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HLTH305 > Chapter 6: Overview of the Canadian health care system > Flashcards

Chapter 6: Overview of the Canadian health care system Flashcards

1
Q

History: Saskatchewan 1947

A

Tommy Douglas establishes universal hospital care program
Services billed to provincial government

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2
Q

History: Saskatchewan 1961

A

Law establishing universal health care coverage passed

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3
Q

History: Saskatchewan 1962

A

Doctor’s strike and Saskatoon agreement

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4
Q

Why did doctor’s strike in 1962?

A

In opposition to the public medical insurance in the province bc citizens associated it with socialism

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5
Q

Saskatoon agreement

A

Permitted doctors to charge patients more than what they were reimbursed from the government
They could extra-bill their patients for the services provided

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6
Q

History: Canada 1957

A

Hospital insurance and diagnostic services act
- provided cost-sharing of hospital and physician services

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7
Q

History: Canada 1965

A

Hall commission report 1
- calls for a universal and comprehensive national insurance program

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8
Q

History: Canada 1966

A

Medical care act
Provinces paying 50% and federal government paying 50%

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9
Q

History: Canada 1979

A

Hall commission act 2
- Abolition of extra-billing and user fees

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10
Q

History: Canada 1984

A

Canada health act
- combined hospital insurance and medical care act

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11
Q

Federalism

A

Divides political authority btwn federal and regional/sub-national governments (provinces and territories)

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12
Q

Why is federalism a source of tension?

A

Federal and provincial governments deciding what they’re required to fund, regulate and reform

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13
Q

Structure of Canada’s health care system

A
  • 13 single payer provincial/territorial health insurance plans
  • Private fee-for-service
  • Fees negotiated btwn provinces and provincial medical associations
  • Primary care is gatekeeper to specialized care
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14
Q

Single payer system

A

Each province and territory has a single government insurance plan that provides a comprehensive range of medical and hospital services

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15
Q

Private fee-for-service

A

Physicians send claims for payment to provincial and territorial health insurance plans and they are reimbursed on basis on the fee schedule

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16
Q

Fee negotiation

A

Provincial government and medical associations of each province or territory get together and decide cost of service

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17
Q

Why is primary care a gatekeeper to specialized care?

A

Family doctors see you first and then can refer you to specialists to reduce costs

18
Q

How do Canadians access care- primary health care?

A

ie. family doctors
- Direct provision of care
- Coordinates patient’s access to health care system for specialized care

19
Q

How do Canadians access care- secondary services?

A

Delivered at hospital, LTC, clinics
Provinces pay for certain home care services

20
Q

Secondary services for veterans

A

Veterans affairs Canada provides home care services to veterans

21
Q

Secondary services for First Nations

A

Federal government provides home care services to First Nations on reserve and some Inuit communities

22
Q

5 principles of medicare (Canada health act)

A
  1. Universality of coverage
  2. Portability of coverage
  3. Reasonable accessibility to services
  4. Comprehensiveness of services
  5. Public administration
23
Q

Universality of coverage

A

Provinces cover 100 percent of their residents hospital and physicians’ services

24
Q

Portability of coverage

A

Residents are covered when they travel outside the country

25
Q

Reasonable accessibility to services

A

Financial charges or other barriers should not impede access to health services
Reasonable compensation to health professionals

26
Q

Comprehensiveness of services

A

Provinces cover all medically necessary services provided

27
Q

Public administration

A

The provinces have to administer their health insurance programs themselves

28
Q

Laws governing funding

A
  1. Sections 91 and 92 of constitution
  2. Medical care act (1966)
  3. Established programs financing act (1977)
  4. Canada health and social transfer (1995)
  5. Canada health transfer (2004)
29
Q

Sections 91 and 92 of the constitution

A

Provinces and territories have primary control over the organization, administration and delivery of health care
Federal government can intervene in health care only through its spending power

30
Q

Established programs financing act (1977)

A

50:50 cost-sharing is replaced with block funding

31
Q

Block fund

A

Sum of money given by one level of government to another for a specific purpose

32
Q

What did block funding lead to?

A

Decreased percentage of funding paid by federal government

33
Q

Canadian health and social transfer (1995)

A

Replaced EPF funding
Single block transfer that empowers federal government to freeze and cap transfers to provinces and territories

34
Q

Canada health transfer (2004)

A

It was recognized that the Canadian health and social transfer was too broad, so they split it up into the Canada health transfer and Canada social transfer

35
Q

Why did they split up the Canada health and social transfer?

A

To provide a certain amount of funding for health care, separately from social funding
When it is grouped together as one lump-sum it is hard to know how money is distributed

36
Q

Current issues with Canadian health care

A

Growing costs
Decreased federal contributions
Tension btwn federal and provincial governments
Wait times
Calls to privatize and charge user fees
Lack of focus on prevention of social determinants of health
Drugs, mental health not covered

37
Q

What should health care reforms focus on?

A

Not only providing more money to the system, but deploying existing resources more efficiently

38
Q

How can health care reform deploy existing resources more efficiently?

A

Centralized intake of patients
Interdisciplinary groups
Doctors working in groups
More after hours primary care clinics to relieve burden on emergency department

39
Q

Why does the US spend so much on health care but see the worst outcomes?

A

Spending money on expensive treatments and technologies
Multi-payer system

40
Q

Current health care funding provided to provinces by federal government?

A

Canada health transfer

HLTH305 (10 decks)

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