week 11- canadian federalism, social union, health policy Flashcards
timeline of federalism and health policy
pre-1980
1980-1984 (maintaining government roles)
1984-1988 (restrianing social program costs)
1988-1997 (restricting the role of government)
1997-present (repairing the social union)
pre-1980
- 1957 Hospital Insurance and Diagnostic Services Act (single payer systme that covered all canadian)
- 1966 Medical Care Act (MCA)
- 1977 Established Programs Financing (EPF)
1966 Medical Care Act (MCA)
Funded through Canada Assistance Plan (CAP)
50/50 cost-sharing
- outside of hospital services
1977 Established Programs Financing (EPF)
- Shift from cost-sharing to block funding
- Transfer of tax points (from federal) to provinces/territories
- Increases based on economic and population growth
- funding from federal should go up in ressations
1980–1984
Maintaining Government Roles
- was important and stable
1984–1988
Restraining Social Program Costs
Weakening of government commitments to health and social programs (between 1986 and 1998, reductions of $41.2 billion in health transfers)
- neoliberisam strongly influence government policy in the USA
- shrinky of funding includig health care
1988–1997
Restructuring the Role of Government
- cut healthcare
Restructuring the Role of Government
- Concern with government budget deficits
- Significant curtailment of federal (and sometimes provincial/territorial) health care spending
- 1995 Canada Health and Social Transfer:
1995 Canada Health and Social Transfer:
- Federal contribution at rate based on previous year with adjustment for GDP at provincial level
- One funding envelope for health care, social spending, and post-secondary education
- Federal spending cuts of $6 billion
period in 1987 is called what?
repaying the social union
- turn around in health spending by the federal government
1997-2016
Reparing the social union
bad social union what does that mean?
- the relatipnship between level of government was getting worse or bad and the basic needs of social services was being lost
1999 budget
increase in health and social transfers of $11.5 billion
- from the federal govern to the provinces and terroities
Health Accords
2000 Health Accord:
2003 Health Accord
2004 Health Accord:
2000 Health Accord:
Increase of $21.2 billion over 5 years
- increase payments from fed
- further funds for emergy , primary care reforms, and provicnal health care system
2003 Health Accord:
Established Health Council of Canada, separated CHST into CHT and CST
- more federal funding for primary care, home care, and drug coverage
- helaht concil of canada to monitor
2004 Health Accord:
Increase of $41 billion over 10 years
- strength health care
- fix of generation
- providing increase in 6% health transfer along with targeting funding for waittime reducing, homecare,
- increase in fed funding of 41billion over 10 years
2011:
Federal Conservative government unilaterally announced scaling back of increases starting in 2014
2015:
Liberals win federal election, promising new Health Accord
2016-2017
Failed Health Accord negotiations
Federal government signed bilateral agreements with each province and territory
- Estimated $31 billion shortfall
- Gives provinces/territories incentives to cut costs (privatization & user fees)
Decreases federal authority to play role to protect and improve medicare
National pharmacare program unlikely
Calls for a new Health Accord
July 2019: Premiers call for new Canada Health Transfer escalator of 5.2%, and increase in federal contributions from 22% to 35%
2016-2017: Failed Health Accord negotiations
Federal government tabled “take it or leave it” proposal
Rejected by provinces and territories
recent updates on Canadian health care
- Manitoba becomes first province to join national pharmecare program with $219 deal- birth control covers, and mediation enhancing access to citizen
british columbia: government of Canada signs pharma care agreement with birth Columbia to improve universal access to free medications
