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.
