Health Care Economics Flashcards

1
Q

the Canada Health Act 1984

A

ensures all Canadians have equitable access to health care services based on their need, not on their ability or willingness to pay

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2
Q

which goverment has the primary jurisdiction in health care admin and delivery?

A

provincial and territorial

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3
Q

what is the main role of the federal government in health care?

A

financial

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4
Q

what are the 5 principles under the Canada Health Act?

A
  1. public administration
  2. comprehensiveness
  3. universality
  4. portability
  5. accessibility
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5
Q

what are the 2 conditions of the Canada health Act?

A

recogniton and information

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6
Q

what is covered under the Canada health act?

A

insured health services are medically necessary hospital, physician, and surgical-dental services (performed by a dentist in a hospital

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7
Q

what are uninsured hospital related services under the Canada health act?

A
  • preferred accomodations, patient requests

- drugs & biologicals ordered after hospitalization

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8
Q

what are uninsured physician related services under the Canada Health act?

A
  • phone services
  • acupuncture
  • medical letters required for work, school, insurance etc.
  • cosmetic services
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9
Q

what groups of people are the exception to provincial coverage and have their health services paid for by the federal government?

A

federal penitentiaries, CAF, indigenous peoples

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10
Q

what is the name of the money the ferderal government gives to all provinces and territories?

A

Canada Health Transfer (CHT)

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11
Q

what is the name for the additional money given to the territories from the federal government>

A

territorial formula financing (TFF)

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12
Q

the Canada health transfer amount is based on ____ and not on ____

A

per capita and not based on needs

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13
Q

what 2 things are a break in compliance with the Canada Health Act?

A
  1. extra billing

2. user charges

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14
Q

what is “extra billing”?

A

charging a fee for anything that is an insured service

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15
Q

what are user charges?

A

charging a fee as a condition of receiving insured health services (ex: charging a facility fee)

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16
Q

what is the Canada health act reimbursement policy?

A

the federal minister of health can give reimbursement to provinces who comply with not chrging for insured services

17
Q

what is a premium?

A

a lump sum of money paid in advance of services

18
Q

what is the premium called if everyone pays the same amount?

A

solidarity

19
Q

what is the premium called if risk-related premiums are based on probable claims?

A

actuarial

20
Q

when are user charges/fees paid?

A

at the time of services

21
Q

what is a co-payment?

A

a fixed % of the service cost

22
Q

what is co-insurance?

A

fixed fee per services

23
Q

what is a deductible?

A

total costs of services paid by the patient up to a max, and then everything else is covered by insurance

24
Q

on average (reports by CIHI) what % of services are paid by public and private plans respectively?

A

Public: 70%
Private: 30%