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Soc 382 > Health Care in Canada > Flashcards

Health Care in Canada Flashcards

1
Q

Medicine in the 19th Century: Types of healthcare providers

A
  • Today, when confronted with illness, we have a set of behaviours that we typically abide to
  • However, in the 19th Century healthcare was provided within the private sphere
  • Should an illness warrant other help, Canadians poorly respected and poorly paid health practitioners, including regular doctors and irregular practitioners
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2
Q

Medicine in the 19th Century: Regular Doctors

A
  • Also known as Allopathic doctors
  • Paved the way for contemporary doctors
  • Treated illness with drugs selected to produce symptoms opposite to the illness symptoms
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3
Q

Medicine in the 19th Century: Irregular Practitioners

A
  • Anything other than Allopathic
  • Homeopathic doctors
  • Eclectics
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4
Q

Medicine in the 19th Century: Homeopathic doctors

A

Treats illness with dilute solutions of drugs that if given at full strength, would produce similar symptoms to the illness; Aim is to stimulate the body’s natural healing process

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5
Q

Medicine in the 19th Century: Eclectic

A

Healers who used form of botanical medicine & relied on complex combos of concentrated plant extracts to treat illness; Relied on herbal remedies

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6
Q

Medicine in the 19th Century: Trust in allopathic doctors

A
  • In the 19th C, the trust in allopathic doctors was no different than any other health pracitioner. The hierarchy of knowledge was not as strong in this period
  • During this time, doctors in Canada were trained under apprenticeship lasting between 3 to 7 years. Apprentices should accompany doctors to assist in procedures such as teeth extraction, bleeding, dressing minor wounds, and how to pulverize bark and roots for certain ointments
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7
Q

Medicine in the 19th Century: First medical schools

A
  • In 1823, Canada opened its first formal medical school in Montreal to later open a second school at King’s College in Toronto in 1842
  • bith schools atarted private, but later become affiliated with universities to ensure students got accredited degrees
  • Opposite ti Canada, the US medical schools were private and therefore, many of the schools were left uncertified, for-profit institutions
  • During this time period training was minimal & almost all training was relayed in lectures, so by the time students graduated they had little to no practical experiences (including specialty doctors)
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8
Q

Medicine in the 19th Century: Knowledge for allopathic doctors

A
  • Lacking
  • Resulted in the reliance of clinical experiences with their patients or extrapolating from abstract and/or untested theories
  • Heroic Medicine was common during the 19th Century
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9
Q

Medicine in the 19th Century: Heroic Medicine

A

Aggressive form of treatment that emphasized curing illnesses through bloodletting - which caused extreme vomiting and/or excessive laxatives and diuretics; in most cases, example of how body attempted to heal itself after immense trauma, which convinced doctors that they themselves cured the patient

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10
Q

Medical Dominance

A

By the late 19th century and the early 20th century, restrictions and curriculum changes were made in medical schools, including the tightening of entrance requirements, increases in academic standards, emphasis on research & the inclusion of clinical experience

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11
Q

Medical Dominance: The Flexner Report (1910)

A
  • A report on the state of American and Canadian medical education
  • Written by a high school teacher of the name Abraham Flexner and commission by the non-profit Carnegie Foundation
  • Used to pass the Canadian Medical Act (1912)
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12
Q

Medical Dominance: 4 Main recommendations included in the Flexner Report

A

1) Abolishment of apprenticeship
2) Minimum two years of clinical experience
3) Accredited medical medical schools be affiliated with a university (eliminating private schools)
4) Formally link medical schools and hospitals

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13
Q

Medical Dominance: Medical dominance of allopathic doctors in the 20th C

A

Medical Dominance refers to hierarchical nature of the HC field and allows those in power to make decisions, gain legitimization and organize the institution

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14
Q

History of HC: Discussions about public HC

A
  • Started in 1919 and continued to debate for several decades
  • In the beginning, public HC threatened the newly established medical dominance
  • Many medical professiobals were in opposition of govt health insurance, except during a brief period in the 1930s
  • Free-market philosophies were embedded w/in the field, which rejected govt intervention; however, the British NA Act constructed health as a provincial responsibility
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15
Q

History of HC: Tommy Douglas

A
  • In 1947 he introduced the Hospital Insurance Plan in SK, including an annual fee of $5 (capping off at $30 per household), for citizens to receive hospital-based services w/o cost
  • Other provinces followed soon after
  • Insurance & pharmaceutical companies became the biggest opposition
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16
Q

History of HC: Hospital Insurance and Diagnostic Services Act (HIDSA)

A
  • Following suit, the federal minister of Health and Welfare launched the HIDSA in March 1957
  • The bill proposed a joint funding arrangement between the federal and provincial govts to provide HC services
  • It passed and became law in April of 1957, and over the next few years, hospital services were provided and funded by both the federal and provincial govts
17
Q

History of HC: Five fundamental principles of medical insurance proposal (1959)

A

1) The plan must be offered to all citizens w/o concern for age, cost, race or physical disability
2) Funding fir program would be through prepayment programs
3) Program must be publicly administered
4) Must be commitment to high-quality Medical Care (included making necessary investments to technology, ppl & infrastructure)
5) Govt would not proceed w/o backing of HC providers & general public

18
Q

History of HC: Medical Care Insurance Act

A
  • Was introduced into legislation in 1961, w/o the support of HC providers (going against the 5th criteria); Although the bill included a fee-for-service compensation, which would pay doctors for each of their HC services that they provided, SK doctors still profusely opposed the bill and shut down their practices in summer of 1962 and garnered national and international media attention
  • Worldwide media coverage condemned the strike
  • Communities in SK rallied support with govt lead HC
  • After 23 days of negotiations, doctors ended their strike & ensured several of their conditions were met; this included autonomy to make medical decisions
19
Q

History of HC: Canadian Medical Association

A

At this time, was lobbying for the federal govt in hopes that they would stick with private HC services; the Liberal party did in fact win the federal election and Prime Minister Pearson gathered the provinces to discuss federal and provincially driven HC, with 2 provinces opposed: QC & AB

20
Q

History of HC: New Proposal for Medical Care Act

A

In 1966, a new proposal was submitted for this act, with four key principles:
1) Provided universal HC
2) Publicly administered
3) Comprehensive coverage
4) Applicable to those moved out of province

21
Q

History of HC: The Canadian Health Act

A
  • Introduced in 1984 to replace the Medical Care Act, but also to address physicians charging additional fees to their patients
  • Extra-billing was widespread across the country in clinics
  • User-fees were also spreading, which was a fixed charge for those who used hospital care after the 61 days
22
Q

History of HC: Two-tier HC system

A
  • Those who can afford vs those who cannot
  • Those who cannot afford additional costs were treated as inferior for their inability to pay, as it was associated with morality and based on individual responsibility
23
Q

Evaluating HC Systems: Sociologists interests

A
  • Interested in comparing HC systems both cross-nationally, but also globally; sociologists seek to examine relationships between health and economic politics, while also paying special attention to social powers
  • Drawing contextual descriptions of successes & failures of varying Hc systems & illuminate health & illness distribution
  • Drawing on impact of indiv & group behaviour when Hc system changes
24
Q

Evaluating HC Systems: Convergence Hypothesis

A
  • Argues that the similarities between global HC systems (which seems to be growing) is due to similar scientific, technological, economic, and epidemiological pressures
25
Q

Evaluating HC Systems: Causes to Convergence Hypothesis

A
  • Globalization increased the staring of info, which included knowledge & medical technology
  • Economic pressure has moved to the convergence of similar Hc systems
  • Demographic changes (aging ppn and lowering fertility rates)
26
Q

Evaluating HC Systems: 4 Indicators to compare HC systems at basic level

A

1) Equity - what is fairness of distribution of HC resources for ppn
2) Cost - the amount of money spent on HC
3) Efficiency - Does system achieve optimal outcomes w best possible use of resources
4) Responsiveness - the ways in which the HC system meets the needs of expectations of its citizens

27
Q

Evaluating HC Systems: Consideration when comparing

A

Some argue that we should not actually be comparing globally, as countries have their own cultural impacts, economic systems and histories, and varying political economies

28
Q

Jordan’s Principle: Indian Act and structural inequalities

A
  • Indigenous, Metis and Inuit are the ‘responsibility’ of the federal govt; however, provinces and territories are responsible for health and social services, leading yo a large gap for individuals on an off-reserve
  • Structural inequalities are detrimental to the health of Indigenous communities across Canada and this is exacerbated by the division of federal and provincial jurisdictions and funding; this was embodied in the 2005 death of 5 y/o Jordan Rivers Anderson
29
Q

Jordan’s Principle: Jordan Rivers Anderson

A

A Cree child from Norway House Cree Nation, suffering from Carey Fineman Ziter Syndrome - a rare neurological disorder; spent two years of his life in a Winnipeg hospital

30
Q

Jordan’s Principle: Issue

A

When Jordan’s condition improved, doctors declared that he could leave the hospital and return home with in-home care that would be tailored to his medical needs; however, the federal govt refused to fund the necessary medical care, including renovations needed in his home, even when Norway House Cree Nation raised funds for a van that was equipped to take him safely to and from home; costs associated with living at home were to be distributed between the federal and provincial govt

31
Q

Jordan’s Principle: Consequence

A

During all the arguments and debates on who could or would pay, Jordan passed away followed by his mother, from grief. They were both stripped of social health and not provided any accommodations

32
Q

Jordan’s Principle: Response

A

In response to public pressure, in 2007 the federal govt adopted this principle, asserting that when an Indigenous child requires HC in and out of home, the govt of first contact would be responsible to pay and jurisdictional disputes would be resolved after the care was provided

33
Q

Jordan’s Principle: 12-48h time frame

A
  • In 2017, Canadian Human Right Trial ordered Canada to process the cases w/in a 12-48 hour time frame, with non-urgent deemed w/in reason
  • Issues pertaining to agreements w provincial and the territories has made the successful implementation of the policy difficult and in some cases unsuccessful
34
Q

Jordan’s Principle: Long wait times

A
  • Seem to be one of the biggest concerns
  • Under this principle, the federal department has 12h for urgent cases; this has persisted in only 33% of urgent cases
  • Compliance rates have been steadily going down, varying between regions
  • As of today, Ontario has the lowest compliance rate and Alberta the fastest (at a 44% of cases being accepted w/in the 12-48h deadline)
  • Issues pertaining to family programs have also become a widespread concern

Soc 382 (12 decks)

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