Health Care Economics Flashcards
the Canada Health Act 1984
ensures all Canadians have equitable access to health care services based on their need, not on their ability or willingness to pay
which goverment has the primary jurisdiction in health care admin and delivery?
provincial and territorial
what is the main role of the federal government in health care?
financial
what are the 5 principles under the Canada Health Act?
- public administration
- comprehensiveness
- universality
- portability
- accessibility
what are the 2 conditions of the Canada health Act?
recogniton and information
what is covered under the Canada health act?
insured health services are medically necessary hospital, physician, and surgical-dental services (performed by a dentist in a hospital
what are uninsured hospital related services under the Canada health act?
- preferred accomodations, patient requests
- drugs & biologicals ordered after hospitalization
what are uninsured physician related services under the Canada Health act?
- phone services
- acupuncture
- medical letters required for work, school, insurance etc.
- cosmetic services
what groups of people are the exception to provincial coverage and have their health services paid for by the federal government?
federal penitentiaries, CAF, indigenous peoples
what is the name of the money the ferderal government gives to all provinces and territories?
Canada Health Transfer (CHT)
what is the name for the additional money given to the territories from the federal government>
territorial formula financing (TFF)
the Canada health transfer amount is based on ____ and not on ____
per capita and not based on needs
what 2 things are a break in compliance with the Canada Health Act?
- extra billing
2. user charges
what is “extra billing”?
charging a fee for anything that is an insured service
what are user charges?
charging a fee as a condition of receiving insured health services (ex: charging a facility fee)
what is the Canada health act reimbursement policy?
the federal minister of health can give reimbursement to provinces who comply with not chrging for insured services
what is a premium?
a lump sum of money paid in advance of services
what is the premium called if everyone pays the same amount?
solidarity
what is the premium called if risk-related premiums are based on probable claims?
actuarial
when are user charges/fees paid?
at the time of services
what is a co-payment?
a fixed % of the service cost
what is co-insurance?
fixed fee per services
what is a deductible?
total costs of services paid by the patient up to a max, and then everything else is covered by insurance
on average (reports by CIHI) what % of services are paid by public and private plans respectively?
Public: 70%
Private: 30%
