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PHARM 120 Final > The Canadian Healthcare system > Flashcards

The Canadian Healthcare system Flashcards

1
Q

What is the WHO definition of health? is it realistic?

A

Health is the state of complete physical, mental and social well being. No one has it all, this is based on individuality. (WHO definition)
- Not just the absence of disease.

not realistic

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2
Q

What does a good healthcare system require (5)

A
  1. Financing mechanism
  2. Well maintained facilities
  3. Well-trained and adequately paid workforce
  4. Reliable information (to base decisions)
  5. Logistics to deliver quality medicines and technologies
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3
Q

Would more money fix our healthcare system? why?

A

No. Fixing the system should be through data and outcomes first

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4
Q

What is Medicare? Who is covered?

A

Canada’s publicly funded healthcare system

All citizens and permanent residents

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5
Q

What is the provincial government responsible for

A

Management, organization, and DELIVERY of healthcare

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6
Q

What is the federal government responsible for

A
  • set national standards
  • provide funding support for provinces
  • Support delivery of healthcare
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7
Q

What are the 3 characteristics of Medicare

A
  1. Curative system
    • works to cure illness rather than prevent
  2. Fragmented
    • Some part of private with mostly public system
    • Shared responsibility between federal and provincial
  3. Mixed funding
    • 75/25% split for public/private. used to be 50/50
    • Works by public payment to private providers
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8
Q

Where is money being spent in Canada?

A

25% hospital
13.9 % drugs
13.5 % physicians

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9
Q

How much do we spend as % of GDP

A

12.7%?

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10
Q

How were hospitals in the 17th century funded?

A

Catholic charities, religious groups, and wealthy donors

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11
Q

How were doctors working in the 18th century working

A

The Hudson’s Bay company employed doctors on the prairies and across BC during this period

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12
Q

How were hospital funds in the 19th century operating

A

Funds to operate large hospitals were in short supply

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13
Q

Explain the British North American act

A

1867
- stated that healthcare is a PROVINCIAL responsibility
- however federal were still in charge of marine and military hospitals
- Ontario passed an act that provided them with annual grants to the hospitals
- CMA + college of physicians and surgeons founded

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14
Q

What was pre-confederation like? (1867-1914)

A

Lack of funds and quality was bad.

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15
Q

What happened in 1910-1914

A
  • Government discouraged patient-MD relationships and said that healthcare is a responsibility of the government
  • CMA wanted a fee-for-service model
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16
Q

What occurred in 1914-1918
What happened on black tuesday (1929)

A
  • A lot of veterans came back injured, lots of babies and cannot afford health
  • Cannot pay medical bills and doctors could not afford a wage
  • CMA wanted a publicly funded HC
17
Q

What was the BC project in 1935

A

They proposed a plan to have. a capitation model ( a per-patient payment for rostered patient) rather than a FFS model
- was denied by the CMA

18
Q

What was the 1948 National health Grants Program

A

1st stage to develop a comprehensive health insurance

19
Q

What occurred in the Saskatchewan story in 1944

A

Tommy Douglas was brought into power
- Implemented a plan that’s fee-for-service but eventually switched to an insurance system
- His five principles:
prepayment, universal coverage, quality care, public administration (non-profit entities for health) and acceptability.
- Doctors didn’t like the change and went on strike.
- Eventually he gave those who wanted a chance to OPT out and bill patients directly

First province to implement universal healthcare insurance

20
Q

What did the 1957 Hospital insurance and Diagnostic Services Act entail

What was covered and what was not?

A

the FEDs cover 50% of provincial costs for hospitals and diagnostic services.

Covered
- Acute
- Convalescent
- Chronic care of patients Diagnostic services
- In-patient drug administration in hospital

Not covered
- Hospitals for tuberculosis
- Mental hospitals
- Nursing homes
- Capital expenditures
- Administrative costs

21
Q

What was The Royal Commission on Health Services (1961-1964) (Hall Commission #1)

What were the issues and barriers?
What were the 3 main areas they focused on in HC

A

“Assess readiness for national system of medical services insurance” (a delay tactic by CMA and SCPS) and a call for “Health Charter for Canadians”

Issues
- Financing methods
- Requirements for health services
- Costs of health services
- Methods of improving the services

Barriers
- Increasing Quebec nationalism
- Alberta & Ontario opposed to federal intrusion

3 main focus areas
1. Health Services
2. Health personnel, facilities, research
3. Financing and priorities

22
Q

What happened in the Medicare Act in 1966

A

National healthcare plan for all provinces.
- 50/50 cost share between FED and public with an opt-out option for doctors
- opt out option means physicians can charge patients directly and they can get reimbursed from the province
- became unsustainable since doctors were now overbilling privately (MD income increased)

23
Q

What did the Hall commission #2 recommend in 1979 after the Medicare act

A

Needed to review “hospital insurance and the diagnostic services act”

  • Goal was to eliminate overbilling by MDs and review the opt out plan
  • Doctors did not want this
24
Q

What happened during the Canada Health Act in 1984

A

It brought both acts together
- the hospital insurance and diagnostic services act (1957)
- Medical care act (1966)

  • Establishes conditions and criterias for insured health care services (national standards that provinces must meet in order to get federal funding)
  • Universal coverage for surgical, dental, and physician services
25
Q

What are the 5 principles of the Canada Health Act
UP PAC

A
  1. Universality (all eligible citizens get healthcare)
  2. Portability (for travels within and out of Canada)
  3. Public administration (non-profit)
  4. Accessibility
  5. Comprehensiveness (all necessary services covered)
26
Q

What happened during 1990-2000
What happened in the Federal-Provincial Health Accord in 2000

A

Less funding to nurses, hospital staffs and MDs migrated

FEDs have more money and are funding provinces well.
- Sponsored by Kirby and Romanow studies

27
Q

What was did Romanow Suggest in his report in 2002.
What were the 3 themes that underlie?

A

3 themes
1. Strong leadership
2. More responsive and efficient
3. Need to make strategic investments to make the system more sustainable
- wants to have more rural access fund
- Reduce wait times in diagnostic services
- establish national home care

He also wanted to establish a federal cash fund of 25% of the cost of insured health services under the Canada health act by 2005

28
Q

What was the agreement in the 2004 Health Accord

A

Have a 10 year plan to strengthen the healthcare system and cover drugs
- They agreed to an annual escalator that said funding increases by 6% each year until 2014 (higher than inflation currently)

29
Q

What was discovered in the 2017 Health Accord

A
  • 10 year plan was unsustainable
  • Agreed to: either a minimum of 3% or a matched to the rate of GDP growth (whatever is higher)
    • however critiques suggested it should be 5.2%

PHARM 120 Final (4 decks)

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