Mod 3 set 1 - Individual and Government action to Poor Health

Question 1

what would individual health insurance cover? what are the eligibility requirements?

Answer 1

hospital stays, surgeries/operations, doctor visits, emergency med needs in other countries
- qualified if you qualify for the provincial health plan

Question 2

how can we attack the problem of poor health?

Answer 2

• individual insurance
• government
• employer

Question 3

what are the key differences between canada and the us with government plans?

Answer 3

US
- 13% of the population has no health insurance
- no universal health care coverage
(one of the only developed countries without it)
CAN
- receive basic coverage
- increasing cost, decreasing funding, provincial and federal govs work together

Question 4

what are the key points about the CHA? 
in terms of: 
1. public administration
2. portability
3. comprehensiveness
4. universality 
5. accessibility

Answer 4

canada health act

1. must be administered by public agency on a non-profit basis
2. portable across provinces
3. cover all necessary hospital and medical services
4. must be available on equal terms
5. everyone has access without financial impediment

Question 5

what is covered by the provinces?

in terms of hospital services

Answer 5

all necessary hospitalization accommodations covered up to ward level rates,

• nursing care, drugs administered in hospitals, lab/diagnostics, physio
• no limit on length of stay

Question 6

whats not covered by OHIP in hospitals?

Answer 6

semi-private / private room
emerge ambulance
glasses/ routine dental care

Question 7

what is covered by the provinces?

in terms of supplementary benefits

Answer 7

dental for kids, eye test (not ohip), prescription drugs for elderly and the poor

Question 8

eligibility for OHIP?

Answer 8

• Canadian resident/ immigration status
• principle home in ontario
• present in canada for 153 days of a year

Question 9

criticisms on the health plan?

Answer 9

• waiting lists/ supply shortage
• administrative inefficiencies
• sacrifice technology for cost cutting

Question 10

who would buy individual health insurance?

Answer 10

self employed people that are do not receive health and dental insurance from an employer

Question 11

How is financing changing with federal government?

Answer 11

-federal government used to cover 50% of costs, now its less than 50%

Question 12

How do provinces balance the costs now that federal gov. covers less?

Answer 12

some raise funds through tax revenues
some use payroll tax on er
some charge their residents a premium

Question 13

What do provinces cover?

In terms of medical services

Answer 13

• x-rays
• diagnostic tests
• certain dental procedures covered when performed in hospital relating to emergency

Question 14

What happens if a physician opts out of provincial plan?

Answer 14

• can charge their own fees that they negotiate with the government
• IN QUEBEC THEY DONT REIMBURSE ANY SERVICES IF PHSYIANS OPT OUT OF PROVINCIAL PLANS

Question 15

When cutbacks are done to provincial plans, what are the first to go?

Answer 15

• supplementary

- specifically, health care practitioners such as chiropractors, massage therapy

Question 16

What are some out out of province benefits?

Answer 16

• reciprocal agreements

- most provincial plans cover emergency hospital and medical costs that outside of canada