health care reform in Canada

Question 1

policy

Answer 1

plans and procedures developed and implemented by governments, agencies, organizations, and associations to achieve desired goals

Question 2

public policy

Answer 2

course of action or inaction chosen by public authorities to address a given problem or interrelated set of problems that is anchored in a set of beliefs about the best way to achieve the goals

Question 3

health policy

Answer 3

can be narrowly focused on health care delivery, or broadly focused on social determinants of health

Question 4

political ideology and health care

Answer 4

libertarian vs collectivist ideologies (few regulations as possible vs focused on covering everybody)

neoliberal vs social democratic welfare state model (market and libertarian vs countries like Scandinavians)

resulting conflict
–health care as a commodity in the marketplace vs a right
– privatization vs public administration and delivery
– user fees vs tax revenues

Question 5

current issues

Answer 5

growing costs
decreased federal contributions
tension between federal gov and provinces
lack of focus on prevention and SDoH
drugs, mental health, dental care not covered

Question 6

mazankowski report

Answer 6

conservative

• report on health care in Alberta
• neoliberal/market based approach
• argues for user fees and privatization

Increase privatization, private administration, less taxes, user fees (to encourage less people getting sick)

Question 7

Kirby report

Answer 7

report falls between Mazankowski and Romanow

• wants publicly funded but also looking for innovations to save money

Expand role of private sector, private vs public not important, providing more government funding, no user fees (will decrease access to care and increase inequalities)
– but supportive of medical savings accounts

Question 8

Romanow report

Answer 8

most social democratic/polis model

more funding and maintain public administration and public payment

universal accessibility

publicly administered services, health care as a right not a commodity, requires more federal funding, user fees would decrease access to care

Question 9

medical savings accounts

Answer 9

recommended by Mazankowski

• employer puts money in account for u and you use that money when you go to doctor

– limited amount, so discourages seeking health care
– any health care you receive after the account runs out, comes from out of pocket savings

Question 10

regionalization

Answer 10

creation of administrations in municipalities and regional areas

• for better local control
• better targeted services
• citizen involvement
• compatible with public health

but - seen as a way to reduce funding that could actually increase costs bc paying for way more administration

Question 11

public-private partnerships

Answer 11

hidden privatization

contracting public services with private entities

public clinic contracting with private building to have their clinic in

Question 12

health care guarantees

Answer 12

wait times for care are seen as an issue

pre-determined wait time deadlines for various procedures

after deadline, service is provided by another public or private provider

Question 13

Primary health reform (Kirby)

Answer 13

Goal: make service provision more streamlined to control costs

suggestions:
* create multidisciplinary health care teams
* alternatives to fee for service like capitation or blended approaches
* incorporate health promotion and disease prevention into primary care