M3: Canadian Healthcare System Flashcards
What were the Consequences of the British North America Act of 1867 (BNAA)?
- Health care the responsibility of the provinces (NOT the federal government)
- Each province had its own system
- No ‘universal’ health care at the start
quebec provides wheelchairs for those over 65, BC does not
What were the Consequences of No Universal Health Care?
- People paid hospitals/doctors directly
- Many could not afford care
- Major illness could reduce even the wealthy to poverty
What was the Canada Medical Act 1912?
What were its Impacts?
Introduced by Sir Thomas Roddick – a physician and Member of Parliament
- Aim of standardizing a qualification in medicine
- Oversee the licensing of medical doctors
Impacts:
- Set a standard for care and quality of physicians
- Limiting # of doctors -> raised their income by creating an artificial scarcity
Why was the Department of Health established in 1919?
happened during the spanish flu
- Quarantine (spread of infectious diseases)
- Food and drug standards and inspections
- Coordination of public health campaigns
- e.g., Campaigns against spread of STIs; campaigns to promote and protect child welfare
What was the effect of the Great Depression?
- Lack of adequate nutrition and housing
- Increased rates of tuberculosis, pneumonia, influenza, etc.
- Patients unable to pay medical bill
- very little cash in circulation
- 40% decrease in GDP
- Unemployment 40%
See pgs. 286-293
In 1930, what are examplea of health policy reform by provincial governments?
1934 – United Farmers of Alberta (UFA) government pass
health insurance legislation
1935 – Social Credit Party overthrow UFA in Alberta and legislation is never implemented
1935 – Pattullo’s Liberal government in BC pass health insurance act. But due to opposition from physicians and conservative party it is never funded/implemented
What did PM Bennett introduce?
Why was it later abolished?
rephrase
1935: Prime Minister Bennett introduces ‘New Deal’ – legislation providing a system of social welfare (including health
insurance and employment insurance)
1937: Under Prime Minister Mackenzie King, many of the reforms under the ‘New Deal’ legislation declared unconstitutional as they violated the provincial/federal division of jurisdiction
Who was Tommy Douglas?
(“Father of Universal Health Care”)
“Father of Universal Health Care”
Premeir of Sask for 16 yrs
spent 70% of Cooperative Commonwealth Federation budget on social services
Dream came true when hospital insurance was introduced
Tommy Douglas
What was the Saskatchewan Medical Care Insurance Act (1961)
▫ Increase health care facilities & created health service refions
▫ Create universal access to hospitals
▫ Air ambulances for rural/remote regions
▫ Met with opposition
▫ Vision not fully realized – removing financial barriers was the first step; focus on illness prevention, health promotion and measures to address the social determinants of health (e.g., poverty, inequality)
1948
What was the National Health Grants Program?
Feds to cover 50% of costs for approved hospital construction
-> increase in building of hospitals across the country
Establish hospitals as the primary place for medical treatment
1957
What was the Hospital and Diagnostic Services Act?
1957: Hospital and Diagnostic Services Act
- Establish 50/50 cost-sharing arrangement between feds and P/Ts for hospital-related services
- On condition that services were provided to everyone on an equal basis
- But institutions for the mentally ill and care institutions like homes for the elderly were not covered
What was the Medical Care Act?
What 4 Criteria had to be maintrained to get the payments
- Implemented by the Pearson liberal (federal) government
- Modeled after Saskatchewan’s health policy
- Opposed by the conservatives (“too costly”) and the NDP (“not comprehensive enough”)
4 criteria must be maintained to get the payments (50/50 split)
1. Universality
2. Comprehensiveness (all needed to be covered)
3. Public administration
4. Portability
What was the Established Programs Financing Act – 1977
(aka ‘New Financing Act’)?
What did it lead to?
- Shift to block funding with a cap on the amount
- Change in funding ratio from 50/50 to 25% federal, 75% provincial
- Provinces/territories gained more control over spending, but faced a cap on cash transfers and higher costs
Concerns:
- Provinces/territories struggling financially
- Growing population and expanded healthcare facilities -> rising costs
- Funding shortfalls led to extra billing and user fees
What were the Ripple effects from EPFA ?
Established Programs Financing Act – 1977
Recommendations:
1. Eliminate user fees and extra billing;
2. Change mechanisms for physicians’ fees;
3. Set national standards for portability, comprehensiveness, accessibility, public admin, universal coverage
What was the Canada Health Act 1984
remember the date
passed unanimously
Federal government will continue transfer payments to provinces as long as the provincial health insurance programs meet 5 funding criteria:
Canada Health Act 1984: Criteria for Federal $
