of the ____ _____ _____ , which is the decision making and policymaking body of WHO, composed of delegations from all WHO member states
World health assembly
How many countries make up the WHO?
193 member countries
The _____ ____ facilitates the work of the world health assembly and advises on technical issues related to health
Executive board
The _____ is the main implementation body of WHO’s policymaking work and includes approximately ______ health experts and support staff.
Secretariat, 8000
WHO has 6 core functions and they’re outlined in the 11th general programme of work for the years 2006-2015:
- Act as a leader and partner on health issues worldwide
2 set research priorities and encourage the sharing of health related knowledge - Estab standards of practice and support and monitor their adoption
- Advance policy options founded on ethical and EBP
- Lend technical support to health intitiaves and contribute to capacity building
- Monitor health issues around the world and identify patterns and trends
How can proposals be submitted to the WHO?
By any assembly member
When can proposals not be submitted?
In times of emergencies and other administrative considerations, proposals for new projects and initiatives can be included on the supplementary agenda of any session of the Assembly
How much majority vote is needed in the WHO for proposals to be adopted?
2/3
Where is policy implementation carried out in the WHO?
Secretariat
Type A influenza in wild or domestic birds. Can become a public health danger if a mutation allows it to more easily infect humans
Avian influenza
When was h1n1 detected? And what is it a mix of?
2009, swine, human, and avian flu
When was the WHO global task force on cholera estab?
1992
What’s the most well known initiative of the WHO program?
Campaign to eradicate small pox, which was successful in 1979
What is the global leader in formulating health policy?
Who
Why has WHO drawn criticism from various groups?
Bc they focus on disease surveillance, many believe that the bureaucratic nature and its perceived slow reaction time undermine their ability to respond in urgent situations
An independent assessment of the WHOs response to h1n1 concluded that the WHo needed improvement in a number of areas:
- No standard way to measure the severity of an outbreak
- Not transparent about the members who served on the emergency committee which led to speculation that they had ties to influenza vaccine producing pharma companies
- They had difficulty distributing the vaccines in developing countries
What did the report on h1n1 recommend?
That the WHO establish an emergency fund for disease outbreaks, have advance agreement in pace with pharmaceutical companies to supply vaccines on an as needed basis, and set up a health emergency corps of personnel to mobilize in the event of ann outbreak
Where is the vast majority of health policy in a country made?
At the national level of each country
Who is canada’s head of state and who cares out the formal duties?
King or queen of england and the governor general of canada carries out the monarchs formal duty
What is canada main legislative body?
House of commons made of elected local representatives called Members of parlaiment
How many political parties are there in Canada and what are they?
- Conservative, liberal, New Democratic, Bloc Québécois, green party
Canada is divided up into electoral districts or _____, on the basis of population with one MP elected per ______
Riding, riding
This acts as a review board in Canada introduced by the house of commons and senators are chosen for appointments by the prime minister
Senate
Elected officials in canada who are not members of the ruling party become the ___ ____.
Official opposition
How many provinces and territories is canada made up of?
10 provinces and 3 territories
Responsibility for national defense, foreign policy, and international trade in Canada rests with ? Where’s healthcare and education lie with the?
Federal government, provincial or territory responsibility
Healthcare in Canada is funded by taxpayers at the provincial level but also through federal taxation by way of the?
Canada health transfer
This act stipulates that provinces and territories insure residents for all medically necessary primary and tertiary care provided by physicians and hospitals.
Canada health act
When was the Canada health act signed into law?
1984
Canada health act sets forth the following:
- Must be admin public ally and as a not for profit operation
- Must provide insurance for all necessary health services
- All residents have the right to the same level of care
- Must be portable from one province or territory to another
- All insured residents should have reasonable access to healthcare services
How are bills introduced in Canada?
Introduced in House of Commons or senate
Goes thru 3 rounds of readings and reviews
Also sent to a committee for clause by clause examination before the third and final reading
If accepted and passed by both chambers it’s submitted for royal assent, this approval is given by the Governor General on behalf of the queen of England
How much GDP in Canada is spent on healthcare?
11%
What’s canadas healthcare spending per capita?
4,196$
The movement of an industry in a country from public to the private sphere.
Privatization
Who are the key stakeholders in Canada?
Federal government, health Canada, federal health dept, provincial govt,
What are the major health priorities faced by canada, two key demographic challenges?
The aging population
Lowpopulation density outside of major urban areas
What specific health concerns is Canada focused on?
Chronic diseases like arthritis and diabetes, mental health concerns like depression
This is a constitutional monarchy and parliamentary democracy?
Sweden
What’s the name of swedens legislative assembly?
Riksdag elected by the people every four years
How many other representatives are selected by the prime minister to become ministers and form the cabinet?
21
Who is the head of state in sweden?
The reigning monarch and they have no power
The swedish constitution is made up of 4 fundamental laws:
- The institute of government (outlines the functioning of swedes government and elections)
- The act of succession (regulates who inherits the throne of the swedish monarchy)
- The freedom of the press act (guarantees the people’s right to disseminate information)
- The fundamental law on freedom of expression (gives citizens the right to access government documents)
Is sweden subject to the legislation of the european union?
Yes, some laws are automatically adopted by sweden however some must pass through a vote in the Riksdag to be formally incorporated
How is healthcare financed in sweden?
Primarily financed through a county council income tax paid by individuals, patients are charged a small fee for services and the county council pays the remaining costs. The govt sets an annual out of pocket ceiling for individuals
How many of the population in sweden use private insurance?
3% due to the comprehensiveness of the public healthcare system
How are new laws proposed in sweden?
Apps a committee of inquiry to study the feasibility
Committee writes a report and circulated to relevant agencies and the council on legislation for consideration
Govt then presents bill to the Riksdag to vote on, if yes it is published in the Swedish code of statutes
What’s the gdp in sweden spent on healthcare?
10%
How much healthcare spending per capita is spent in sweden?
3,690$
What do primary health care centers offer in sweden?
Basic medical and public health services
What do county and district hospitals offer in sweden?
Provide specialized healthcare services such as organ transplants and heart surgery
Who wields the influence on healthcare and health policy in sweden?
National, county, and municipal levels of government
Healthcare priorities in sweden are established by?
The national board of health and welfares health reports 2009
What data sets are included when looking at the population of sweden?
Living conditions survey, household finances survey, national public health survey, national databases on waiting lists and wait times, health care barometer
How is progress measured in sweden?
Against the goals of the national public health strategy of 2003 and have 11 target areas set forth in the strategy from an earlier health report that identified the most pressing issues in sweden in terms of mortality and morbidity.
What do the 2003 goals of sweden fall into?
Safe reproduction and expression of sexuality
Decreased alcohol and tobacco use
Safe working conditions
Prevention of communicable diseases
What type of government does china operate under?
Single party socialist system of government
Cpc
Communist party of china
Npc
National people’s congress which is the main legislative body in china
Who manages the national government of china through the national people’s congress?
Communist party of china
What’s the executive body of the chinese government?
State Council
Who elects the president of china?
The national peoples congress
China is governed by a ___ ___, it stipulates that the cpc is the sole political party in power and that china will remain a socialist society that all power belongs to the people.
Written constitution
What laws govern the healthcare system in china?
Fundamental health law and the hygienic common law
When did china introduce a universally healthcare system that intends to cover 90% of the population?
2009
China has four government insurance schemes that resulted from the expansion:
- The basic scheme for urban workers:
- the urban resident scheme For other urbran residents such as children and students
- the rural cooperative system For rural population
- Medical assistance program for the poor
___ care is delivered through local health clinics and small hospitals in china
Primary
_______ care is provided at regional borough hospitals or larger teaching and research hospitals in urban areas
Specialized
What’s the GDP spent on healthcare in china?
5%
How much is chinas healthcare spending per capita?
309$
The political bureau of central committee of the communist part of china plans legislation in how many year increments?
5 year periods
What was the ministry of health in china renamed to?
The commission of public health and family planning
This is the main body in policymaking in china and play a leadership role.
Central government
This is the main body in policymaking within jurisdiction and tend to focus on interests of their own department
Relevant ministries
This is in charge of policy interpretation and implementation in china and focuses on local interests
Local governments
These market power, have influence and the ability to evade administrative power in china. They secure government funding, hospital ratings, and market share
Hospitals and medical institutions
They have the right to prescribe, hold information superiority. Like personal development, income, and professional reputations
Medical staff
This has a market power and is interested in maximizing profits
Pharmaceutical industry
They have the right to choose medical services, are interested in healthcare quality, fairness and access to care
The public
These are government affiliated policy advisory body and provide policy advisory services. They are consistent with the interests of their respective ministries
Think tanks
This influences the public opinion, support different stakeholders. They have diverse interests according to policy preferences
The media
This is an area of study, research and practice that focuses on improving health and achieving health equity for all people worldwide
Global health
Worldwide changes in many aspects of peoples lives driven by the exchange of information across borders and characterized by increased production of goods and services by developing countries and the expanded interdependence of developed and emerging economies
Globalization
How many degrees with the world warm by 2100?
4 degrees
These have become a concern for all countries as global trade, tourism, international relations, and migration facilitate the spread of disease
Infectious diseases
What is one of the greatest current challenges developed, emerging, and developing countries face?
Global rise in noncommunicable and chronic disease
These were once considered confined to the wealthy people and wealthy nations
Noncommunicable diseases
These are associated with 2/3s of all global mortality
Noncommunicable diseases
Name risk factors associated with noncommunicable diseases:
Tobacco use, alcohol, bad diets, physical inactivity
What’s the estimated loss in national income from heart disease, stroke and diabetes in china, russia?
18billion in china, and 11 billion in russia, 9 billion in india, and 3 billion in brazil
What is an example of best buy interventions to be cost effective in reducing disability adjusted life expectancy associated with noncommunicable diseases?
Raising taxes on cigarettes, restrict access to alcohol, providing primary car diet counseling promoting healthy living and physical activity in mass medica and offering vaccination programs
The majority of health systems are strained by these issues?
Aging population and chronic disease
OECD
Organization for economic co-operation and development, which is where researchers found that healthcare spending in these countries in the 70s… gdp in the 70s was 5.3% compared to 9.5% in 2009
This is used in New Zealand which increased public funding of preventative and public health activities, encouraged general practitioners to form nongovernmental primary health organizations (PHO’s) and change payments from fee for service to capita tend fees paid to the PHO
Primary health care strategy
Who placed their health system under the ministry of finance rather than the health ministry?
Israel
Payment related incentives often used by insurance companies or government payers to reward healthcare providers, such as physicians and hospitals for meeting per established performance measures for quality nd efficiency
Pay for performance
Evidence based and systematically developed protocols (statements) used to assist healthcare providers in making appropriate healthcare and clinical decisions regarding specific conditions or circumstances
Clinical practice guidelines
Using the best available evidence acquired through the scientific method to guide clinical decision making
Evidence based medicine
These are the most important predictors of unmet healthcare needs; that is disparity is a multifaceted issue that extends far beyond the health system
Individual income and sociodemographic statues
This refers to the obligation of patients to pay for a portion of the health care services they receive. Its typically used as an incentive to avoid excessive or unnecessary utilization, however, it may also deter appropriate utilization
Cost sharing
What countries have placed taxes on unhealthy foods in hope of steering consumers to healthier choices?
Nordic ones
When did japan adopt universal health insurance coverage?
1961
How much of japans population is 65 or older?
20%
What’s the goal of japans long term care insurance program?
To provide institutional and community based long term care services to adults over 65 and to ease financial and emotional burdens for their caregivers
How did japan pay for their long term care program?
They diverted some of their general tax revenues to the program and. Levied a new tax on adults over 40
Who has one of the lowest life expectancies and highest cancer mortality rates in the European Union?
Denmark
What is denmarks health legislation reform?
Health Act of 2007
This is a nerve agent that can paralyze muscles needed for breathing
Sarin
What should health policy related to bioterrorism focus on?
Preparedness efforts, as with natural disasters and pandemics, and the plans that are put in place must be carefully and thoroughly executed
Canada established this in 2002 to assess the safety, clinical effectiveness, and cost effectiveness of new drugs presented by pharmaceutical companies and provides recommendations to all participating drug plans.
Common drug review
How do canadas drug plans attempt to control public expenditures?
By administering them separately from general health service plans and to attempt to use cost sharing mechanisms
Fairpharma care in canada was implemented in 2003 and has three main goals:
Keep government spending low
Providing access to all necessary medications
In a way that is equitable the people of all income levels
When did south korea implement universal health insurance
1989
South korea is plagued with several issues around their health care:
Benefits are still limited compared to those of other developed countries
Public sector has little involvement in the delivery of healthcare
Costs rapidly rising
Some insurance plans are in financial distress
What accounts for about 10% of the global burden of disease?
Acute diarrhea disease and other diseases attributable to poor water sanitation
How many people world wide have a lack of access to an improved water supply., one of the most preventive measures that can be taken to lower mortality rates
1 billion people
These are a group of noncommunicable diseases responsible for 13% of the global burden of disease
Mental illnesses
Name some neuropsychiatric disorders?
Unipolar disease Bipolar disorder Schizophrenia Epilepsy Etch and drug abuse Dementia and anxiety
Who are at a greater risk for mental illness?
The poor and less educated or face acute financial strain
WHO-AIMS?
World health organization assessment instrument for mental health systems
Governments in developing countries generally spend about _____% of their total budget on health in comparison to developed countries spending about ____% of its GDP on health
5%, 9.5%
These are organizations that are operated independent of the government
Nongovernmental organization
MEHH
Modern environmentally health hazards
PCFV
Partnership for clean fuels and vehicles
How many residents does china have?
1.3 billion
What challenges happened with chinas healthcare system in 1978 when the country moved from a communist based to a capital based market economy?
- Overal spending on healthcare rapidly increased while govt funding decreased
- Rates for noncommunicable diseases and health disparities are on the ride
- The cost of healthcare has become prohibitively expensive for many particularly those living in rural areas
In response to the issues china faced with healthcare they passed the what policy in 2008, to address the equity and accessibility through 5 mandates that correspond to major health problems identified by the chinese ministry of health?
Healthy china 2020
What are the 5 mandates of Healthy China 2020?
- Expand healthcare to cover 90% of the population
- A national drug system must be established to meet basic pharmaceutical needs
- Grassroots level improvements of medical care and public health must occur
- Basic public health services including preventive health must expand
- Hospital reform must be instituted to abate the health systems increasing tendency to commercialize
When did the fall of the soviet union happen?
1991
What are some of the public health issues the ukraine faces?
1.4% have TB, high rate of HIV/AIDS 1.6% have it
What’s the Ukraines biggest contributor to the country’s mortality rate?
Cardiovascular disease due to high rates of smoking and drinking
What two issues if overcome in Ukraine would improve the overall population health?
Addressing the dysfunctional health system and corrupt government
