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Health Science 130 > Final > Flashcards

Final Flashcards

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1
Q

What happened from 1967 to early 1900’s ?

A
  • no income or social services programs established at federal/provincial levels
  • there was no federal involvement
  • British North America Act fed marine hospitals + quarantine
  • the province is responsible for health/ there’s a provincial responsibility
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2
Q

What happened from the 1920’s to 1930’s?

A
  • first federal Department of Health created in 1919
  • increasing recognition of problem of vulnerability
  • beginning of growth of hospitals
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3
Q

What happened from 1947 to 1961?

A
  • Sask initiated first hospital insurance plan in 1947, other provinces followed
  • Hospital Insurance and Diagnostic Services Act in 1957 insures hospital care
  • all provinces w/ hospital had insurance systems by 1961
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4
Q

What happened in 1962?

A

Sask established medical insurance plan for physicians’ services

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5
Q

What happened in 1966 to 1972?

A
  • Medical Care Act 1966
  • this was implemented in 1968
  • federal government to share the costs 50-50 w/ the provinces for all medical services provided by a doctor outside of hospitals
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6
Q

What happened in 1977?

A

Established Programs Financing Act

  • cost sharing was replaced by block funding
  • funding was cash payments and taxing policies based on population size and GNP
  • there was federal funding for extended health care: nursing + long-term care
  • there was now extra billing for physicians
  • there was also user fees
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7
Q

What happened in 1984?

A

Canada Health Act
- principles + criteria for provinces to receive federal support

  • there are prohibitions of extra billing and user fees added to existing components
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8
Q

What are the 5 principles of Canada Health Act?

A

C: COMPREHENSIVENESS
- all medically necessary services provided by hospitals, doctors and dentists working in the hospital should be covered

U: UNIVERSALITY
- certain groups should not have an advantage to priority access to providers - just because you have more money/power should not make you get better treatment and prioritized - uniform delivery and conditions

  • the plans that are existing in each province must entitle all insured persons to health insurance coverage on uniform terms and conditions

P: PORTABILITY
- you are covered while traveling within Canada or if you go to the US - if there is an emergency in Alberta and you’re from BC, you’re charged the same rate as in BC

  • the system must cover persons when they move to another province or territory or when they travel

P: PUBLIC ADMINISTRATION
- the provincial government is accountable to us, the people

  • operated on a non-profitable basis by a public authority that is accountable to the provincial/territorial government

A: ACCESSIBILITY
- must have reasonable access without financial barriers

  • the system must have reasonable access to medically necessary hospitals + physician services w/o financial or other barriers
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9
Q

What are the key features of the Canadian Health Care System?

A
  • Health care delivery is the responsibility of the PROVINCES
  • Privately delivered and publicly financed
  • Private providers and public not-for-profit hospitals (hospitals have budgets)
  • Fee-for-service funding and global budgets
  • Choice of practitioner
  • Universal coverage applies to less than ½ of total health care expenditures ( we spend a lot of our own money on our healthcare needs)
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10
Q

How do we finance health care and how is the money distributed?

A
  • taxes
  • health insurance premiums
  • out of pocket expenditures
  • global budgets
  • fee for service billing
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11
Q

what are the key messages from the CIHI report 2016?

A
  • total health expenditure expected to reach $228.1 billion or $6299 per Canadian in 2016
  • by 2016, about $228.1 billion was spent on healthcare in Canada
  • hospitals, drugs and physicians are the 3 largest categories of spending, it has been relatively stable

> they account for the largest shares for health dollars in 2014

  • since 2010, the rate of growth in health spending has barely kept pace w/ the rates of inflation + population growth combined
  • provincial/territorial per capita health expenditures vary
  • Canada’s per capita health care spending among the highest internationally
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12
Q

What was the spending trend from 1975-2016?

A
  • the system was created in 1975
  • over time, there was a steady growth up
  • about 11% of GDP (gross domestic product)
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13
Q

What is Canada’s health spending like in 2023? (from 1975-2023)

A

about $334 billion was spent on healthcare in 2023

  • there has been a steady increase
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14
Q

What did the total health expenditure as a percentage of GDP in Canada from 1975-2016 say?

A
  • it went up around 11%
  • we’re at 12.9%
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15
Q

Why do hospitals spend less money than they used to?

A
  • because they send patients home
  • they transferred the responsibility on to family
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16
Q

How is the spending distributed in health care?

A
  • 25.6% on hospitals
  • 13.8% on physicians
  • 13.9% on drugs
17
Q

What is the health spending in 2023 by category?

A
  • hospitals: 25%
  • drugs
  • other institutions
  • physicians
    > around 14%
  • public health: slightly over 5%
  • other health spending: 5%
  • home + community care
  • capital
  • administration
    > less than 5%
18
Q

What is the impact of the aging population on the healthcare system?

A
  • not the biggest impact, but nonetheless has an impact
  • less than 1% a year, there’s a lot of variation across the country
  • there’s a smaller impact in Ontario + the West b/ there’s more youth
  • the impact is most among frail elderly people with multiple chronic conditions
  • providing care for those who are frail and elderly and have multiple chronic conditions costs a lot of money due to their amount of care - a large amount of money goes towards them
  • this will become a further challenge as the percentage of the population who is 80 and older increases
19
Q

What is the health spending like on seniors ?

A
  • for age 65+ in years 2011 to 2021…

> the share of spending went from 14.4% to 18.5% - it’s steady

> the share of the population went from 44.9% to 43.2%

  • aging has an impact but not the only driving factor
20
Q

Are we spending a larger percent of the provincial budget on health?

A

yes

  • health care costs are going up
21
Q

How much of BC’s budget gets spent on healthcare?

A

43%
- it is increasing
- percentage that gets spent on education decreases

22
Q

What provinces spend less than average ($5167) on healthcare?

A
  • BC ($4872)
  • ONTARIO ($4883)
  • PEI ($4988)
  • NB ($4350)
  • NS ($5064)
23
Q

How much is BC spending on per person for healthcare in 2023?

A
  • $9182
  • 4.6% per person growth
24
Q

Which country spends relatively more on their healthcare than any other country?

A
  • America
  • almost 20% of the GDP is spent on healthcare in the US
  • America is the highest spender
  • Canada spends b/w 10% to 15% of the GDP
  • Canada is one of the top senders
25
Q

What were we comparing our eye on in 2016?

A
  • Moderating effects of economic growth and government deficits
  • Change in Canada Health Transfer formula
  • Growth in number of physicians and physician compensation
  • Population aging and potential impact on spending
26
Q

According to the Canadian Institute for Health Information in 2014…

how many physicians were in the country in 2014

what was the increase in the year 2012?

what was the number of physicians per population in Sept. 2014?

A
  • 77000
  • 3.4%
  • 220 per 100000 which was the highest ever record
27
Q

why is there a doctor shortage?

A
  • at some point, more doctors moved abroad compared to moving back
  • there’s a distribution problem
    > more doctors choose to work in urban areas

> we have a lot more doctors in Van compared to Prince George

> doctors are NOT located in the places they’re need

> even if they go to the rural areas, they tend to want to come back

> a solution to this was to get med students from rural areas that would want to actually stay there

  • another part of this is how doctors are practicing and who is practicing

> who is practicing medicine has shifted

> there’s more women, and they practice differently

> even if there are enough doctors that are proportional to the population, the way they practice makes a difference

-> not all doctors are going to want to work for 70 hours a week, they want a work-life balance - working less

> if there is a large proportion of doctors who are working less hours, it contributes to the shortage

Health Science 130 (2 decks)

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