Lecture 3

Question 1

Total health expenditure per Canadian in 2019

Answer 1

$7068 per Canadian

Question 2

Health expenditure percent of GDP?

Answer 2

11.6%

Question 3

Where is most of the money for healthcare being spent in Canada?

Answer 3

Hospitals

Question 4

Where do the feds get money for health care?

Answer 4

General taxation.

Question 5

Where do the feds direct money for health care?

Answer 5

Transfers to provinces. Direct payments for: armed forces, correctional facilities, and First Nations and Inuit.

Question 6

Eligible persons for the Non-Insured Health Benefits Program

Answer 6

A First Nations person who is registered under the Indian Act. An Inuk recognized by an Inuit land claim organization. A child less than 18 months old whose parent is registered First Nations or Inuk.

Question 7

Where do the Provinces get money for health care?

Answer 7

The feds. General taxation. Premiums.

Question 8

Where do Provinces direct their money for health care?

Answer 8

Service provision (physicians, hospitals, regional health authorities)

Question 9

Fee-for-service

Answer 9

Health professional paid set amount for each service provided.

Question 10

Salary

Answer 10

Health professional is employee of organization and responsible for services as outlined in employment contract.

Question 11

Capitation

Answer 11

Payment according to number of patients. Fee structure can include premium for complex cases. Pays practice whether consult occurs or not. Practice team may include number of disciplines.

Question 12

Incentive payments/pay-for-performance

Answer 12

Payment for reaching target outcome

Question 13

In Canada, how are primary care physicians paid?

Answer 13

Fee-for-service except in Ontario where they are now primarily reimbursed through capitation.

Question 14

In Canada, how are specialists paid?

Answer 14

Fee-for-service, with some exceptions.

Question 15

Block funding/global budgets

Answer 15

Institution paid certain amount per year to provide service. Generally calculated based on previous year’s amount and types of services offered, adjusted for demographic change, health care costs, and inflation.

Question 16

Activity-based funding

Answer 16

Payments are allocated funds based on the type and volume of services provided, and the complexity of the patient served.

Question 17

How are long-term care homes paid?

Answer 17

Global budgets. Sometimes per diem adjustment funding in Ontario and Alberta.

Question 18

How is home and community care paid?

Answer 18

Mix of global budgets and a variety of other payment mechanisms.

Question 19

How are pharmacists paid?

Answer 19

Prescription and dispensing fees (essentially fee-for-service)

Question 20

How are hospitals paid?

Answer 20

Global budgets. Ontario uses an activity-based funding model.

Question 21

Bundled payments

Answer 21

Single payments that are disbursed to groups of provider entities involved in delivering a defined “episode” of care for a particular health condition or procedure.

Question 22

Population-based integrated payment model

Answer 22

A single, time-defined payment to groups of providers for a population of enrolled patients or residents of a particular geographic area, regardless of whether they use health service or not.

Question 23

Insurance

Answer 23

Guarantee of compensation for specified risk in exchange for payment of premium. A mechanism for “risk pooling”.

Question 24

Health insurance

Answer 24

Programs that pool resources to provide protection against the cost of medical services.

Question 25

Information asymmetry (feature of health care and health insurance)

Answer 25

Providers know more about how health services will affect patients than patients do.

Question 26

Mandate of the Hall Commission

Answer 26

To recommend such measures, consistent with the constitutional division of legislative powers in Canada, as the Commissioners believe will ensure the best possible health care is available to all Canadians.”