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2RR3-The Canadian Health Care System
Terms in this set (36)
Health Care in Canada
-predominately publicly financed
-Universal, comprehensive coverage for medically necessary hospitalization, in-patient and out-patient services
-Doctors are not employed by the government
-private practitioners paid on a fee for basis service
-set rules and standards
-give money for people for following the rules
-give health services to specific groups
-Deliver Health Services
-Planning, financing, and evaluating provisions of hospital, physician and allied health care services
-managing some aspects of prescription care and public health
first province to establish public, universal hospital insurance: Tommy Douglas
all 10 provinces and two territories had public insurance plans that provided comprehensive coverage for in-hospital care
all provincial/territorial plans had been extended to include doctors' services
1974 Lalonde Report
-The White Paper
-Marc Lalonde - Minister of National Health and Welfare
-A New Perspective on the Health of Canadians: A Questioning of the Efficacy of Medical Interventions
-Report found that health care, in fact, has very little to do with "health"
-More accurate description of the primary activities of the health care sector was "sick care"
-dude basically discovered determinants affected health
Major Contention of the 1974 Lalonde Report
Determinants of Health:
One of the 1st formal statements by any western government concerning the broader array of determinants that define the "health" of a population
Broadened "health care" to the "health care field"
Determinants of Health and the report
changes in lifestyles or social and physical environments would lead to more improvements in health than would be achieved by spending more money on existing health care delivery systems
Preventing illness is better than treating illness
Impact of the 1974 Lalonde Report
gave rise to a number of successful proactive health promotion programs which increased awareness of the health risks associated with certain personal behaviors and lifestyles
fed passes the Canada Health Act to discourage hospital user charges and extra-billing by physicians
the Act provides for an automatic dollar-for-dollar penalty if any province permits such charges for insured health services
Health Promotion Framework
health is a resource for living influenced by our beliefs, culture, social economic and physical environments"
Achieving Health for All: A Framework For Health Promotion
Ottawa Charter for Health Promotion
1986: The Charter and the Framework
-offered a "strategy" for change that embraced the criticisms put forward since the Lalonde report
-focused on the broader social, economic, and environmental factors that affect health
- these determinants include income, education, physical environment
-Health Promotion becomes "mainstream"
1989: Canadian Institute of Advanced Research
Individual determinants do not act in isolation
It is the complex interaction among determinants that can have a far more significant effect on health
Leads to why some groups are healthier than others
1994: Strategies for Population Health: Investing in the Health of Canadians
Population health approach officially endorsed by the federal, provincial and territorial Ministers of Health
Health Canada has now made promoting the population health approach one of its four business lines
Canadian Health Act Five Criteria
The administration of the health care insurance plan of a province/territory must be carried out on a non-profit basis by a public authority accountable to the provincial government
Canadian Health Act
-ensures that all residents have access to medically necessary hospital and physician services
-based on need, not on ability to pay
-sets the criteria and conditions that provinces/territories must satisfy to qualify for their full cash transfers under the Canada Health Transfer (CHT)
All medically necessary services provided by hospitals, medical practitioners, and dentists working within a hospital setting must be insured
Insured hospital services include: in-patient care at the ward level, all necessary drugs, supplies, and diagnostic tests, and a broad range of out-patient services
Chronic care services are also insured (minus accommodation)
What services are "medically necessary"?
Answers the question: "What is covered?"
All insured persons in the province/territory must be entitled to public health insurance coverage on uniform terms and conditions
Answers the question: "Who is covered?"
Coverage for insured services must be maintained when an insured person moves or travels within Canada or travels outside the country
Answers the question: "Where am I covered?"
Reasonable access by insured persons to medically necessary hospital and physician services must be unimpeded by financial or other barriers
Answers the question: "When am I covered?"
no extra-billing by medical practitioners or dentists for insured health services under the terms of the health care insurance plan of the province/territory
no user charges for insured health services by hospitals or other providers under the terms of the health care insurance plan of the province/territory
Where Does The Money Come From?
-Citizens: Federal and provincial taxes, direct purchase of private insurance and direct purchase of medical and non-medical services
Federal Government: Canada Health Transfer
Equalization support to less wealthy provinces
Programs for medical and non-medical research and public health and Direct health services for selected Aboriginal populations, veterans, military personnel, Federal inmates, "foreign" visitors, RCMP
Provinces/Territories: Program and service payments to providers, institutions and health authorities for "medically necessary" doctor and hospital services under the CHA and Supplementary programs not covered by the CHA (eg. Home care, long-term care, drug coverage)
Programs for medical and non-medical research and public health
Who does Federal gov pay for?
Aboriginal populations, veterans, military personnel, Federal inmates, "foreign" visitors, RCMP
Financed primarily through taxation
Some provinces use ancillary funding methods
Alberta and B.C. utilize health care premiums
Today, the fed's contribution to provincial health programs is done in a single block transfer (CHT)
Canada Health Transfer
Largest federal transfer to provinces/territories
Provides cash payments and tax transfers in support of health care
Gives provinces/territories the flexibility to allocate payments according to their priorities, while upholding the principles of the CHA
Provincial health insurance plans must adhere to the principles of the CHA in order to be eligible for the full federal transfer payments
What if Provinces break rules?
they dont get money
Produced by the federal Minister of Health, Health Canada, and the Department of Justice
Full examination of each province/territory and their compliance to the CHA
Typically, when a province/territory is penalized, it is either because of extra-billing issues or queue jumping
Health care spending accounts for one-third of provincial program expenditures
Weaknesses of the System
Home Care focus:
Long term care substitution
Acute care substitution
"all provinces and territories provide a range of health services that go beyond the requirements of the CHA"
These include programs such as pharmacare, home care, ambulance services, and aids to independent living
The Canadian Health Care System is not designed to prevent illness
Who is responsible for preventing us from getting sick?
Both the Federal and Provincial governments have started to shift the emphasis of the health care system away from institutionally-based delivery models to integrated community-based models which place increased emphasis on health promotion and prevention
2002: Royal Commission on the Future of Health Care in Canada
Focus on the Determinants of Health
Regional and Community Delivery of Health Services
Primary Health Care Reform
A Change In The System
Federal Government has attempted to combine a Population Health Model with a Health Promotion Model
This constitutes a shift away from acute care
Most provinces/territories have decentralized decision-making on health care delivery to the regional or local board level
Health Care Reform
2004: First Minister's Meeting on the Future of Health Care: 10-year plan to strengthen health care
Reducing Wait Times and Improving Access
Strategic Health Human Resource (HHR) Action Plans
Primary Care Reform
Access to Care in the North
National Pharmaceuticals Strategy
Prevention, Promotion and Public Health
Accountability and Reporting to Citizens
Dispute Avoidance and Resolution
Sets with similar terms
Canadian Health Care Jeopardy
Canadian Health Care System
HW Ch. 3
Chapter 1 - History of Health in Canada
Sets found in the same folder
2RR3-Income and Health
2RR3- Education and Health
2RR3-Food , Housing and Health
2RR3-Work and Health
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