6b The Future of Canada's Health System

Question 1

What are some critical disruptions shaping health care’s future?

Answer 1

The greying patient (and provider)
The new health care consumer
The blessing and curse of technology
The rise of chronic disease
The information revolution

Question 2

What percentage of our provincial budget is spent on health care?

Answer 2

Health care now accounts for over 40% of provincial budgets.

Question 3

How much has spending on health care increased in the last decade?

Answer 3

Spending on health care has doubled over the last decade - 215 billion in 2014 (140 billion spent on the public system)

Question 4

What is the largest contributing factor to rise in health care costs?

Answer 4

Increased use of the system

Question 5

What are some things to think about when assessing value for money in health care?

Answer 5

What do we value about health care?
What do we value about the way health care gets delivered?
What do we value about the relationships between providers and patients.
What do we want the system to achieve?
We need a better understanding of what we get for our health care dollars.
Evaluate the efficiency and utilization of our health care organizations/providers.
Ensure we are getting full value for resources.
What are the limits to care?
Ethical and practical implications of finite resources and uncertain knowledge.
Evidence-based health care.

Question 6

What were the implications of the Romanow Report (2002) regarding medicare?

Answer 6

“Medicare house needs remodeling but not demolishing”

Question 7

What were the implications of the Romanow Report (2002) regarding the views of Canadians regarding health care?

Answer 7

Canadians are worried about the fiscal sustainability of their health care system.
Canadians have expressed concerns about timely access.
Canadians want both levels of government to “stop the hollering and finger-pointing that passes for debate”.
Canadians need to clearly express their values.

Question 8

What did the Senator Kirby Report (2001) address?

Answer 8

The fundamental principles on which Canada’s publicly funded health care system is based;
The historical development of Canada’s health care system;
Health care systems in foreign jurisdictions;
The pressures on and constraints of Canada’s health care system;
The role of the federal government in Canada’s health care system.

Question 9

What are the five distinct federal roles in health and health care according to the Senator Kirby Report (2001)?

Answer 9

Financial role
Research and Evaluation role
Infrastructure role
Population Health role
Service Delivery role

Question 10

What is the Federal Government’s Financing role according to the Senator Kirby Report (2001)?

Answer 10

Financing role: The transfer of funds for the provision of health services administered by other jurisdictions.

Question 11

What is the Federal government’s Research and Evaluation role according to the Senator Kirby Report (2001)?

Answer 11

Research and Evaluation role: funding innovative health research and evaluation of innovative pilot projects.

Question 12

What is the Federal government’s Infrastructure role according to the Senator Kirby Report (2001)?

Answer 12

Infrastructure role: support for the health care infrastructure and the health infostructure, including human resources.

Question 13

What is the Federal government’s Population health role according to the Senator Kirby Report (2001)?

Answer 13

Population health role: Health protection, health and wellness promotion, illness prevention, and population health.

Question 14

What is the Federal government’s Service delivery role according to the Senator Kirby Report (2001)?

Answer 14

Service delivery role: The direct provision of health services to specific population groups.

Question 15

What does the political “right” (conservatives) think about sustainability of Canada’s health care system?

Answer 15

The right argues that healthcare costs are progressively being pushed to levels that cannot be sustained, and uses this as a premise for proposing reforms that involve
privatized delivery of services and options for people to pay for their own care.

Question 16

What was the conclusion of the 2008 report by the Fraser Institute?

Answer 16

The report concludes that Canada’s current public health insurance system is simply not financially sustainable through public means alone and recommends several changes.

Question 17

What does the Fraser Institute’s 2008 report suggest as a way to encourage efficient use of health care?

Answer 17

Encourage the efficient use of health care by requiring patients to make co-payments for any publicly funded medical goods and services they use.

Question 18

What does the Fraser Institute’s 2008 report suggest as a way to relieve cost pressures facing the public health insurance system?

Answer 18

Relieve cost pressures facing the public health insurance system by legalizing the right of patients to pay privately (private insurance or out of pocket) for all types of medical goods and services, including hospitals and physician services, as is currently allowed for access to prescription drugs.

Question 19

What does the Fraser Institute’s 2008 report suggest regarding reimbursement to health providers for their services?

Answer 19

Allow health providers to receive reimbursement for their services from any insurer, whether government or private.

Question 20

What does the Fraser Institute’s 2008 report suggest regarding shifting the burden of medical price inflation onto the private sector?

Answer 20

Shift the burden of medical price inflation onto the private sector by allowing providers to charge patients fees in addition to the government health insurance reimbursement level.

Question 21

What does the Fraser Institute’s 2008 report suggest regarding creating incentives for cost and quality improvements?

Answer 21

Create incentives for cost and quality improvements by permitting both for-profit and non-profit health providers to compete for the delivery of publicly insured health services.

Question 22

What does the left (socialist) think about sustainability of Canada’s health care system?

Answer 22

The left argues that we can pay for the health system we want. They say we need to be careful, lest sustainability concerns undo our long-standing commitment to an equitable healthcare system, one where personal means do not determine access to services.

Question 23

What are Jim Adam’s hierarchy of healthcare needs? (bottom to top of pyramid)

Answer 23

Environmental Health Needs (eg. clean wayer, adequate sanitation and clean air).
Basic Healthcare Needs (eg. immunizations and preventative screening).
Medically Necessary Needs (eg. acute care for sickness or injury).
Health Enhancements (eg. cosmetics and LASIK surgeries).
Optimal Health (eg. holistic & personalized health & wellness).

Question 24

What are the components of the Alberta Health Charter?

“When I interact with the health system, I expect that I will:”

Answer 24

When I interact with the health system, I expect that I will:
- Have my health status, social and economic circumstances, and personal beliefs and values acknowledged.
- Be treated with respect and dignity.
- Have access to team-based primary care services.
- Have the confidentiality and privacy of my health information respected.
- Be informed in ways that I understand so that I may make informed decisions about my health, health care and treatment.
Be able to participate fully in my health and health care.
Be supported through my care journey and helped to find and access the health services and care that I require.
- Receive information on the health system and education about healthy living and wellness.
- Have timely and reasonable access to safe, high quality health services and care.
- Have timely and reasonable access to my personal health information.
- Have the opportunity to raise concerns and receive a timely response to my concerns, without fear of retribution or an impact on my health services and care.

Question 25

What are the points in the Alberta health charter regarding expectations of the public?
“Taking my circumstances into account and to the best of my abilities, when I interact with the health system, I understand that I will be asked to:”

Answer 25

• Respect the rights of other patients and health providers
• Ask questions and work with providers to understand the information I am being provided.
• Demonstrate that I, or my guardian and/or caregivers, understand the care plan we have developed together and that steps are being taken to follow the plan.
• Treat health services as a valuable public resource.
• Learn how to better access health services.
• M make healthy choices in my life

Question 26

What is a collective good?

Answer 26

A collective good is one that is consumed collectively

Question 27

What are externalities?

Answer 27

Positive or negative consequences (to others)

Question 28

What is market failure?

Answer 28

> 1 sub-optimal provider, or monopoly

Question 29

What is provision of order?

Answer 29

Monopoly of force/sovereign authority

Question 30

What is social justice?

Answer 30

Absence is unjust or unfair