History of Medicare Flashcards
Hospital Insurance and Diagnostic Services Act
Passed in 1957 by the Government of Canada. A law that sets out the common conditions that provincial governments would have to satisfy in order to receive shared-cost financing through federal transfers.
British North America Act (1867)
Administration and delivery of health care was the responsibility of provinces/territories.
Role of the Federal Government
1) Financing of Health Care Services (key role!)
2) Coordination
3) Research
4) Infrastructure
5) Public Health and Public Safety
6) Direct Provision of Health Care Services to First Nations and Inuit Communities, Military, Federal Penitentiaries, and Refugees
KODs
Keep Our Doctors movement supporters (against Medicare).
Which Factors Contributed to Medicare?
1) Economic Conditions (people keep going into poverty for paying for medical services)
2) Cost of Health Care System (establishment of hospitals and procedures increased health care costs)
3) Physicians (very against Medicare, negative factor/barrier)
4) Government Interest (supported Medicare)
Before Medicare
Community-based retainers/recruitment. Municipal contracts with doctors.
Fee for Service
Every time the patient comes, they have to pay.
Capitation
The doctor is given a set amount of money to treat one patient whether they come once or fifty times.
Socioeconomic Status (British Columbia)
1) Labour Unrest in BC
2) Poor Economic Conditions
3) WWI Veterans
Physicians’ Resistance
1) Revolt against Communist ideology.
2) Fee for service vs capitation payment.
History of Medicare
1945, federal government puts a plan to share with provinces the costs of medical insurance.
Disagreement Regarding Medicare
1) Jurisdiction (Who is in charge of what?)
2) What Type of Care? (What services gets covered? What service don’t get covered)
3) How It Would Be Organized?
4) Voluntary Participation (If you don’t have work health insurance, you will get covered by Medicare. If you do have work health insurance, you pay for your healthcare)
5) Physician-Sponsored or For-Profit Insurance Plan (Not all physicians were comfortable with treating healthcare as a for profit system)
1947
Saskatchewan was the first province to implement a universal hospital services plan (start of medicare).
1948
Federal health minister introduced the Hospital Grants Program (to build hospitals) and British Columbia implements universal hospital insurance.
1957
Federal government enacted the Hospital Insurance and Diagnostic Services Act (signed by all provinces in 1962) that cost-shares hospital insurance with provinces.
1962
Saskatchewan implemented universal medical care insurance after a province-wide 23 day doctors’ strike (medicare).
1966
Federal government introduced the Medical Care Act (signed by all provinces by 1972) to cost-share single-payer universal medical care insurance with provincial governments.
Pillars of Medicare
1) Universality (everyone has access to healthcare regardless of situation and background)
2) Portability (doesn’t matter where in Canada you are original from, you will get healthcare covered in the event of an emergency)
3) Public Administration (there isn’t a private insurance company that is controlling the finances, only the government)
4) Accessibility (Hall Commission Canada Health Act - 1984) (prevents extra billing)
5) Comprehensiveness (covers a variety of necessary services)
Hall Commission Canada Health Act (1984)
For every dollar doctors extra charge, that dollar will be taken away from your funding.
National Forum on Health (1994)
Mended the relationship between federal and provincial governments regarding healthcare funding.
Royal Commission on the Future of Health Care in Canada (2001)
The Romanow Report (2002) which outlines the importance of Medicare but lists a variety of areas where Medicare is lacking.
Standing Senate Committee on Social Affairs, Science, and Technology
The Kirby Report (2002) which identifies the challenges regarding the healthcare system in Canada ex. wait times and access to health services.
First Ministers’ Accord on Health Care
When provinces get together and work together to see what works and what doesn’t.
