Week 3: History of Medicare

Question 1

What was in place before Medicare?

Answer 1

BNA Act (1867): Admin of and delivery of healthcare is responsibility of provinces and territories.
- Since beginning of 1900s, there have been groups advocating for some sort of public med insurance program
- Fluctuating economy impacting discussion on public care funding.

Question 2

What is the role of the Federal Government?

Answer 2

• Financing of Healthcare services
• Coordination
• Infrastructure
• Research
• Public Health and Public Safety
• Provision of healthcare services DIRECTLY to FN, Inuit, Metis, Military & Federal Penetentaries and refugees
• Except for regulation of health professionals.

Question 3

What are the factors that contributed to medicine?

Answer 3

• Economic Conditions
• Cost of Healthcare System
• Physicans (one of the limiting factors)
• Government Interest

Question 4

British Columbia’s involvment in getting Medicare

Answer 4

• Community based retainers/recruitment (Municipal contracts w/doctors)
• SES Factors (Labour unrest in BC, Economic Conditions, WWI veterans)
• First Province to get legislation and funding

Question 5

Who resisted against Medicare most in BC?

Answer 5

• Revolt against communist ideology
• Fee for service vs capitation
• Only time supported during Great Depression

Question 6

What happened regarding medicare in WWII?

Answer 6

1945 - federal gov put a plan to share w/provinces cost of medical insurance.
Disagreements: Jurisdiction, type of care provided, organization and logistics, voluntary participation, physican sponsored or for profit insurance plan

Question 7

Where was Medicare first implemented?

Answer 7

Saskatchewan (called the Saskatchewan Medicare Act)

Question 8

What are the pillars of medicine?

Answer 8

• Portability (can go to diff provinces with the home province rembursing)
• Universaility (coverage provided)
• Public Administration
• Comprehensiveness (goal: to cover all eligable services)
• Accessibility (1984 - Hall Commission Canada Health Act)

Question 9

What is the 1984 - Hall Commission Canada Health Act?

Answer 9

Added extra part where doctors cannot add extra billing, and every dollar taken from patients the federal gov wouldn’t provide to provinces.

Question 10

What are some recent developments in Medicare?

Answer 10

• National Forum on Health (1994)
• Royal Commission on the Future of Health Care in Canada (2001)
  1. Romanow Report (2002)
• Standing Senate Committee on Social Affairs, Science, and Technology
  1. First Minister’s Accord on Health Care