module 7 Flashcards
The structure of Canadian Medicare
Federal Responsibilities for health care
- Setting and administering the National Principles under the Canada Health Act
- Financially supporting the provinces through the Canada Health Transfers
- Funding and delivering primary health care to
First Nations People living on reserves
Inuit communities
Canadian Forces personnel
Eligible veterans
Inmates in federal penitentiaries
Some refugees - Health protection and promotion
Regulation, inspection, and recalls of Pharmaceuticals, Food, and Medical devices - Consumer safety
- Disease surveillance and protection (population health)
National Principles under the Canada Health Act:
- It sets rules for healthcare across the country.
- Financial Support to Provinces:
- Gives money to provinces for healthcare through Canada Health Transfers.
Providing Healthcare to Specific Groups:
Takes care of health services for First Nations, Inuit, Canadian Forces, veterans, inmates, and some refugees.
- Health Protection and Promotion:
- Keeps people safe by regulating and inspecting drugs, food, and medical devices.
Consumer Safety: - Ensures products are safe for people to use.
Disease Surveillance and Protection: - Keeps an eye on diseases in the population and takes steps to protect public health.
The Five Principles within the Canada Health Act
- Public Administration:
Health plans in each province must be run by a non-profit public authority accountable to the government.
2.Comprehensiveness:
All necessary medical services in hospitals and from doctors are covered. What’s necessary is decided by each province with input from doctors.
- Universality:
Everyone with insurance gets the same coverage, no matter their health condition. - Accessibility:
People should easily access needed hospital and medical services without facing financial barriers. - Portability:
If you move to another province, your health coverage moves with you for three months, allowing time to register with the new plan. There might be some limits on services outside your home province.
Provincial Responsibilities for health care
- Defining which services are “medically necessary” for health insurance programs
- Provision of medically necessary services with full costs covered by the government (by OHIP, for example)
- Planning and funding care of hospitals
- Planning and implementing health promotion and public health initiatives
- Negotiation of fee schedules with physicians
Ontario Health Insurance Plan (“OHIP”)
Covers basic medical and emergency services, as long as they are medically necessary
Eligible if
Your main residence is in Ontario
You were in Ontario most of the first six months you lived here
You are in Ontario at least 153 days/year
You are a Canadian citizen or have Immigration status, or with a valid work permit for more than six months
What isn’t covered by OHIP?
Drugs
Dental Care (unless deemed medically necessary and provided within a hospital setting)
Psychology
Optometry
Ambulance and paramedical services
Phyisotherapy
Ohip+ and trillium
Ontario Drug Benefit Program (ODP aka OHIP+)
ODB covers most of the cost for more than 4,400 medications. To qualify, you must be:
Over the age of 65, or living in a long-term care home or home for special care
Under the age of 25, and not already covered by a private drug plan
Receiving professional home and community care services
Be receiving benefits from Ontario Works or the Ontario Disability Support Program
Be enrolled in the Trillium Drug Program
Trillium Drug Program
helps to cover some of the costs of for high-cost prescriptions. You are eligible if:
You live in Ontario and have a health card
You do not already qualify for ODP
You do not have a private drug plan that would cover full costs
You spend more than 4% of your after-tax household income on prescription-drug costs
Medical Assistance in Dying (MAiD):
in 2015, the Supreme Court of Canada said that certain parts of the law against helping someone die needed to change. They said it goes against people’s rights and freedom. So, in 2016, the Canadian government made a new law (Bill C-14) allowing some adults to ask for help in dying if they meet certain conditions. The law also set rules to make sure it’s done safely. Each province had a year to make their own rules about this. In 2017, Ontario made their own rules called the Medical Assistance in Dying Statute Law Amendment Act 2017.
“We are an agency created by the Government of Ontario to connect, coordinate and modernize our province’s health care system. We work with partners, providers and patients to make the health system more efficient so everyone in Ontario has an opportunity for better health and wellbeing.” (Ontario Health, nd, para 1)
ontario health
We provide scientific and technical advice and support to clients working in government, public health, health care, and related sectors
Public health ontario
Facilitate and offer access to telemedicine services to Ontarians, through secure virtual program
Ontario telemedicine network
The difference between Primary Care, Secondary Care, and Tertiary Care
refers to the first stop that most people take if they are feeling unwell. Your family doctor’s clinic or nurse practitioner clinic,
Often offer support for a broad number of ailments, but may be restricted by the types of equipment that are available to them. Some acute care (emergency care) is an example
Primary Care
refers to specialist care.
You family doctor may refer you to a specialist for for further assessment if the presenting problem is outside of their scope. For example, an older adult may be referred to a Geriatrician (specialist who works in Geriatric Medicine) or a Geriatric Psychiatrist (specialist who works in Geriatric Psychiatry).
SecondaryCare
