Module 06 Flashcards
(101 cards)
1
Q
What does Universal health coverage do according to the WHO?
A
- includes health promotion, prevention, treatment, rehabilitation, and palliative services
2
Q
What are the two criteria that a country needs to meet to be classified as a provider of universal health coverage
A
- passed legislation
- essential service coverage
3
Q
explain when a country has met criteria of passing legislation
A
- if they possess healthcare legislation that explicitly states that the entire population is covered under a specified health plan
4
Q
explain when a country has met criteria of essential service coverage
A
- is based on the service coverage index which is rated on a scale from 0-100, and is a measure of essential health service coverage based on 4 components
- high score = high coverage
5
Q
what are the 4 components of essential health service coverage
A
- Reproductive, maternal, newborn, and child health
- Infectious diseases
- Non-communicable diseases
- Service capacity and access
6
Q
what are the 4 main methods used by countries to finance healthcare coverage
A
- social insurance
- self-coverage
- private health insurance
- employer based insurance
7
Q
explain social insurance
A
- Employers and employees, including self-employed individuals, pay contributions towards health services
- Usually legislated by law and covers the entire population
- Wealthier people and companies often pay more into these funds
- Governments may contribute subsidies to provide increased funding
8
Q
explain self-coverage
A
- Healthcare insurance is provided and financed by the government through tax payments
- Taxes such as income tax and sales taxes on goods are some examples that fund state-based coverage
- money is pooled by the government and used according to the country’s need
9
Q
explain private health insurance
A
- Individuals purchase private healthcare insurance to cover the cost of healthcare services
- available to all at a nominal cost
10
Q
explain employer based insurance
A
- Insurance is purchased by employers for their employees and financed through employer or join employer-employee contributions
- may be subsidized by the government
11
Q
explain access to services
A
- provided at little or no cost to the individual
- close in proximity to where the individual resides
- comprehensive medical, dental, eye care, mental health, and pharmaceutical
12
Q
what makes health services good quality
A
- Healthcare professionals have the resources they need to provide quality care
- Evidence-based healthcare services and policies
- Client-centered care
- Timely service
- Educated and efficient healthcare workers
13
Q
what are the 3 different UHC systems
A
- single-payer coverage
- regulated private coverage
- mixed public-private
14
Q
what country has a single-payer coverage system
A
UK
15
Q
Which country has a regulated private coverage system
A
- netherlands
16
Q
which country has a mixed public-private system
A
- france
17
Q
explain the single-payer coverage system
A
-What is covered: Comprehensive care with NO copays at point of service
-Who is covered: All residents
-Financing & Care Delivery: Government finances health care with taxes & pays providers directly
18
Q
explain the regulated private coverage system
A
- What is covered: Government-defined health benefits; deductibles for some services
- Who is covered: everyone is required to have insurance unless they qualify for an exception
- Financing & Care Delivery: People pay premiums for regulated private health coverage; insurers pay health providers
19
Q
explain the regulated mixed public-private
A
- What is covered: Wide range of services with some cost sharing; private insurance fills gaps
- Who is covered: all residents
- Financing & Care Delivery: Government finances non-profit funds that pay providers; most people buy additional private insurance
20
Q
what are the 4 underlying requirements that must be met before a country can claim they have reached UHC?
A
- Healthcare system
- finances
- access
- health workers
21
Q
explain healthcare system that meets UHC requirements
A
- A high quality and efficient healthcare system that is able to meet priority health needs
22
Q
explain finances that meet UHC requirements
A
- Financing that supports healthcare services and prevents financial hardships for medical care
23
Q
explain access that meet UHC requirements
A
- To effective technology and medicine to diagnose and treat medical conditions
24
Q
explain health workers that meet UHC requirements
A
- Sufficient capacity of well-trained and motivated health workers to meet the needs of patients
25
what are the 3 main branches of a simple health systems model
- structure
- provision
- health outcomes
26
what does the structure of the simple health systems model include?
- financing
- infrastructure
27
what does the provisions of the simple health systems model include?
- access
- quality
28
what does the health outcomes of the simple health systems model include?
- health outcomes
- equity
- social protection
- public satisfaction
29
what are the 5 components of a well-functioning healthcare system response to needs
- participating
- improving
- protecting
- providing
- defending
30
explain participating
- Making it possible for people to participate in decisions affecting their health
31
explain improving
- Improving the health status of individuals and communities
32
explain protecting
- Protecting people against the financial consequence of ill health
33
explain providing
- Providing equitable access to people-centered care
34
explain defending
- Defending the population against health threats
35
What is the First Nations Health Authority? (FNHA)
- Structure that is separated into black to ensure adequate coverage of healthcare for indigenous peoples across BC
36
What are the three parts of the FNHA funding structure
- protection
- benefits
- support
37
What are the key improvements in health service provisions in indigenous communities from BCs model of indigenous self governance?
- participation: improved participation in immunization clinics
- training: mandatory cultural safety training for staff and access to training programs for remote regions
- access: improved access to health services through remote delivery models and election health services
- time: decreased overall service times
38
What are healthcare systems in high-resource countries marked by?
- their ability to provide high-quality health services to a majority of the population
39
healthcare in canada
- All citizens qualify for health coverage for medically necessary services, regardless of their medical history, personal finances or standard of living
- funding is primarily drawn from the provincial and federal budgets (tax-fund)
- predominately governmental organization of health services
40
why did a group of doctors strongly oppose the new universal healthcare legislation (medicare)
- they believed that the new program would enable the government to dictate how doctors practiced medicine, restricting which diagnostics or treatment could be used
41
does canada achieve UHC?
- yes, over 90% of its population with healthcare coverage which is legislated through the Canada Health Act
42
What does the Canada health act (1984) specify?
- the conditions that provincial and territorial health insurance programs must comply with to receive compensation from the federal government
43
What are the 5 components of Canada Health Act
- public administration
- comprehensiveness
- universality
- portability
- accessibility
44
in Canada where does financing for medically necessary hospital and physician services come from?
- tax-funded public insurance system
45
How are services that are beyond medically necessary paid for?
- paid out of pocket or through private insurance
46
are physicians private entities in canada?
yes
47
what does medicare cover?
- it is required to provide insured persons coverage of insured health services
48
list covered health services
- doc visiits
- in patient-hospital care
- emergency room visits
- most essential surgeries
- psych visits
- pt in hospital
49
List non covered health services
- private psych visits
- dental care
- eye care
- prescription drugs
- cosmetic surgery
- Allied health services
50
How are healthcare services funded in Canada
- provincially funded as set out and guided by the Canada Healthcare Act
51
who is responsible for First Nations and inuit individuals health care
- The federal government based on the Indian Act of 1876 and Treaty 6
52
Who covers the health services not covered by federal government for First Nations and inuit individuals
- First Nations and inuit health branch (FNIHB) of the federal government
53
What is NIHBP inclusion criteria
- a person must be a Canadian citizen and meet one or more of these criteria
- be a registered Indian according to the Indian act
- be an inuk recognized by one of the inuit land claim organizations
- be an infant less than one year of age whose parents is an eligible recipient
54
Are those in the Canadian Armed Forces covered under the Canada Health Act?
- no
55
Who are the Canadian Armed Forces covered by?
- the National Defence Act and as such, their care is under the responsibility and governance of the National Defence
56
What services does the National Defence Act provide Canadian armed forces?
- similar coverage that is provided through provinces or territories that are aligned with the Canada health act
- also required to provide additional and tailored services that meet the unique and high risk nature of the Canadian Armed Forces
- comprehensive medical care, supplemental health care, occupational health care, preventive medicine, health promotion and comprehensive dental care
57
Explain the Interim Federal Health Program (IFHP)
- provides temporary and limited coverage of health care benefits for groups of people not covered under provincial or territorial insurance
58
Who does the IFHP provide coverage for
- resettled refugees, protected person’s in Canada, refugee claimants, victims of human trafficking and detainees
59
What care does IFHP cover
- supplemental health care including urgent dental, eye care, prescription drugs and allied health services such as PT
- the immigration medical exam, including any diagnostic tests required
60
are immigrants covered by IFHP?
- NO
- They are required to cover all costs of their medical needs for three months, until they are eligible to apply for healthcare in the province/territory they reside in
61
Explain France's healthcare system
- largely funded by government national health insurance
- Supplemental coverage may be bought from private insurers
62
why was France ranked the best healthcare system in 2000 by the WHO
- its positive health outcomes and high rating of overall satisfaction by citizens
63
Canada's mental health system
- two-tier system
- those who can afford the services get the care they need and want, and those who cannot, go without
64
Who pays for mental health in canada
- Families pay due to lack of government funding
65
Australias mental health coverage
- Universal health coverage known as medicare, is publicly funded and administered by the federal government
66
Who funds Australias health
- government
- public sector
- private sector
67
Access to primary healthcare in Canada
- struggles with providing access to family doctors
- there is a low practicing doctor per capita ratio, especially when compared to other OECD countries
68
What do long wait times for primary care in canada force people to do
- emergency departments
- walk-in clinics
69
what is Canada's response to long wait times for primary care
- Ontario made changes to encourage and support family physicians to have timely/same-day appointments
- ex. that family physicians are now penalized if their rostered patients seek care in a walk in clinic
70
What is Germany's primary care system
- mandatory private insurance (funded through taxation and insurance premiums) to enable the provisions of universal health coverage
71
What does Germany do well in their healthcare system that Canada could adopt to decrease wait times for primary care?
-Great access to family doctors, as experienced in Germany. Could decrease wait times for Canadians in need of health services
72
Explain home and community care in Canada
- provincial and territorial governments in Canada are responsible for overseeing home and community care for their respective jurisdictions
- many Canadians do not receive the amount of care they need or any care at all
73
What does Canada's aging population mean for the government of canada
- presents challenges to ensure both the well-being of seniors and Canadas future prosperity
74
What does the ACA aim to do
- provide universal healthcare by mandating that all Americans have healthcare insurance
75
Pros of the ACA
- Slows rise of care costs as preventative services are covered
- covers 10 essential health benefits
- coverage of pre-existing conditions
- children can stay on their parents health insurance plans
76
Cons of ACA
- Raised income tax rate
- The ACA taxed those who didn't purchase insurance, until 2019 this fine was eliminated
-buisnesses with 50+ full-time employees need to offer health insurance
77
List the strengths of Canada's healthcare
- Provides access to medically necessary healthcare services through taxation
- Provides relatively high-quality healthcare
- The healthcare system is fiscally conservative
78
What populations lack access to basic medical care
- people coming from low-resource countries
- major global health inequality
79
what must healthcare systems in lo-resource countries do to move towards universal health coverage
- make the most of what they have
- incorporate innovation
- optimize human resources
80
what needs to be considered when comparing health needs in low-resource and high-resource countries
- the health needs in these two populations are very different
* High resource countries: Individuals commonly require care for chronic or lifestyle-based disease. Ex. CVD
* Low-resource countries: Health issues are often associated with: poor living conditions, inability to access healthcare, health illiteracy, malnutrition
81
what is a major barrier to accessibility of healthcare services in low-resource countries
- geographic accessibility
82
what is geographic accessibility influenced by?
- lack of infrastructure and communication in remote areas
- travel time to health services
83
what is geographic accessibility influenced by in indigenous community
- doctor retention and lack of indigenous doctors
- lack of health infrastructure
84
What is 'brain drain'
- when skilled workers leave their communities to pursue better opportunities
- large drains of medical professionals can be detrimental d to a healthcare system, particularly in rural areas
85
what is a major problem in low-resource countries
- retaining talent
86
is Cuba's healthcare system successful?
- yes, cuba has never lacked healthcare professionals in the community
87
What are the 3 principles Cuba's medical model if based on
- Insurance should cover all medical fees
- Health providers should understand and live in the community they serve
- Focusing on the community is more effective than focusing on the individual
88
What is the film SAUD about
- using new approaches and resources to advocate for healthcare globally
89
What did the film SAUD document?
- the healthcare system of several under-developed countries, while highlighting the benefits of Cuba’s remarkable healthcare system
90
What are the key factors in the success of the Cuban Healthcare system?
1. Integration of public health
2. Doctor-patient ratio
3. community health networks
4. Central Government Support
91
Explain iteration of public health in the Cuban healthcare system
- There is equal emphasis on preventative/proactive healthcare services, and disease management/reactive healthcare services
* most other countries focus on disease management not prevention
92
explain doctor-patient ration in cuban healthcare system
- extremely high doctor-patient ration (1 doc per 175 people in Cuba vs 1 doc per 500 people in Canada)
- doctors are more equally distributed throughout the population, allowing them to give quality, uniform health care to all citizens of the country
93
explain community health networks in cuban healthcare system
- policymakers created a system of primary care clinics that brought the doctors directly to the communities, providing them with housing and salaries
94
explain central government support tin the cuban healthcare system
- Many of the features identified would not have occurred had there not been an obvious commitment to health provision by the President
- significant government commitment to health care ensures universal access to healthcare services and a true commitment to health as a human right
95
list the weaknesses of the Cuban healthcare system
1. drug & equipment storage
2. lack of freedom for doctors and patients
96
explain the drug & equipment storage weakness in the Cuban healthcare system
- common and essential medicines and equipment are often conspicuously absent in Cuba
- there is a substantial black market for drugs or medical services that are otherwise accessible
97
explain the lack of freedom for doctors and patients weakness in the Cuban healthcare system
- weaknesses in the following spheres; right to privacy in physician-patient relationship, Informed consent, right to refuse treatment, and right to protest or sue for malpractice
- do not have as much freedom to chose where they will practice
98
what is the south-south cooperation
- using a model of successful programs in one low-resource country to model in another low-resource country
99
what countries have used the south-south cooperation
- cuba & gambia
100
what happened after Gambia followed the cuban healthcare system?
- remarkable transformation in which Cubans helped develop a new health system, increasing access to clean water, reducing the burden of malaria and making improvement to nutrition
101
what were the obstacles of applying 'a cuban model'
- lack of willingness from doctors to meet community needs
- lack of government support for universal access to public health care
