Chapter 10 - History & Current State of Medicare in Canada

Question 1

(4) basic objectives of the Medical Care Act in 1968

Answer 1

1) universality - available to all
2) portability - portable from province to province
3) comprehensive coverage - include all necessary medical services
4) administration - non-profit basis

(Canada Health Act of 1984 added accessibility)

Question 2

Development of Medicare over the last half-Century was influenced by (7) social forces

Answer 2

1) movement of Western industrialized societies towards rationalized bureacratic social organization & monopoly capitalism
2) spread in Western Europe of social welfare legislation
3) benefits to medical profession in maintaining fee-for-service, hospital & technology-based practice
4) interest of insurance companies in maintaining their share of profitable market
5) interest of drug/medical/hospital supply companies in continuing to increase their profits
6) interests of urban labor unions & farm co-operatives in social welfare benefits for their members
7) qualities & dedication of individuals in position of power at the right time (Tommy Douglas)

Question 3

1) movement of Western industrialized societies towards rationalized bureacratic social organization & monopoly capitalism

Answer 3

not until 20th Century was work of physician regarded as most effective form of medical care → efficacy of doctor established in the public mind

• growth & development of the medical profession served to enmesh physician within bureaucratic structures

Question 4

2) spread in Western Europe of social welfare legislation

Answer 4

1st legislation passed in Germany in 1880s

Universal medical Insurance introduced to Britain in 1912

introduction of medicare in Canada must be seen in context of the spread of similar policies in Western Industrialized world

Question 5

3) benefits to medical profession in maintaining fee-for-service, hospital & technology-based practice

Answer 5

in 1934, Canada Medical Association supported state medical insurance if it was administered by non-political body who were mostly med. practitioners, free choice on method of payment, medical control over fee scheduling & compulsory coverage up to certain income level

After WW2 & return of economic growth, majority opposed medicare

Question 6

4) interest of insurance companies in maintaining their share of profitable market

Answer 6

opposed medicare

• wanted to continue making moeny

Question 7

5) interest of drug/medical/hospital supply companies in continuing to increase their profits

Answer 7

opposed government intervention in medical financing

Question 8

6) interests of urban labor unions & farm co-operatives in social welfare benefits for their members

Answer 8

advocated for national medical insurance but only in SK was there action to make it happen

Question 9

Impact of Medicare on Canadians

Answer 9

inequities continue

• many costs not covered (transportation etc)

Question 10

Involvement of the state in practice of medicine has resulted in (4) changes in the actual work of doctors

Answer 10

1) working conditions
2) degree of control over patients & occupations in medical field
3) self-regulation in education, licensing, discipline
4) actual content of work

Question 11

Universal medical insurance has altered medical profession through (4) constraints

Answer 11

1) administrative
2) economic
3) political
4) social

Question 12

Constraints that have altered the medical profession through Universal medical insurance

1) administrative
2) economic
3) political
4) social

Answer 12

1) increased bureacratic surveillance
2) cutbacks → not possible for all doctors to reach desired salary level - without jeapordizing quality of care
3) what proportion of society’s resources should be dedicated to medical care
4) to provide equitable access, doctors may only be allowed to practice in certain areas where their services are needed