week four- budgets Flashcards
who
WHO is the directing and coordinating authority for health within the United Nations system
To achieve the highest level of health for all people
Federal Jurisdiction
Establishes and delivers national principles for health care through the Canadian Health Act (CHA)
Provides financial assistance for provincial and territorial health care services (done by transferring tax money to share costs of health care services)
Deliver health care to First Nations, Inuit people, military veterans, federal inmates and RCMP
Promotion of health and prevention of disease (public health programs and consumer safety)
Provincial and Territorial Jurisdiction
• Implementation of insurable health care in accordance with the principles of the Canada Health Act
• Allocation of hospitals and long-term care facilities
• Determines employment of health care professionals for hospitals and long-term care facilities (determines the health care mix)
• Distributes money to various health care services
• Reimburses physicians and hospital expenses
Unique plan coverage i.e. drug coverage, ambulanc
Private Health Insurance
- Canadians can buy private insurance coverage or can participate in an employee benefit plan offered by the employer
- Dental plans
- Vision care
- Pharmaceuticals
- Therapies (physio, speech, massage)
Canadian National Health Care System
Designed to ensure Canadians have a reasonable access to medical treatment, hospital &physician services on a uniform prepaid basis (Health Canada, 2006)
1947:
Saskatchewan initiates provincial universal public hospital insurance plan (known today as OHIP)
1962:
Saskatchewan introduced a universal, provincial medical insurance plan to provide doctors’ services to all its residents
Tommy Douglas is the ‘Father’ of medicare in Canada
In subsequent years the remaining provinces and territories follow suit
1984:
Canada Health Act, Federal Government combines both hospital and medical acts; to establish 5 basic principles for health care:
– Universality available to all eligible residents of Canada
– Comprehensive coverage for hospital and physician services
– Accessible without financial and other barriers; available to all Canadians on the basis of need
– Portable within the country and during travel abroad
– Publicly Administered public authority administers and operates the plan on a non-profit basis
The Canada Health Act establishes principles & criteria:
provincial & territories health insurance in order to receive full federal cash transfers in support of health
Canada Health Transfer (CHT)
Federal government provides cash & tax transfers to provinces & territories in support of health through the Canada Health Transfer (CHT)
The CHA establishes criteria and conditions related to insured health services and extended health care services that the provinces and territories must fulfill to receive the full federal cash contribution under the Canada Health Transfer (CHT).
Canada Health Act imposes:
- financial penalties that prevent physicians from charging more than provincial schedule of fees.
- bans user fees and extra billing
- Establishes a provincial/territorial reciprocal billing agreement for out-patient hospital services provided out-of province/ territory
Canadian Institute of Health Information (CIHI)
Independent, not-for-profit organization that provides essential data and analysis on Canada’s health system and the health of Canadians
CIHI’s data and reports focus on:
- Health care services
- Health spending
- Health human resources
- Population health
Canadian Health Services Research Foundation (CHSRF)
Canadian Health Services Research Foundation (CHSRF)
– Independent non profit corporation
– Funded by federal government
– Promotes and funds management and policy research in health services and nursing
– Collaborates with health system decision makers to support and enhance the use of research evidence
Example:
– Research in the 1970s indicated that patient outcomes and costs varied significantly in different parts of the country
– Studies related to unnecessary surgeries and outcomes for patients impacted on physician practice
Annual Conference of Ministers of Health discuss a broad range of issues.
– Advisory Committee on Governance and Accountability
– Advisory Committee on Health Delivery and Human Resources
– Advisory Committee on Information and Emerging Technologies
– Advisory Committee on Population Health and Health Security
Primary Health Care
is the foundation of the health care system: first point of contact people have with the health care system
The first encounter with a health care provider (nurse/ doctor/pharmacist/telephone advice line)
Health care services include:
- insured primary health care (ie: physicians and other health professionals services)
- care in hospitals (account for the majority of provincial and territorial health expenditures)
Canadian Federal Government (2000) –
Invested $800 million in Primary Health Care Transition Fund (support provinces/territories to improve and expand primary health care delivery in Canada)
Primary Health Care has five guiding principles
Equitable access (health and health services)
Public participation
Appropriate technology
Intersectoral collaboration
Reorient health system to promote health and prevent disease and injury
Canada’s health care system is public but not nationalized
-Each province/territory manages its own insurance system includes own healthcare identification cards
-Once care moves beyond the services required by the Canada Health Act - inconsistency from province to province in the extent of publicly-funded coverage: Out-patient drug coverage Rehabilitation Dental Eye care, as well as vision care Mental health Long-term care
-substantial portion of such services being paid for privately, either through private insurance, or out-of-pocket
Services Not covered by OHIP
- Ambulance services.
- Routine eye examinations for people aged 19-64;
- Some Physiotherapy )may be partially covered or not at all.
- Regular dental exams; only some dental surgery that is done in a hospital will be covered.
- Podiatrists are only partially covered by OHIP.
- Chiropractors.
- Necessary emergency medical tx obtained outside of Canada is only covered on a very limited basis
