Health Care Organization and Governance Flashcards
Federalism
A strategic compromise that divides powers and responsibilities between two main levels of government, a central union level and a state or regional level. Is more responsible to local health needs, has more diffusion of power and more veto points (more steps that need to be taken to implement a policy), and more levels of government.
Federal System
A central government deals with issues of common concern such as economic policy, foreign policy, and national defence. It also guarantees autonomy to specific territorial units such as provinces and territories.
Federal Government Roles
1) Financial Role
2) Research and Evaluation
Provision of Health Care Infrastructure
3) Public Health and Safety
4) Service Delivery
5) Indigenous, Military, Prisoners, Refugees are the Federal Government’s Responsibility
Provincial Government Roles
1) Financing of Health Care Services
2) Provision and Administration of Services
3) Coordination of Services
4) Regulation of Health Care Professionals
Federal Government
Expenditure power.
Provincial and Territorial Governments
Regulatory powers.
Health Premiums
The cuts made on peoples’ paychecks that go straight into healthcare. Raise less than 20% of the provincial health spending. Occurs in British Columbia, Ontario, and Quebec.
50/50
Since 1958. It was too restrictive for provinces on how they could spend their money and it was too risky for the federal government because they had no control over spending.
EPF
Established Programs Financing which was negotiated in 1977. Gave greater flexibility to provinces (not as controlling over how the money would be spent) and the federal government put a cap on the funding based on the economic growth. Provinces were paying more and the federal government was paying less.
CHST
Canada Health and Social Transfer (1994). Gave money to the provinces with no restrictions but gave less money became 70-30. Provinces felt the financial burden so they started closing medical schools and firing medical staff.
2004
Canada Health Transfer. Reintroduced annual increase at 6% for 10 years.
Where is Most of the Health Care Money Being Spent?
1) Hospitals (25.8%)
2) Drugs (13.7%)
3) Physicians (13.3%)
Provincial Coverage
1) Prohibition or discouragement of supplementary private health insurance.
2) Compensation from the federal government for all Medicare services provided to members of the Armed Forces and inmates of federal prisons.
3) The majority of funding for long-term care is provided by the provinces and territories.
4) All jurisdictions provide pharmaceutical coverage for the older people and the very poor.
5) Virtually no public coverage is provided for dental care and vision or for CAM therapies.
