Midterm - Health Policy Flashcards
What are the inputs of Policy Making?
Election results
Public opinion
Communication to decision makers
Media coverage (will cover next week)
Social Movements
Evidence
Values
What is the election system in Canada?
First past the post system
Elections held every 4 years on fixed cycle since 2007 (on the third Monday in October) unless:
PM resigns
Vote of non-confidence in House of Commons
What are Social Movements ?
Collective grouping whose purpose is to enact change
Organized/disorganized
What type of Political System in Canada?
Constitutional monarchy
Queen is the Head of State (GG)
PM is the Head of Government
What does Responsible government mean?
Government must be responsive to citizens
Cabinet ministers are individually responsible to Parliament and are also collectively accountable for all decisions of cabinet
What is the Executive branch (Federal)?
Decision-making branch
Includes
The King (Governor General)
Prime Minister and Cabinet
Public service
What is the Legislative branch (Federal)?
House of Commons - elected - 338 ridings (170 for majority)
Senate - Appointed by the Governor General (on advice of PM) - 105 Senators
Responsibility to make laws
How money is distributed
How programs will run
What projects will be funded
How does a bill become a law?
First Reading
Second Reading
Committee Stage (includes a report)
Third Reading
Repeat steps (1-4 in other Chamber)
Royal Assent
What is the Judiciary (Federal) branch?
Review laws made by legislature
Can strike them down if they are unconstitutional
How is the Provincial Government organized?
Executive branch: Lieutenant Governor (represents the King), Executive Council (Cabinet Ministers appointed by Premier)
Legislative branch: Legislative Assembly (Members of Legislative Assembly, Members of Provincial Parliament)
Judiciary
What is the Municipal Government?
No official powers under Constitution
Have delegated authority from province
Include: Mayor, City Council (Councillors that represent wards), Board of Health
What are the Important Sections of the Constitution for public health?
91 – the federal governments powers: Dominion of Canada responsible for international quarantine & marine hospitals, care of sick seamen, indigenous people and members of the armed services, as well as control of narcotic drugs
92 – the provincial governments powers: Provinces responsible for “establishment, maintenance & management of hospitals, asylums, charities & eleemosynary institutions
No huge mention of health and who is responsible for it
What is the Canada Health Act?
1984
Establishes the criteria for universal health care across Canada
Establishes monetary arrangement between federal government and provinces
Provinces must respect the Act in order to receive transfer payments
All PTs are responsible for funding the HC systems in their jurisdictions
How does the federal government influence health?
Direct and indirect taxing is the main sphere for influencing health
Feds have money to contribute towards health - distribution of payments to provinces
Can set standards that the provinces have to implement if they want to receive federal funding
Federal government responsible for a lot of things related to the determinants of health
What is the Federal Government Role in Health?
Financing healthcare
Provision of health care services to certain groups (First Nations living on reserves, Inuits, Members of the Canadian Forces and Prisoners in federal penitentiaries , Refugee claimants )
Health protection and regulations (Pharmaceutical products, foods, medical technologies )
Surveillance and disease prevention
Financing of health research
What is the PT Role in Health?
Manage, provide and pay for the majority of health care services (Services are financed partially by federal transfer payments)
Ensure that the principles of Health Care Act are respected
Plan, finance and evaluate health care in Hospitals, By doctors and other health care professionals
Plan and implement public health initiatives
Negotiate salaries with health professionals
Offer and finance supplementary medical services for certain groups (Ex. Prescriptions for seniors and children under 25)
Who is responsible for health of Indigenous populations?
Federal government’s role - Provision of public health services offered by First Nations and Inuit Health Branch - Health care to on-reserve and Inuit - Non-insured health benefits to registered indigenous and Inuit
Provincial government - Physician and hospital care
Many communities design and run own health related programs
What is the Oakes Test?
A legal test used in Canadian constitutional law to determine whether a law that infringes upon a right or freedom protected by the Canadian Charter of Rights and Freedoms can be justified under Section 1 of the Charter
* Burden is on government to prove that any limitation to Charter rights is justified
This section allows for reasonable limits on rights and freedoms as long as those limits can be justified in a free and democratic society.
- law must have pressing and substantive objective
- must have rational connection between law and objective
- law must minimally impair right or freedom
- law must be proportionality between the benefits of the law and its deleterious effects
What are the Fundamental Freedoms - Charter of Rights and Freedoms?
Section 2. Everyone has the following fundamental freedoms:
(a) freedom of conscience and religion;
(b) freedom of thought, belief, opinion and expression, including freedom of the press and other media of communication;
(c) freedom of peaceful assembly; and
(d) freedom of association.
What is the Mobility of Citizens - Charter of Rights and Freedoms?
Section 6. (1) Every citizen of Canada has the right to enter, remain in and leave Canada.
What is Life, liberty and security of person - Charter of Rights and Freedoms?
Section 7. Everyone has the right to life, liberty and security of the person and the right not to be deprived thereof except in accordance with the principles of fundamental justice.
What is the Equality before and under law and equal protection and benefit of law - Charter of Rights and Freedoms?
Section 15. (1) Every individual is equal before and under the law and has the right to the equal protection and equal benefit of the law without discrimination and, in particular, without discrimination based on race, national or ethnic origin, colour, religion, sex, age or mental or physical disability.
What is the Detention or imprisonment - Charter of Rights and Freedoms?
Section 9. Everyone has the right not to be arbitrarily detained or imprisoned.
What sections of the Charter of Rights and Freedoms are important for Public Health?
Fundamental Freedoms
Mobility of Citizens
Life, liberty and security of person
Equality before and under law and equal protection and benefit of law
Detention or imprisonment
What is the Notwithstanding Clause?
Parliament can declare that any piece of legislature is still going to apply regardless of charter of rights and freedom – only apply to section 2 and 7-15 of charter
What types of International agreements that are common in health?
Treaties - binding
Declarations - non- binding
Frameworks and Action Plans - strategic documents
How are international agreements enforced?
Self-enforcement: relying on countries to enforce their agreements domestically
Countries may shame other countries for not following it
What are challenges in enforcing international agreements?
Sovereignty
Variability in Commitment (States may not prioritize international obligations).
Funding and resources vary
Lack of Centralized Enforcement: (no centralized authority to enforce international treaties).
What is the Policy Domain?
substantive area of policy over which participants in policy making compete and compromise
What is a Policy Community?
the group of people that are involved in the policy making in a specific domain (open or closed)
Who are Official actors in policy?
Have power to make/enforce policies
Activities sanctioned by Constitution, Legislature, Executive, Judiciary
Who are Unofficial actors in policy?
Play role in policy process but NO official legal authority
Remain important to process
The Federal Health Portfolio consists of:
Canadian Food Inspection Agency (food safety)
Canadian Institutes of Health Research (CIHR) – fund research
Health Canada
Patented Medicine Prices Review Board (Ensures that manufacturers’ prices of patented medicines are not excessive)
Public Health Agency of Canada