Module 2

Question 1

Canada’s HCS is primarily under the control of….

Answer 1

Provinces and Territories –> British North America Act

Question 2

How are national objectives achieved?

Answer 2

• Financial incentives –> Carrots and sticks by the federal Gov’t
• Voluntary and collaborative action

Question 3

Define canada’s health care system

Answer 3

-a predominately publically funded, privately delievered system of 13 interlocking independent health care systems

Question 4

Macro Components

Answer 4

Drugs, Hospitals and other facilities, HCP, Funding

Question 5

Hospitals

Answer 5

• 95% of hospitals operate on non-profit basis
• Global Spending Budget –> Must operate within this budget

Question 6

Physicians

Answer 6

• often first point of contact
• systems gatekeepers - control access to specialists, diagnostic testing, etc
• reimbursed by public funded sources
• fee-for-service based on quantity of services provided rather than quality of care

Question 7

Community HCP paid by….. and hospital paid by…..

Answer 7

1. Private, work related insurance, or out of pocket
2. Medicare

Question 8

Is drug therapy often covered by medicare?

Answer 8

No

Question 9

Do most canadians have drug coverage?

Answer 9

yes

federal drug plans, provincial, private, worker compensation boards

Question 10

Primary Care

Answer 10

First contact
Pharmacists, nurses, physicians
Doctors office, out-patient clinics, pharmacies, etc

Question 11

Secondary Care

Answer 11

• Psychiatric medicinal and surgical care
• Network of regional hospitals provide basic acute care and emergency services
  PA, North Battleford, Swift Current, etc

Question 12

Tertiary Care

Answer 12

• Highly sophisticated diagnostic and tx
• Often by referral from secondary care
• Neurosurgery, oncology, etc.
• Regina, Saskatoon, PA

Question 13

Rehabilitation

Answer 13

• Major emphasis on teamwork and collaboration

Question 14

Rehabiltation Covered by….

Answer 14

Medicare, Private Insurance or out of pocket, WCB and SGI

Question 15

Two-tiered healthcare/medicine

Answer 15

Hospitals have global funding. Not included is SGI and WCB. If get WCB and SGI in, get more money
Public –> Longer wait times

Question 16

personal Care Home

Answer 16

• light needs not covered by community-based services
• cover the cost

Question 17

Special care homes

Answer 17

• facility that provides institutionalized long term care services to meet:
• People with heavy needs that cannot be appropriately met through home/community based services

Question 18

Public Health Involves

Answer 18

a) Population health assessment
b) Health promotion, monitoring and surveillance
c) prevention and protection

Question 19

Define Medicare

Answer 19

• a public-funded single-payer system that provides through hospitals and physician services deemed medically necessary without financial cost to insured persons

Question 20

HIDS

Answer 20

Hospital insurance and diagnostic services act
- fifty-fifty cost sharing agreement between Feds and Provs

Question 21

MSA

Answer 21

Medical Services Act
- National medical service program to compliment HIDS

Question 22

What two acts make medicare?

Answer 22

HIDS and MSA

Question 23

What are the principles of Medicare?

Answer 23

Publically adminstered
Comprehensive
Universal
Accessible
Portable

Question 24

Publically Adminstered

Answer 24

The health plan of each province or territory must be administered and operated on a non-profit basis by a public authority accountable to the provincial government.

Question 25

Comprehensive

Answer 25

must cover all medically necessary services provided by hospitals and physicians. Includes drugs administered in hospitals and a range of out-patient services.

Question 26

Universal

Answer 26

The plan must entitle 100 percent of the insured population to all insured services based on uniform terms and conditions

Question 27

Accessible

Answer 27

Must provide reasonable access to insured services without barriers.

Question 28

Portable

Answer 28

Residents are entitled to coverage when they move to another province, or when travelling within Canada or abroad.

Question 29

Private Insurance in Medicare

Answer 29

Medicare does not allow for private insurance for health services covered by Medicare.

As a result, private insurance is only available for services not covered by Medicare such as prescription drugs, and services provided by non-physician HCPs in the community

Question 30

Chaoulli Decision

Answer 30

a right to private insurance where the public system is inadequate

if the public system fails to deliver care within a reasonable time (access), individuals have the legal right to purchase/use private insurance.

Question 31

Rule of Exclusivity

Answer 31

Doctors are not required to participate in Medicare.

If not participating in Medicare physicians are free to charge patients for covered elective services; but cannot concurrently receive payments from Medicare for some patients and privately for other patients for the same covered services.

Question 32

Attributes of Quality in Canada’s HCS

Answer 32

Accessible - avilable when and where care is needed
Effective - tx that work
Safe - Low risk of harm
Patient-centered - reflect pts preferences
Equitable - to each according to need
Efficient - best bang for buck
Properly resourced - appropriate funding
Integrated - organized and connected to reduce waste
Population health focus - prevent illness and enhance health

ASEEPP

Question 33

Stereotype

Answer 33

• a generalized conception of people that results in a concious or unconcious categorization of the members of the group

Question 34

Prejudice

Answer 34

• beliefs, feelings, opinions and actions directed toward partcular individuals or groups based on stereotypical generalizations

Question 35

Discrimination

Answer 35

• the denial of equitable treatment, civil liberties and or oppurtunities to individuals or groups
• education, acess to services, employment, etc.

Question 36

Cycle of Discrimination

Answer 36

1. Observed practice/behaviour of entire group
2. Stereotype “They are”
3. Prejudice “They can’t”
4. Discrimination “We won’t”
5. Reaction “They will” –> frustrated by attempts to overcome exclusion, group members focus efforts on permitted roles and cativities

Question 37

Are additional charges allowed in Medicare?

Answer 37

Additional charges for insured services are not allowed; but must also provide a ‘reasonable’ level of compensation to the health care facility or provider