Chap 6 Health Care Flashcards Preview

FIN 512 > Chap 6 Health Care > Flashcards

Flashcards in Chap 6 Health Care Deck (27):

Health care / 5 criteria provinces and territories must meet under the Canada health act

1) public administration
2) comprehensiveness
3) universality
4) portability
5) accessibility


Health care / comprehensiveness

It must cover all health services provided by hospitals, physicians or dentists and additional services where the law permits it


Health care / universality

All provinces or territory's residents must be covered by the plan


Health care / accessibility

The same service must be provided for all residents in all provinces or territories


Health care / 2 services prescribed by the health act

1) extended heath care service
2) insured health service


Canada Health Act/ 4 extended heath care services

1) nursing home intermediate care service
2) adult residential care service
3) home care service
4) ambulatory health care service


Canada Health Act/ insured health service

This means hospital service, physician service and surgical dental services provided to insured persons, but does not include any health services under any other act of parliament and provincial workers' compensation


Canada Heath Act /3 prohibitions

1) extra billing
2) user charge/fee
3) any service provided by a provincial plan may be not provided by a private clinic for a fee


Canada Health Act/ excluded coverage

1) Uninsured hospital service (private room, telephone and television)
2) uninsured physician service ( telephone advice, medical certificate, court testimony, cosmetics service, tattoo removal)


Canada Health Act / 4 people not covered

1) member of Canadian forces
2) royal Canadian mounted police
3) prisoners
4)persons who have not completed s min period of residence in Canada


Alternative medical practitioners partially covered by some provinces and territories

Chiropractors, podiatrists, osteopath, naturopaths, licensed massage therapists, acupuncturists, physiotherapist


opted out and non participating physicians

every jurisdictions allows physicians to operate outside the provincial and territorial health plan and bill their patients directly;


opted out doctors (definition)

bills the patient directly at the amount not exceeding the amount in the schedule of benefit and the patient is then reimburced


non participating doctors

bills the patient directly without regard to the limits of the schedule of benefits and the patient cannot be reimbursed


Health care : 5 priority areas

1) Cancer care
2) Cardiac treatment
3) diagnostic test
4) Joint replacement
5) Cataract surgeries


health care: 5 areas that need to be addressed

1) Wait time for children
2) Surge capacity
3) Health Human Resource
4) Gender based analysis
5) Cinderella diseases


Health care: surge capacity

ability to access unused capacity outside of the local region or province in case of an emergency


health care: Cinderella diseases

Diseases that were not recognized or prioritized in the 5 areas selected in the benchmarks


health care: 5 reasons for longer wait time

1) poorly organized services
2) shortage of healthcare workers
3) physicians not working in teams
4) cuts to hospital services
5) need for more long term and home care


American health care: medicare

universal health care for people over 65


American health care: medicaid

universal healthcare for low income people


2 types of supplementary health care plan

1) group plans provided by employers
2) private plans paid for by individuals


Group health plan

Offered by employer or associations. When premiums are only paid by employers, employees must pay extra for family coverage


Health care: cafeteria plan

each employee is allocated a certain number of points and chooses the coverage he or she will spend the points on


health care group plan coinsurance and deductible requirements

annual deductible between 35 and 50$ and there is no penalty for being under-insured since rates increase every year


Long term care insurance

can apply for it between 18 and 80. Once in place, it cover for life if you have cognitive impairment or can no longer perform 2 of the 6 activities of daily life


3 types of long term care insurance

1) Reimbursement policies
2) indemnity policy
3) income policy