Week One

Question 1

Who is Tommy Douglas?

Answer 1

Invented Medicare and Is from saskatatchwan

Question 2

What did the Hospital Insurance and Diagnostic Services (1957) entail?

Answer 2

it was apart of the development of health care system
Provided universal public hosital insruance and cost share specific healthcare services with provinces & territories for publicly funded inpatient hospital and diagnostic services.

Question 3

What is the medical act? (1996)

Answer 3

-Addiontally cost share one half the provision of insured phsyician services with the provinces and territories
Principles needed to be made, cause they wanted equity
Started the CANADA HEALTH ACT

Question 4

What is the Canada Health Act?

Answer 4

to protect, promote and restore the physical and mental well-being of residents of Canada and to facilitate reasonable access to health services without financial or other barriers.“
– Federal legislation for publicly funded health care insurance

Question 5

What are the 5 criteria for health care to recieve funding?

Answer 5

1. Public Administration
2. Comprehensiveness
3. Universality
4. Portability
5. Accessibility

Question 6

What are the 4 conditions to receive funding B

Answer 6

1. Give Information to anyone
2. Needs to recognize the funding given
3. Absolutely no user fee’s by physicians
4. No extra fee’s by physicians

Question 7

True or False:

The provinces have primary jurisdiction in the administration and delivery of health care services.

Answer 7

True

Question 8

True or False:

The federal government sets the health care priorities and resources for the provinces.

Answer 8

False- the provinces do

Question 9

The federal government sets out the criteria and conditions that must be satisfied by the provinces and territorial health plans to qualify for the federal Canada Health Transfer

Answer 9

True

Question 10

Who is Covered by the Canadian Health Act?

Answer 10

Insured People: a personal lawfully entitled to be or to remain in Canada & have their home in Canada

Question 11

Who are the excluded people from the Canadian Health Act?

Answer 11

Excluded people: Serving members of the Canadian forces and inmates in federal prison
• They have coverage through a separate federal program

Question 12

What are the Insured Health Services?

Answer 12

Medically Necessary Services: hospital, physician and surgical dental services( performed in the hospital) are provided to insures persons
Medically Necessary means: Act does not define, “medically necessary”
It differs between individuals
There is no definition of what is medically necessary, nor is their universal definition around provinces

Question 13

What does the medical necessary Services focus on?

Answer 13

Services provided by physicians and not other health care professionals; and
Services provided in hospitals versus other settings.

Question 14

The Accord is?

Answer 14

• Expired March 31 2014 after the Harper government refused to renegotiate it
• Starting in 2017-18, a major cut to the Health Transfer Tax of $36 billion over 10 years
We Don’t have a Health Accord
• Lack of agreement has left provinces to develop their own plans
• Provinces want a 6% annual increase in health care transfers to the provinces
• Large budgetary demand on federal budget
• Jane phlipt states new accord with address issues such as pharmacare strategy, home care and improved mental health and palliative care services.

Question 15

What do people use their health care for? what brings up the costs

Answer 15

Dental Care
Hearing Aids
Glasses
Drugs
Mobilty 
Reno's
Caregivers
Assisted

Question 16

Why is our health care at issues for sustainability

Answer 16

• Aging population;
• Advanced technology, procedures, diagnostic tests;
• Demanding consumers;
• Increasing prevalence of chronic disease

Question 17

7 for Principles of Heath Reform

Answer 17

No perfect health care system
Adopting ideas from other countries
Simplicity trumps complexity
Place caps on spending and engage in strategic rationing
Fairness in finance and acess
Higher spending does not correlate with quality care
Micromanagement is suboptimal

Question 18

How do we pay for healthcare?

Answer 18

Increase revenue through taxes to pay for healthcare;
Aggressively reduce the costs of healthcare; and/or
Reduce spending in other areas such as education, social services, infrastructure

Question 19

What are the Four Basic Models of Health Care Delivery?

Answer 19

Beverdige
Bismarck
National Health Insurance
Out of Pocet

Question 20

What is the Beveridge Model?

Answer 20

Health care is provided and financed by the government through tax payments
Most hospitals and clinics are owned by the government
Lower costs per capita (gov’t controls what doctors can charge)
Close to total government control
Great Britain

Question 21

What is the Bismark Model?

Answer 21

Health care is financed jointly by employers and employees through payroll deduction (“sickness funds”)
Non profit
Plans have to cover everybody (universal coverage)
Doctors and hospitals private
Tight regulation gives government much of the cost-control power
=== Germany,

Question 22

The National Health Insurance Model

Answer 22

• This system has elements of both Beveridge and Bismark
• It uses private sector providers, but payment comes from a government – run insurance program that every citizen pays into
• Since there’s no need for marketing, no financial motive to deny claims and no profit
• Cheaper and much simpler administratively than American
• Canada, Taiwan

Question 23

Out of Pocket Model

Answer 23

The Out-of-Pocket Model
• Plan” used by most nations which are too poor / disorganized to provide any mass medical care
• In these poor countries, only rich can afford medical care
– In rural regions of Africa, India, China and South America, hundreds of millions of people go their whole lives without ever seeing a doctor
– Rely on ‘village healers’ and home remedies
– May pay a doctor’s bill with potatoes or other produce

Question 24

Pro’s of Obama Care:

Answer 24

Pros: more people have health insurance, affordable, pre existing health coditions aren’t denied, more screenings covered, & low drug costs

Question 25

Cons of Obama Care

Answer 25

higher insurance premium, mandatory to buy (fined), some tax are increasing, and business don’t cover now

Question 26

Explain A grade of B—

why did Canada only get a B ???

Answer 26

• Limited availability of comprehensive health information systems;
• Wait times;
• Management systems that don’t focus on quality of health outcomes;
• Age of population, lifestyle choices, physical activity & eating habits;
• Dropped to 10th place from 5th place due to mental disorders, diabetes, musculoskeletal & cancer diseases and medical misadventure;
• Key issue is lack of physical activity, obesity & diet

Question 27

The Cambie Surgical Centre in British Columbia is a private for-profit clinic offering standard surgical procedures covered by the province to those individuals willing to pay more, and not wait for care. This primarily contravenes what principle of the Canada Health Act?

a) Universality
b) Public Administration
c) Portability
d) Comprehensiveness

Answer 27

B) Public Administration

Question 28

The concept of ‘medical necessity’ is poorly defined in the Canada Health Act, but often aligns with which statement?

a) Basic health needs are covered
b) Patients wanting surgery will be covered
c) Medical services delivered in a hospital by a health care provider are covered
d) Care provided in an emergency or for urgent circumstances are covered

Answer 28

C: Medical services delivered in a hospital by a health care provider are covered

Question 29

• Mr. Kowalski is looking for a family doctor. He learns that he can obtain one by joining a family practice clinic, but will have to pay a $1,200 enrollment fee.
o Which Canada Health Act Principle does this violate?

Answer 29

Acessibility & they are charging a user fee

Question 30

• Mrs. Gomes lives in Barrie, Ontario and is moving to an assisted living residence in Montreal to be closer to her daughter. She is worried about what will happen when she tries to access healthcare in Montreal.
o What will you tell her as a nurse?

Answer 30

Notify her about the portability principle