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D2 > Module 1 HISTORY HCS > Flashcards

Module 1 HISTORY HCS Flashcards

1
Q

BNA Act

A

-1867
-British North Act
-Explained how the newly formed Canadian government would work under the new confederation
-Federal government (National) umbrella over the smaller provincial governments

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2
Q

BNA FEDERAL government responsibilities

A

-Health of indigenous people
-Health policy and contagious diseases
-Pharmaceutical and Food safety

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3
Q

Pharmaceutical and Food Safety became ..

A

The department of health in 1919

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4
Q

BNA PROVINCIAL & TERRITORIAL government responsibility

A

Public health
-hospitals
-mental health facilities/asylums
-education
-Social services

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5
Q

Following the BNA act all provinces passed legislation

A

“Insanity act”

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6
Q

Asylums

A

-Were first introduced as “retreats from society”
-Built the hope that with early intervention and several months of rest people with mental illness could be cured

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7
Q

Asylums “Bedlam”

A

In the eighteenth century, Europeans used to travel to bedlam to watch the people who lived there as holiday entertainment

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8
Q

History of Mental Health “causes”

A

-Demonic possession, sin, or biological causes

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9
Q

History of mental health early care

A

-included a variety of treatment forms; mostly inhumane
-1700’s began more humane treatment due to french physician Philippe Pinel

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10
Q

Philippe Pinel

A

-Cause for more humane treatment for mental health in 1700’s
-Began social and psychological approaches = Moral Therapy
-first to start talking to patients, no chains =social and empathy psychological therapy (not successful)

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11
Q

Canadian Asylums

A

-Early asylums began in Quebec and the Maritimes
-Eventually each province opened an asylum
-Moral therapy lacked access
-Overcrowding in asylums
-1900th century began radical therapies

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12
Q

20th Century Canadian Asylums

A

-Electroconvulsive Therapy
-Lobotomies
-Psychotherapy

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13
Q

Dorthea Dix

A

-Advocate in the 1800’s for more humane treatment (Canadian asylums)
-Met with Pope

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14
Q

Changes to Canadian Asylums

A

-Late 1950’s-1960 = introduction of psychotropic drugs
-Provincially funded psychiatric hospital
-Changing values
-New philosophies in mental health care
-Promise of deinstitutionalization

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15
Q

Deinstitutionalization

A

-1950’s-1980’s
-Canadian Mental Health Association (CMHA) published a framework for mental health reform (1963)
-Recommendations “mental health should be dealt with in the same organizational, professional framework as physical illness”
-“Receive the same excellence of medical care”

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16
Q

Deinstitutionalization =

A

Dehospitalization

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17
Q

Deinstitutionalization/Dehospitalization

A

-A shift from the institution to the community
-More humane
-Less expensive
-The use of psychotropic medication
-Community based services
-Community housing
-Canadian Mental Health Association

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18
Q

Deinstitutionalization outcome

A

-Not as successful as planned
-Limited resources in place
-Trans institutionalizations
-Policy changes continue = The mental health strategy for Canada and the 2007 Senate report “Out of the Shadows at Last”

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19
Q

Provincial & Territorial Government responsibilities

A

-First hospital Hotel Dieu de Quebec in 1637 =relied on financing from the wealthy & organizations
-1900’s -Governments started providing some funds for hospitals
-Religious and charitable agencies

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20
Q

In the 1920’s Majority of health services were delivered by:

A

-Volunteer agencies

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21
Q

1920’s Volunteer Agencies

A

-Order of St. John (St John Ambulance)
-The Canadian Red Cross Society
-Victorian Order of Nurses (VON)
-Children’s Aid Society
-Canadian Mental Health Assoc

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22
Q

Medical and Hospital Care 1800’s-1900’s - Poor

A

-No health care
-Family provided
-Received health care in crowded hospitals

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23
Q

Medical and Hospital Care 1800-1900’s -Wealthy

A

-Avoided hospitals
-Hired Dr’s privately
-HC provided by nurses in homes

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24
Q

Medical and Hospital Care 1800’s-1900’s -Middle class

A

Somewhere in between

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25
Q

Historical Indigenous Health Services

A

-Provided by Shamans, Medicine men or women
-Indigenous philosophy of health
-Four sacred medicines

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26
Q

WW1

A

-WW1 was a global war originating in Europe that lasted from July 1914-November 11 1918

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27
Q

WW2

A

World war 2 also known as the Second World War was a global war that lasted from 1939-1945

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28
Q

Influences of the World Wars -Medical Advances

A

-Between 1919 and 1939 improved medical care
-Triage was introduced
-The traumatic injuries required advanced anesthesia, infection control and surgery
-Stored blood (blood banks)
-X ray machines improved
-Powerful electron microscopes were invented
-Oximetry was developed during WW2
-Penicillin

29
Q

Canadian Medical Discoveries (1922)

A

Advent of insulin

30
Q

Canadian Medical Discoveries (1936)

A

Hans Selye = Father of the field of stress research

31
Q

Canadian Medical Discoveries (1948)

A

First artificial kidney machine

32
Q

Canadian Medical Discoveries (1950)

A

Introduction of lumpectomy for treatment of breast cancer

33
Q

Canadian Medical Discoveries (1951)

A

First device to deliver radiation in the treatment for breast cancer

34
Q

Canadian Medical Discoveries (1961)

A

Discovery of blood forming stem cells

35
Q

Canadian Medical Discoveries (1965)

A

First artificial knee joint

36
Q

Evolution of Social Safety Net: The Great Depression

A

-Formerly independent people joined public welfare
-Assistance was granted in the form of food, clothes, and fuel
-This aid was money left from 19th century poor relief systems of municipal aid and supplemented by charitable donations

37
Q

Evolution of Social Safety Net

A

-As a result of the Great Depression, Canadian social-political philosophy changed
-Governments through tax dollars, should play a role insuring an acceptable standard of living and access to services for all

38
Q

Nationally Legislated Social Safety Net (1942)

A

McKenzie King (PM) unemployment insurance

39
Q

Nationally Legislated Social Safety Net (1944)

A

Family allowance (now called child tax benefit)

40
Q

Nationally Legislated Social Safety Net (1948)

A

National Health Grants Program

41
Q

Nationally Legislated Social Safety Net (1952)

A

Old age security (70 yr and older)

42
Q

Prior to Medicare

A

-Before WW2 health care in Canada was privately delivered
-Doctors often went without payment
-People suffered and or died without medical care
-Financial ruin

43
Q

Tommy Douglas

A

-1904-1986
-Believed health was a basic human right available to anyone on the basis of need
-Leader of first socialist party in North America
-As premier of Sask. introduced government insurance for hospitalization and later, medical doctor visits
-Led way for social reforms in the rest of Canada

44
Q

Tommy Douglas Growing Up

A

-Born in 1904
-Born in Scotland
-Immigrated to Winnipeg
-Was diagnosed with osteomyelitis in leg
-Couldnt afford surgery, surgeon donated care to save
-Witnessed beatings of workers in Winnipeg general strike
-Became Baptist minister and went to Brandon College
-First posting as minister in 1930 in SK during economic depression

45
Q

Evolution of Medicare: First Stage

A

-To remove money as a barrier to access to care
-Government of SK under tommy Douglas
-Municipal & Hospital Services plan (1947) guaranteed residents of Sask hospital care in insurance premiums

46
Q

Evolution of Medicare

A

-1957 hospital insurance and diagnostic services act
-50/50
-Sharing cost

47
Q

Evolution of Medicare: Next step

A

-1966 Medical Care act (based on Hall commission) =cost sharing of hospital and medical services
-All provinces
-No one would be denied health care for economic reasons

48
Q

Medical Care Act/Medicare

A

-Each province/territory was allowed to administer the plan independently within the guidelines set by the Federal government
-The 5 pillars of healthcare must be met
-Medicare covers hospital costs and medically necessary expenses
-Fee for service
-2nd stage of Medicare > Prevention

49
Q

5 Pillars of Healthcare

A

-Universality
-Portability
-Comprehensive coverage
-Public administration
-Accessibility

50
Q

Fee for Service

A

Oldest and most widely accepted method of physician payment in Canada

51
Q

1970’s

A

-Health system flourished -hospitals were built
-Health spending increased
-Provinces saw the need for health services within the community
-Response: Federal Provincial Fiscal Arrangements/Established Programs Financing Act 1977

52
Q

Established Programs Financing Act

A

-Funding was reallocated to community services, long term care, ambulatory care, and some components of home care

53
Q

Alexander Fleming

A

Discovered penicillin

54
Q

Department of health now

A

Health Canada

55
Q

Asylum first opened in

A

Islamic societies
Was meant to be peaceful until Europe religious view ruined it (different treatment)

56
Q

Type of patients sent to asylums

A

Those with:
Learning disabilities
Dementia
Post partum

57
Q

1900th century radical treatments

A

-leaching, spinning chair, insulin shock therapy

58
Q

Trans institutional settings

A

Smaller
Boarding homes
Group homes
Foster homes
Nursing homes
Prisons

59
Q

Health Care Reform

A

-Late 70’s-80’s
-Block transfers - provinces paid more
-Hospital cutbacks
-Restrictions on MD fees
-Extra billing
-User fees

60
Q

Hall Report #2

A

-Canada’s National Provincial Health Program Report for the 1980’s
-Extra billing - violated Medicare
-Was a movement towards a 2-tiered health system
-Recommendations: doctors could bill outside Medicare
-National standards be set
-Accessibility be added
-Form a National Health Council

61
Q

1980’s Health Care Reform: Lobby for action

A

-Canadian Nurses Assoc
-Nurse unions
-Other health care agencies lobbied strongly for the maintenance and improvement of Medicare

62
Q

1980’s Health Care Reform - Lobby Against Action

A

-Physicians
-Dr strike in Ontario
-Banning extra billing violated their rights to contract directly with patients

63
Q

Health Care Reform of 1990’s

A

-Federal liberals significantly reduced funding to provinces
-Hospitals had trouble functioning within reduced budgets
-Closures, restructuring, downsizing, services cut and lay offs
-Doctors and nurses left the country
-Fewer nurses were needed, nursing education programs were cut

64
Q

History of Canada Overview 1950’s-1990’s

A

-1950’s-1960’s = Federal Government played a central role 50/50 cost sharing
-1970’s = Federal Government began to withdraw from central role/less transfer of money, less restrictions
-1980’s = increased costs lead provinces to introduce “extra billing”
-1984 = Fed Gov concerned of encroachment of universality and accessibility = Canada Health Act 1984
-1990’s = no more money

65
Q

2000’s new report

A

-From Michael Kirby
-2002
-Said Canada’s HC system was not sustainable as operated
-Suggested new taxes or insurance based on income
-Wanted privatization

66
Q

Evolution of our HC system (2002)

A

-Royal Commission = The Commission on the Future of Health Care in Canada
-Purpose: to preserve Medicare’s survival
-The Romanow Commission
-Consultations across the country

67
Q

Romanow Commission Findings

A

-HC system was sustainable
-Recommended polices and measured to improve the system and it’s long term sustainability (including reducing wait times)
-Create a Health Council of Canada (monitoring body)

68
Q

Romanow’s Recommendations

A

-To create Rural and Remote Access Fund to improve timely access to care in rural and remote areas
-To create Diagnostic Services Fund to reduce wait times for diagnostic services
-To develop a Primary Health Care Transfer to remove obstacles to the renewal of primary care delivery (Health Canada)

D2 (4 decks)

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