Lecture 2: Global Health and the Canadian Healthcare System Flashcards
According to Maioni, why does Canada perpetuate the myth of a unified health care system?
It is identity-building and identity-reinforcing. The liberal government was mostly involved in this, some call the Canada Health Act “branding”.
The Federal Government provides health care insurance for which populations?
- quarantine hospitals
- marine hospitals
- First Nations
- “aliens”
- prisons
- military
- government sponsored refugees
- veterans
when did funding from the feds to provinces change to a fixed-block? What year did the amount in that fixed block drop drastically?
1977, 1995 (Health and Social Transfer - ironically named since it sounds like we’d get more but nope).
True or False: the federal government has a hands-on role in administration and funding decisions of provincial health authorities.
False. As long as the provinces abide by the CHA they can do whatever they want.
The Constitution Act of 1982 allowed what?
provinces to get exclusive jurisdiction for management of hospitals, asylums, charities, and eleemosynary institutions.
What does the Canada Health Act of 1984 do?
Stipulates terms of receiving fixed-block grants from the feds. The terms are the 5 requirements we all know and love :p
Name the 5 stipulations for getting federal money to your province for health care.
Universality, Public Administration, Portability, Comprehensiveness, Access.
Universality implies that everyone that has insurance can have access to the same level of care no matter where they are. According to Maioni, where can this go wrong?
- ## since some are covered provincially but others federally, people can “fall between the cracks”. This is especially relevant for off-reserve First Nations, Metis, immigrants, and sometimes refugees.
Public Administration means that our systems must be non-profit. Do hospitals and physicians then work for the state? If not, how are they paid?
Hospitals can be owned by anyone, and physicians can be private entities. They are paid by the province (single-payer) and the amount of funding is determined by past spending, current and future need, and negotiations between professional orders.
Portability is important when on vacation. Does this work the same way in in-patient and out-patient facilities?
Not necessarily. In-patient facilities will usually bill the other province directly, while in out-patient one may have to pay up front and ask to be re-imbursed later by ones home province.
Comprehensiveness is the ability to provide many levels of care. Can you think of any current debates and issues relating to this topic?
- The big question tends to be: what gets covered by public funds? What doesn’t?
- Increases in day surgeries, drug therapy, chronic diseases, aging populations, and crossover issues that also involve social services raises the demand for more coverage for out-patient services.
Access is especially important, and relates to universality often. While most think of regional issues (access to services in the far north, urban vs rural), are there any hot topics that could also restrict access to services for many people (hint: think about our neighbours)?
- extra-billing
- inadequate amount of doctors in general (foreign-trained debates?)
- current lawsuits in various provinces stating wait times are unreasonable so we should have private services.
With the increasing segmentation of our health systems, which level of care has been affected the most?
primary level of care, since this is the entry-point. When the system is too separated, there is no common entry-point into the system and the continuum of care is more chaotic.
name some challenges that the health care system is experiencing
- care in remote locations
- First Nations health
- primary care reform (medical “home”)
- increase in non-insured services
- chronic diseases
- increased expectations on system and workers
- aging population
- funding to prevention or treatment
Approximately how much of the world is disabled according to WHOs report? what proportion of that is in developing countries?
15%, so around a billion people. Of that, 80% in developing countries.
