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GLPH 271 > Module 6 > Flashcards

Module 6 Flashcards

Universal Health Care

1
Q

universal health coverage

A

the UN general assembly adopted the 2030 Agenda for Sustainable Development, which included the 17 SDGs
the third SDG aims to promote the well-being and ensure healthy living for all individuals at all ages, meaning that universal health coverage (UHC) is a key component of the SDGs

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2
Q

UHC enables

A

all people to have access to the health services they need, whenever, wherever, and without financial hardship
UHC includes health promotion, prevention, treatment, rehabilitation, and palliatives services

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3
Q

evaluating the global prevalence of UHC

A

researchers often categorize a country as a provider of UHC if it meets two criteria: passed legislation and essential service coverage

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4
Q

UHC: passes legislation

A

a country meets this criteria if they possess healthcare legislation that explicitly states that the entire population is covered under a specific health plan

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5
Q

UHC: essential service coverage

A

this criteria is based on the service coverage index, which is rated from 0-100, and is a measure of essential health service coverage based on 4 components
a high score indicates high coverage

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6
Q

essential service coverage components

A
  1. reproductive, maternal, newborn, and child health
  2. infectious disease
  3. non-communicable diseases
  4. service capacity and access
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7
Q

funding health coverage

A

4 main methods used by countries to finance healthcare coverage
1. social insurance
2. state coverage
3. private health insurance
4. employer based insurance

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8
Q

social insurance

A

employers and employees, including self employed by individuals, pay contributions towards health services
these are usually legislated by law and cover the entire population
wealthier people and companies often pay more into these funds, but not always
governments may contribute subsidies to provide increased funding

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9
Q

state coverage

A

healthcare insurance is provided and financed by the government through tax payments
taxes such as income tax and sales taxes or goods fund state based coverage
all the money is pooled by the government and used according to the country’s needs

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10
Q

private health insurance

A

individuals purchase private healthcare insurance to cover the cost of healthcare services
some countries make private health insurance available to its citizens at a nominal cost

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11
Q

employer based insurance

A

insurance is purchased by employers for their employees and financed through employer or joint employer-employee contributions
this insurance may be subsidized by the government

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12
Q

healthcare models

A

the beveridge model
the Bismarck model
the National Health Insurance Model
the out-of-pocket model

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13
Q

access to health services

A

services are provided at little or no cost to the individual
services provided are close in proximity to where the individual resides
services available are comprehensive medical, dental, eye, mental health, and pharmaceutical

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14
Q

quality of health services

A

healthcare professionals have the resources they need to provide quality care
evidence based healthcare services and policies are practiced
client-centred care
timely service
educated and efficient healthcare workers

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15
Q

UHC in UK

A

single-payer
comprehensive care with NO copays at point of service

all residents are covered

government finances health care with taxes and pays providers directly

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16
Q

UHC in Netherlands

A

regulated private coverage

government-defined health benefits; deductibles for some services are covered

everyone is required to have insurance unless they qualify for an exception

people pay premiums for regulated private health coverage; insurers pay health providers

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17
Q

UHC in France

A

mixed public-private

coverage: wide range of services with some cost sharing; private insurance fills gaps

all residents are covered

government finances non-profit funds that pay providers; most people buy additional insurance

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18
Q

requirements for UHC

A

these must be met before a country can claim they have reached UHC
- healthcare system
- finances
- access
- health workers

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19
Q

requirements for UHC: healthcare system

A

a high quality and efficient healthcare system that is able to meet priority health needs

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20
Q

requirements for UHC: finances

A

financing that supports healthcare services and prevents financial hardship for medical care

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21
Q

requirements for UHC: access

A

access to effective technology and medicines to diagnose and treat medical conditions

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22
Q

requirements for UHC: health workers

A

sufficient capacity of well-trained and motivated health workers to meet the needs of patients

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23
Q

healthcare systems

A

the organization of people, institutions, and resources that deliver healthcare services to meet the needs of a population
the configuration varies from country to country

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24
Q

a simple health system model

A

model includes three main branches: the structure, the provision, and the health outcomes

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25
Q

a simple health system model: structure

A

encompasses the financing of the health services and the infrastructure (hospitals, clinics, health centres) leads to particular goals or health outcome that are mediated by the provision of services

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26
Q

a well functioning healthcare system

A
  • a robust financing mechanism
  • a well-trained and adequately paid workforce
  • reliable information on which to base decisions and policies
  • well-maintained facilities and logistics to deliver quality medicines and technologies
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27
Q

a well functioning healthcare system: response to needs

A

can respond in multiple ways:

  1. Defending: defending the population against health threats
  2. providing: providing equitable access to people centred care
  3. protecting: protecting against the financial consequences of ill health
  4. improving: improving the health status of individuals and communities
  5. participating: making it possible for people to participate in decisions affecting their health
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28
Q

barriers to a well functioning healthcare system

A

disproportionate focus on specialist curative care

fragmentation of competing programs, projects, and institutions

pervasive commercialization of health care delivery in poorly regulated systems

insufficient resources, including finances

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28
Q

wealth of a nation and its health expenditure

A

in general, poorer nations tend to spend less on health expenditure
as the wealth of a nation increases, its health expenditure tends to increase

29
Q

First Nations Health Authority: BC

A

it is important to also consider how culturally sensitive a healthcare model is
in 2013 BC established a model and funding structure that secured self-governance and Indigenous control over healthcare across BC’s native regions
the FNHA was then developed

30
Q

FNHA structure

A

3 blocks: protection, benefits, and support

31
Q

FNHA: protection

A

health promotion and disease prevention, environmental health, etc.

32
Q

FNHA: benefits

A

medical transportation, short term crisis intervention, mental health counselling, dental care, prescription drugs, medical supplies, vision care, etc.

33
Q

FNHA: support

A

healthy system capacity, human resources, facilities, health system transportation needs, etc.

34
Q

key improvements with Indigenous Self-governance

A

improved participation at immunization clinics

mandatory cultural safety training for staff and greater access to training programs in remote regions

improved access to health services through remote delivery models and electronic health services

decreased overall service times

35
Q

healthcare in canada

A

all citizens qualify for health coverage for medically necessary services, regardless of their medical history, personal finances, or standard of living
it is a non-commoditized model, funding is primarily drawn from the provincial and federal budgets (tax-funded model)

36
Q

UHC in Canada

A

Canada achieves UHC because it provides over 90% of its population with healthcare coverage which is legislated through the Canada Health Act, which has 5 main principles:
- public administration
- comprehensiveness
- universality
- portability
- accessibility

37
Q

Canada Health Act: public administration

A

administration of provincial health insurance must be carried out by a public authority on a non-profit basis
they must also be accountable to the province or territory, and their records and accounts are subject to audits

38
Q

Canada Health Act: comprehensiveness

A

health services must be comprehensively insured
this includes hospitals, physicians, and surgical dentists

39
Q

Canada Health Act: portability

A

a resident of one province or territory can move to a different province or territory and still obtain coverage from their home province during a minimum waiting period
this also applies to residents that leave the country

40
Q

Canada Health Act: universality

A

all insured residents must be entitled to the same level of healthcare

41
Q

Canada Health Act: accessibility

A

insured persons must have reasonable access to healthcare facilities, and these facilities must be given reasonable compensation for the services they provide

42
Q

access to healthcare in Canada

A

provincial and territorial health insurance plans in Canada are required to provide insured persons coverage of insured health services. services that are not deemed medically necessary require the individuals to pay out of pocket expenses or have private insurance

43
Q

covered health services

A

doctors visits
in-patient hospital care
ER visits
essential surgeries

44
Q

not covered health services

A

private psychologist visits
dental care
eye care
prescription drugs
cosmetic surgery
physiotherapy

45
Q

a comprehensive definition of medically necessary

A

without a comprehensive definition, healthcare in Canada is not equitable

46
Q

Provincially funded healthcare systems

A

ex: Ontario has OHIP
the Canadian federal government gives the provinces and territories money and tax transfers to help pay for the publicly funded health services through Canada Health Transfer

47
Q

funding Indigenous Peoples Health Care

A

health care of First Nations and Inuit individuals are the responsibility of the federal government based on Treat 6 and the Indian Act
First Nations and Inuit individuals are insured by the federal government for health related goods and services not insured by the provincial or territorial government (drugs, dental care, vision, etc.)
covered by Non-insured Health Benefits, governed by FNIHB

48
Q

NIHBP inclusion criteria

A

a person must be Canadian citizen and meet one or more of the following:
- be a registered Indian according to the Indian Act
- be an Inuk resident by one of the Inuit Land Claim organizations
- be an infant less than 1 year old whose parent is an eligible recipient

49
Q

funding Canadian Armed Forces health care

A

not covered under Canada Health Act, but covered by the National Defence Act and governed by the National Defence (provides similar coverage as the Canada Health Act, but provides additional tailored services that meet the unique and high risk nature of the Canadian Armed Forces)

50
Q

funding health care of individuals under pressing circumstances

A

interim federal health program (IFHP) provides temporary and limited coverage of health care benefits for groups of people not covered
this includes resettled refugees, protected persons in Canada, refugee claimants, and detainees
immigrants are not covered by IFHP

51
Q

France’s comprehensive healthcare systems

A

largely funded by national health insurance
supplemental coverage may be bought from private insurers

52
Q

Canada’s mental health coverage

A

mostly comes from out of pocket money

53
Q

Australia’s mental health coverage

A

public sector: mental health services are funded and delivered, including specialized mental health care delivered in public acute and psychiatric hospital settings, state and territory sepcialized community mental health care services, social housing programs

private: private psychiatric hospital and private services provided by psychiatrists

54
Q

access to primary healthcare in Canada

A

there is a low practicing doctor per capita ratio in Canada, especially compared to other OECD countries like Australia, France, and Switzerland
additionally, Canada ranks very low for people who are able to book a same or next-day appointment with their family physician, leaving many people having to go to the ER or walk in clinics

55
Q

access to primary care in Germany

A

Germany has mandatory private insurance, funded through tax and insurance premiums, to enable the provision of UHC
Germany has a higher doctor to population ratio than Canada

56
Q

home care in Canada

A

there are publicly funded home and community services available in Canada for those who meet the requirements, but many Canadians do not receive the care they need or any at all
home care includes:
- in home nurse and therapy
- homemaking
- personal support services
- other related services

57
Q

community care services in Canada

A
  • non clinical supports
  • meals
  • transportation
  • supported living
  • home help
  • other assistance
58
Q

Canada’s aging population

A

as Canada’s population continues to grow and age, there is an increasing need for quality, publicly funded home care for the elderly

59
Q

pros of affordable care act (ACA, USA)

A

slows the rise of care costs as preventative services are covered
covers 10 essential health benefits which include preventative and wellness visits
coverage for pre-existing conditions
children can stay on their parents’ health insurance plans

60
Q

cons of ACA

A

raised the income tax rate
the ACA taxed those who didn’t purchase insurance until 2019
people chose to pay the fine rather than pay for coverage

61
Q

healthcare systems in low resource countries

A

400 million people lack access to basic medical care, with the majority of these people coming from low resource countries

62
Q

health needs of low resource populations

A

health issues are often associated with:
- poor living conditions
- inability to access healthcare
- health illiteracy
- malnutrition

63
Q

healthcare obstacles in low resource countries

A
  • geographic accessibility
  • retaining talent (skilled workers leave to pursue better opportunities)
64
Q

healthcare in Cuba

A

it is a model of successful low resource healthcare provision
Cuba has spent 40 years making healthcare a priority despite a lack of money, medicines, and supplies

65
Q

Cuban medical model

A

based on 3 principles:
1. insurance should cover all medical fees
2. health providers should understand and live in the community they serve
3. focusing on the community is more effective than focusing on the individual

66
Q

key factors in the success of the Cuban healthcare service

A
  • integration of public health
  • doctor-patient ratio (high)
  • community health networks
  • central government support
67
Q

weaknesses for Cuban healthcare

A
  1. drug and equipment storage (black market for medical drugs and services)
  2. lack of freedom for doctors and patients (right to privacy, informed consent, right to refuse treatment)
68
Q

healthcare in Gambia

A

successful South-South cooperation has occurred between Cuba and Gambia
Cubans helped develop a new health system increasing clean water access, reducing malaria burden, and making improvements to nutrition

69
Q

obstacles to applying a Cuban model in Gambia

A
  • lack of willingness from doctors to make sacrifices to meet the needs of the community (includes loss of talent to urban centres and private clinics)
  • lack of government support for universal access to public healthcare

GLPH 271 (4 decks)

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