lecture 5 (ch 8)

Question 1

list 3 types of healers

Answer 1

allopathic doctors
homeopathic doctors
eclectics

Question 2

allopathic doctors

Answer 2

aka regulars
cure by opposites
heroic measures

Question 3

homeopathic doctors

Answer 3

let like be cured by like

stimulate sick persons natural defences by using small amount of natural substance that in larger amounts would cause the same symptoms

Question 4

eclectics

Answer 4

botanical medicine

used herbal based remidies in massive doses creating complex, compounded drugs

Question 5

what is common w all types of healers

Answer 5

must have passed experience down to mentee, barely did any training, and then established their own practice

Question 6

how did allopathic doctors come to assume medical dominance in 19th century?

Answer 6

first to attempt to organize themselves as a profession

allopaths sought to:
- license allopathic doctors and control admittance to practice of medicine
- distinguish allopathic meds from other healers

Question 7

the order in which the STATE formally recognized the health care professions was as follows:

Answer 7

homeopathy (1859)
eclectics (1861)
allopaths (1869)

Question 8

who made flexner report + what year

Answer 8

Abraham Flexner

1910

Question 9

result of flexner report

Answer 9

80% of medical schools were closed

ushered in new standard of medical education

Question 10

what did flexner report recommend

Answer 10

eliminate apprenticeship system (instead taught thru school)

medical schools should be affiliated w universities (to ensure highest caliber med schools)

implement standardized entry requirements to med school (so best students are accepted)

scientific method as the only way to understand and treat disease

hospitals to be centers of learning

Question 11

Canada medical act

Answer 11

1912

recommendations of flexner report led to standardized procedures across canada, which became called the canada medical act

it gave allopathic doctors medical dominance defined as;
- freedom from control by other occupations and groups
- ability to control other health occupations

Question 12

what year did government first mention implementing medical insurance system

Answer 12

1919

Question 13

year of dominion provincial conference on reconstruction

Answer 13

1945

Question 14

who was tommy douglas + what he do

Answer 14

in 1947, he was premier of Saskatchewan

started Hospital Insurance Plan
- 5 dollars per person annual fee to max of 30 dollars a household
- patients were not charged for hospital services
- by end of year nearly all of Saskatchewan was covered
- success of this inspired other provinces

Question 15

Hospital insurance and diagnostic services act (HIDSA)

Answer 15

1957

federal gov and provinces agree to share medical costs
- fed gov takes 50% and provincial takes other 50%
- in exchange, province agrees to abide by national standards for hospital care and submit to an annual audit

Question 16

what did tommy douglas do in 1959?

Answer 16

introduced bill for medical insurance, covering more than just hospitals

5 principles of bill
- universal
- annual fees (socialized medicine)
- public control
- improvements to healthcare system
- legislation must be approved by doctors n public

Question 17

socialized medicine

Answer 17

cost of program distributed over entire population instead of person paying right after a visit

Question 18

what happened to medical insurance in saskatchewan in 1962

Answer 18

it became a law

Question 19

medical care act

Answer 19

1966

passed by fed gov + was fully implimented nationally by 1972

4 principles:
- universal
- all eligible citizens entitled to insured health services
- publicly administered
- offered on not for profit basis by public authority accountable to the government

Question 20

under the medical care act were ppl entitled to coverage when they moved to another province?

Answer 20

yes but they had to live there for 6 months before coverage started

Question 21

what replaced the medical care act and the hospital insurance and diagnostic services act?

Answer 21

canada health act

Question 22

canada health act

Answer 22

1984

added fifth principle; accessibility

• access to medically necessary hospital and physician services must be unimpeded by financial or other barriers
• eliminated extra billing and user fees

Question 23

how would we describe our Canadian system

Answer 23

first dollar coverage

publicly funded

privately provided

provincially adminstered

national health care plan

Question 24

how are doctors paid under our system

Answer 24

fee for service basis, not for each patient

Question 25

block funding

Answer 25

fed gov annually transfer provinces a block of money for healthcare which would increase based on the economic growth

Question 26

established programs financing act

Answer 26

1977 changed from shared costs to block funding reduced fed gov share of the cost of medical insurance from 50% to 25%

Question 27

when was health care first perceived to be in crisis

Answer 27

when established programs financing act started in 1977

Question 28

3 phases of development

Answer 28

mid 1970-1991 growth phase 1992 - 1996 - growing concern abt costs of healthcare - cost of health care began to decline - gov face large discal deficits - leads to retrenchement and disinvestment 1997 - now - return to stability; growth phase - introduction of CHST - fed gov begins to provide money to provinces to achieve goals

Question 29

Canada health and social transfer (CHST)

Answer 29

was split in 2003 into Canada health transfer and Canada social transfer

Question 30

new agreemeent in 2003 from stephen harper

Answer 30

6% annual increase extended until 2016, thereafter increases are tied to economic growth hands off approach; no further investment in system wide improvements, leaving provinces to innovate on their own

Question 31

what other challenges does canadian health care system face?

Answer 31

june 2005 supreme court decision court rules that access to waiting list is not access to health care it is unconstitutional to ban private insurance if public system cannot provide services in timely manner

Question 32

how did quebec respond to the june 2005 supreme court decision

Answer 32

introduced parallel private (for profit) system