lecture 5 (ch 8) Flashcards
list 3 types of healers
allopathic doctors
homeopathic doctors
eclectics
allopathic doctors
aka regulars
cure by opposites
heroic measures
homeopathic doctors
let like be cured by like
stimulate sick persons natural defences by using small amount of natural substance that in larger amounts would cause the same symptoms
eclectics
botanical medicine
used herbal based remidies in massive doses creating complex, compounded drugs
what is common w all types of healers
must have passed experience down to mentee, barely did any training, and then established their own practice
how did allopathic doctors come to assume medical dominance in 19th century?
first to attempt to organize themselves as a profession
allopaths sought to:
- license allopathic doctors and control admittance to practice of medicine
- distinguish allopathic meds from other healers
the order in which the STATE formally recognized the health care professions was as follows:
homeopathy (1859)
eclectics (1861)
allopaths (1869)
who made flexner report + what year
Abraham Flexner
1910
result of flexner report
80% of medical schools were closed
ushered in new standard of medical education
what did flexner report recommend
eliminate apprenticeship system (instead taught thru school)
medical schools should be affiliated w universities (to ensure highest caliber med schools)
implement standardized entry requirements to med school (so best students are accepted)
scientific method as the only way to understand and treat disease
hospitals to be centers of learning
Canada medical act
1912
recommendations of flexner report led to standardized procedures across canada, which became called the canada medical act
it gave allopathic doctors medical dominance defined as;
- freedom from control by other occupations and groups
- ability to control other health occupations
what year did government first mention implementing medical insurance system
1919
year of dominion provincial conference on reconstruction
1945
who was tommy douglas + what he do
in 1947, he was premier of Saskatchewan
started Hospital Insurance Plan
- 5 dollars per person annual fee to max of 30 dollars a household
- patients were not charged for hospital services
- by end of year nearly all of Saskatchewan was covered
- success of this inspired other provinces
Hospital insurance and diagnostic services act (HIDSA)
1957
federal gov and provinces agree to share medical costs
- fed gov takes 50% and provincial takes other 50%
- in exchange, province agrees to abide by national standards for hospital care and submit to an annual audit
what did tommy douglas do in 1959?
introduced bill for medical insurance, covering more than just hospitals
5 principles of bill
- universal
- annual fees (socialized medicine)
- public control
- improvements to healthcare system
- legislation must be approved by doctors n public
socialized medicine
cost of program distributed over entire population instead of person paying right after a visit
what happened to medical insurance in saskatchewan in 1962
it became a law
medical care act
1966
passed by fed gov + was fully implimented nationally by 1972
4 principles:
- universal
- all eligible citizens entitled to insured health services
- publicly administered
- offered on not for profit basis by public authority accountable to the government
under the medical care act were ppl entitled to coverage when they moved to another province?
yes but they had to live there for 6 months before coverage started
what replaced the medical care act and the hospital insurance and diagnostic services act?
canada health act
canada health act
1984
added fifth principle; accessibility
- access to medically necessary hospital and physician services must be unimpeded by financial or other barriers
- eliminated extra billing and user fees
how would we describe our Canadian system
first dollar coverage
publicly funded
privately provided
provincially adminstered
national health care plan
how are doctors paid under our system
fee for service basis, not for each patient
block funding
fed gov annually transfer provinces a block of money for healthcare which would increase based on the economic growth
established programs financing act
1977
changed from shared costs to block funding
reduced fed gov share of the cost of medical insurance from 50% to 25%
when was health care first perceived to be in crisis
when established programs financing act started in 1977
3 phases of development
mid 1970-1991
growth phase
1992 - 1996
- growing concern abt costs of healthcare
- cost of health care began to decline
- gov face large discal deficits
- leads to retrenchement and disinvestment
1997 - now
- return to stability; growth phase
- introduction of CHST
- fed gov begins to provide money to provinces to achieve goals
Canada health and social transfer (CHST)
was split in 2003 into Canada health transfer and Canada social transfer
new agreemeent in 2003 from stephen harper
6% annual increase extended until 2016, thereafter increases are tied to economic growth
hands off approach; no further investment in system wide improvements, leaving provinces to innovate on their own
what other challenges does canadian health care system face?
june 2005 supreme court decision
court rules that access to waiting list is not access to health care
it is unconstitutional to ban private insurance if public system cannot provide services in timely manner
how did quebec respond to the june 2005 supreme court decision
introduced parallel private (for profit) system
