Selected Milestones in the Development of the Canadian Health Care System Handout Flashcards
What were the contextual factors during the <1867 time period?
Developing Canadian society, communicable diseases, epidemics (esp. Aboriginals)
Philanthropic/church/community support
What were some major milestones that occurred during the <1867 time period?
Boards of health, Vaccination, Resistance to imposed care/quarantine
Reliance on philanthropic/church/community support
What were the implications of the <1867 time period regarding health care?
Vaccination, statutory imposed care/quarantine
Heavy psychological investment by church/philanthropic support, little attention in British North America Act
What significant things occurred in 1867? (milestones)
Confederation
BNA Act Division of powers
What was the effect of the BNA Act division of powers in 1867?
Trigger for Federal/Provincial support
What are the contextual features of the health care of the early 1900s?
Increasing technology/professionalization; cost of health care, economic stresses/depression, UK social security reforms.
What milestone was reached during the early 1900s?
Review of role of government and social security (some programs for economic security, OAP 1927)
What significant contextual factor occurred in 1927?
Federal Department of Health was created
Which important milestone was reached in 1927?
Old Age Pension Act
What were the implications of the creation of the Federal Department of Health and the Old Age Pension Act in 1927?
First shared cost Federal/Provincial program.
What significant contextual factor was influencing the nation in 1935?
The Great Depression
What significant milestones were reached in 1935?
Feds try Unemployment Insurance; Provinces challenge in the court
What were the implications of the contextual features (the Great Depression) and milestones (Feds trying Unemployment Insurance, and Provinces challenging in court) in 1935?
Provinces draw line in the sand, provides more clarity around Federal/Provincial responsibilities.
What occurred during the 1940’s that was a significant contextual factor?
Rowell Sirois Commission on Federal Provincial Relations
What milestones were reached in 1940?
Recommendations (of the Rowell Sirois Comission) mired in Federal/Provincial debate but unemployment insurance erected.
What significant contextual feature occurred in 1943?
Marsh Report on social security
Heagerty Report on health insurance
What were the results of the Marsh Report on social security and the Heagerty Report on health insurance in 1943?
Recommendations mired in Federal/Provincial debate.
What were the implications of the 1940 changes (Rowell Sirois Comission, Unemployment Insurance)?
More collaborative spirit.
What were the implications of the 1943 Marsh Report, Heagerty Report, and ongoing Federal/Provincial debate?
Increased attention and awareness, but not partnership.
What occurred during the mid-1940’s?
Tommy Douglas and CCF rise to power in Saskatchewan
What occurred in Saskatchewan in 1947?
Saskatchewan introduced hospital insurance.
What was the implication/significance of the introduction of hospital insurance in Saskatchewan in 1947?
First government sponsored hospital insurance scheme for a whole province.
What occurred contextually in 1945?
End of World War II, Feds interested in “welfare state” and cooperation with provinces.
What milestone was reached in 1945?
Dominion - Provincial Conference on Reconstruction
What was the implication of the end of WWII in 1945 and the Dominion-Provincial Conference of Reconstruction?
Renewed cooperative spirit.
What was the context in 1947? (what was happening)
Continued interest by feds in “welfare state”
What milestone was reached in 1947?
1947 Hospital Construction grants
What were the implications of the hospital construction grants on 1947?
Proliferation of hospital construction
What were the contextual factors of the 1950’s?
Other provinces follow Saskatchewan, and Feds introduce legislation in late 1950's. Medical care (outside of hospital) still not covered.
What milestones were reached during the 1950’s?
1957 Hospital Insurance and Diagnostic Services Act (all implemented in 1961)
1961 Saskatchewan introduces medical care insurance
What were the implications of the 1957 Hospital Insurance and Diagnostic Services Act?
National federal/provincial government sponsored hospital insurance scheme, incentive for hospital care
What were the implications of the introduction of medical care insurance in Saskatchewan in 1961?
First government sponsored medical insurance scheme, First Doctor’s strike, reliance on foreign MD’s
What was the context between 1961-1966?
1966 baby boom; anticipated capacity increase
What milestone was reached between 1961-1966?
Hall commission recommends medical care insurance, increased med school capacity.
What were the implications of the Hall commission’s recommendations for medical care insurance and increased med school capacity?
“oversupply” based on extrapolations, medical care insurance.
What was the context in 1968?
National focus on Medical Care Insurance Act in force 1968 (all on board by 1972)
What milestone was reached in 1968?
1968 National Medical Care Insurance
What occurred contextually during the 1970s?
1970’s cost pressures (noted from HIDS) under scrutiny
What milestone was reached during the 1970’s?
Task force on cost of health services reports.
What was the implication of the report from the task force on health services (1970’s)?
Continued concern, ultimately EPF and community care incentives.
What were the contextual factors in 1977?
Cost pressures continue, feds seeking means to diminish unfettered commitment to shared costs.
What milestone was reached in 1977?
Established Programs Financing Act + incentives
What were the implications of the 1977 Established Programs Financing Act?
Severe financing pressure on provinces, beginning of expansion of non-hospital care.
What was the context during 1979?
Concern over extra billing following EPF change in funding.
What milestone was reached in 1979?
Hall II recommends “accessibility” provision.
What was the implication of the Hall II recommendation of “Accessibility”? (1979)
Accessibility enshrined Canada Health Act 1984
What occurred contextually in the 1980s?
Economic challenges, continued demand and cost pressures Period of review
What milestone was reached in the 1980s?
Provinces rethink delivery
What was the implication of the 1980s economic challenges and provinces rethinking of healthcare delivery?
Reform
What was the context in 1991?
Federal deficit reduction strategy, more autonomy for provinces.
What milestone was reached in 1991?
Bill C-69
What was the implication of Bill C-69?
Shift in transfer payments - shift of cash transfer to transfer of tax points, diminished clout to enforce Canada Health Act
What occurred in the 1990s contextually (1994)
Continued federal retrenchment
What milestone was reached in 1994?
National Forum on Health scolds feds for diminished ability to enforce Canada Health Act
What was the implication of the National Forum on Health? (1994)
“Cash” to “Tax Transfer” shift ceased.
What were the contextual features of 2002?
Contained cost pressure, concerns for sustainability
What milestones were reached in 2002?
Romanow Comission; Kirby Enquiry into Federal role in health care
What were the implications of the 2002 Romanow Comission and Kirby Enquiry into Federal role in health care?
Recommendations for home care, pharmaceutical insurance.
What was the context in 2003?
Concern over potential that more resources are needed, Romanow report received.
What milestone was reached in 2003?
2003 First Ministers Accord on Health Care Renewal
What were the implications of the 2003 First Ministers Accord on Health Care Renewals?
Appearance of working together; additional resources for system, Health Council established.
What was the context in 2004?
Ongoing concern, goodwill, economic “stability”
What milestone was reached in 2004?
10 Year Plan to Strengthen Health Care
What were the implications of the 2004 10 Year Plan to Strengthen Health Care?
Appearance of working together; additional resources for system
What was the context of 2012?
Economic challenges, expectations
What milestone was reached in 2012?
Federal Government unilaterally imposes terms on funding post-accord
What were the implications of the 2012 Federal Government imposition of funding terms (post-accord)?
Increased pressure on provinces for cost containment
What is the context of the Health Care system in 2017?
Continued cost pressure, concerns for sustainability.
