Week 8 Flashcards
The Fight for Universal Health Care
-Prior to late 1940s, access to health care was based solely on ones ability to pay.
-According to the British North America Act of 1867, the federal government exerts a strong influence on Canadian health policy.
-But provinces manage health care
-Provinces moved slowly toward universal public health care only under pressure from non-governmental groups.
The Marsh Report of 1943
detailed the need for comprehensive, universal social programs, including health care.
-Canadian historian Michael Bliss described the Marsh Report as “the most important single document in the history of the Welfare State in Canada”.
-By 1966, most of Marsh’s recommendations had become law in Canada.
Key Events Leading up to Canada’s Health-Care Model
In 1947, Saskatchewan Hospital Services Plan came into effect under the leadership of Premier Tommy Douglas
The Hall Report of 1964
recommended a comprehensive health service patterned on the Saskatchewan model.
The Medical Care Act
was passed in 1968
-By 1972, all provinces & territories had extended their plans to include physician services
The Canadian Health Act (1984)
further strengthened the universal nature of the public health-care system in Canada.
The Roman Report (2002) Three main themes
1) Strong leadership is needed to maintain medicare
2) The system should become efficient and responsive
3) Both short-term and long-term strategies are needed to maintain universal health care.
The Commission’s report also addressed Indigenous health, access to health care, and the impact of globalization and applied research.
Debating the Future of Health Care in Canada
Medicare is funded publicly by government insurance. It is administered through hospitals and other health-care settings and privately delivered mainly by physicians (self-employed or as physician-owned corporations).
Medicare Pros
-Supporters of medicare insist that a two-tier system would undermine the public system, foster inequality in access, and that more “medically necessary” procedures should be provided publicly to make the system work for Canadian citizens.
Medicare Con’s
-Critics of medicare say that a “two-tier system” (private and public medicine side by side) would be more cost efficient and provide more choices for consumers
The Five Principles of Medicare
1) Public Administration
2) Comprehensiveness
3) Universality
4) Portability
5) Accessibility
1) Public Administration
All administration of provincial health insurance must be carried out by a public authority on a non-profit basis.
2) Comprehensiveness
All necessary health services, including hospitals, physicians, and surgical dentists, must be insured.
3) Universality
All insured residents are entitled to the same level of health care.
Portability
A resident that moves to a different province or territory is still entitled to coverage from their home province.
Accessibility
All insured persons have reasonable access to health-care facilities.
Provincial Variations
-Health spending per person varies among provinces and territories
-Total health spending per person is highest in Newfoundland and lowest in Quebec.
The amount spent per person reflects:
-The population of each province and territory and its health-care needs.
-The organization of health services
-Personnel compensation
-The sharing of costs between public and private sectors.
Public medicare has important advantages over a private health-care system:
-Public financing spreads the costs across society, rather than only to those who are unfortunate or sick.
-Financing health insurance through taxation is efficient; it does not require a separate collection process.
-Medicare encourages Canadians to seek preventive care services and to treat problems before they worsen
-The government can cut costs, as it is largely a single buyer of health care supplies and services.
Threats to Canada’s Public Health-Care System
Several trends indicate increased privatization in our system:
-The “de-listing” of specific services covered by medicare
-The transfer of care out of areas covered by medicare to areas that are not covered
-The contracting out of “non-core” medical services (ex: ambulances, and rehabilitation services).
The Components of Well-Being
The primary factors that shape the health of Canadians are not medical treatments or lifestyle choices but rather the living conditions we experience
These conditions are known as the social determinants of health (SDH).
-SDH are the economic and social factors/conditions that affect/influence the health of individuals & communities. Ex: education, housing, living condition, unemployment, work condition.
The Social Determinants of Health
Indigenous status
Disability
Early life
Education
Employment and working conditions
Food insecurity
Health services
Gender
Housing
Race
The Advantageous Role of Community Health Centres (CHC)
There is growing interest in the CHC model across the country, to cut costs and as a community-based approach.
-Focus is on prevention, education, community development, social action, and health promotion
-CHCs address four main determinants of health: living and working conditions, available social support, individual behaviour, and genetic makeup
-Social workers are central to the provision of both direct care and community development in the CHC model of health-care delivery
The Residual Impacts of Colonization
-As a result of the Indian Act, the federal government appointed itself over Indigenous people’s health care.
-The health status of some Indigenous peoples lags far behind that of other Canadians
-Some communities are healthy and thriving, but others face many challenges, often stemming from the residual impacts of colonization.
Traditional Indigenous Approaches to Health and Healing
As one of 94 calls to action, the Truth and Reconciliation Commission (2015) has urged the federal government to establish mechanisms to narrow the health-care gab between Indigenous peoples and other Canadians.
These mechanisms include:
-Building Indigenous healing practices into the health-care system, and
-Spending more on Indigenous healing centres.
Medical Social Work Practice
-Family consultation \
-Group work
-Patient advocacy
-Direct casework
Interdisciplinary Teamwork
-In a hospital setting, the social worker is often a member of an interdisciplinary team that includes members of the other health professions, such as: general medicine, nursing, nutrition, physiotherapy, occupational therapy, and psychiatry.
-The role of social workers is becoming more central in this holistic approach to health and healing, which addresses not only the physical aspects of health, but also the social, cultural, mental, and spiritual aspects.
The Central Role of Social Workers
The goals of social workers in interdisciplinary teams might include helping a client:
-Cope with a new diagnosis
-Face and cope with a diagnosis of terminal illness
-Enter a parenting role successfully
-Interface with providers of long-term care
-Adjust to being discharged from hospital and benefit from appropriate post-discharge supports for recovery.
Social Work in Other Health-Care Settings
-local medicine clinics, community health centres, HIV/AIDS clinics
-Family planning, prenatal care.
What is mental health?
A state of wellbeing in which the individual
-Realizes their own ability
-Can cope with the normal stress of life
-Can work productively & fruitfully, & make contribution to their communities.
The Mental Health Continuum
All of us lie somewhere on the mental health continuum, depending on our unique genetic makeup, environmental factors, family dynamics, and stressors in our lives.
Mental wellness
At one end of the continuum is “mental wellness” Mental wellness exists when there is a reasonable balance in all aspects of ones life- physical, intellectual, social, emotional, and spiritual.
Mental Illness
At the other end is “mental illness”, a term referring to a range of emotional and mental health problems that may be long-lasting and that may interfere with family, school, social, or work-related activities.
Risk factors Associated with Mental Wellness/ At the Individual Level
-Genetic influence
-Having a long-term physical illness
-Being easily angered
Signs and Symptoms of Mental Health
-Depression lasting for longer than a few weeks
-Confused thoughts, delusions, and/or hallucinations
-Extreme fears or anxiety that seem “out of proportion” to circumstances or events.
-Lack of motivation for a prolonged period of time.
-Persistent feelings of helplessness/hopelessness.
Diagnostic and Statistical Manual of Mental Disorders, DSM-5
-Bipolar and related disorders
-Anxiety disorders
Depressive disorders
The Mental Health Commission of Canada
-Was formed in 2007
-tasked originally with 3 major objectives
-To develop a national mental health strategy
-To oversee the development and implementation of an anti-stigma and anti-discrimination campaign.
Changing how we see mental illness
-Language matters.
-Educate yourself
-Be kind
-Listen and ask
-Talk about it
A Holistic Approach Toward Treatment
-focuses on the person as a whole rather than on symptoms alone. The recovery model:
-Avoids assumptions based on a person’s diagnosis
-Affirms the potential to lead a meaningful life despite co-existing symptoms
-Views recovery as a journey and a process
-Sees individuals as playing a key role in their recovery.
-Taps into individuals talents, resources, and potential instead of focusing on illness, symptoms, and problems.
-Allows individuals to take responsibility for and control their own health-related choices.
What Factors Influence Recovery?
Social workers must adapt to the diversity of persons living with mental illness. Factors that influence recovery include:
-Access to education and employment opportunities.
-Quality and availability of treatment.
Mental Illness & Substance Use and Substance Use Disorder
A substance use disorder is a physiological dependency on a drug to sustain a sense of well-being and to avoid withdrawal symptoms.
Factors Related to Substance Use Disorders (Biological, Psychological, and Sociological Factors)
-Biological factors may include a genetic predisposition to substance use and substance use disorders
-Psychological factors focus on personality traits and the effects of social learning on behaviours associated with substance use.
-personality disorders and other mental illnesses may increase a persons risk
Sociological factors include the social determinants of health, ex: poverty, unsafe communities, and low educational attainment.
-Patterns of substance use and substance use disorders vary by gender, race, social class, ethnicity
Adopting a Harm Reduction Approach
-Harm reduction refers to any strategy or behaviour that an individual uses to reduce the potential harm that may exist for him or her.
-Harm reduction includes a range of options, such as adopting safer drug use techniques, using licit rather than illicit drugs, and decreasing the amount and/or frequency of use.
-Harm reduction may involve abstinence- although abstinence is not necessarily a goal.
