Class Notes (839,094)
Canada (511,185)
SOSA 2503 (28)
Lecture 4

Lecture 4 - The Canadian Healthcare System.docx

6 Pages
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Department
Soc & Social Anthropology
Course Code
SOSA 2503
Professor
Emma Whelan

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The Canadian Healthcare System `“My friends, watch out for the little fellow with an idea.” – Tommy Douglas Goal: understand structure to understand health care debates/political issues Overview Constitution: health care is a provincial responsibility - Healthcare was provincial in British North American Act (1800s) - Canada Act in 1982, Pierre Trudeau repatriated the constitution Federal Government: –Sets national principles for insured health care –Monitors implementation of these principles –Provides funding assistance - transfer payments –Delivers health services to First Nations, Inuit, military, RCMP and federal prison inmates –Funds and promotes medical and scientific research - Federal gov‟t insures basic service across provinces, coordinating and redistributes money from rich to poor provinces, principles, monitoring of principles, funding assistance NOT socialized medicine –Private practitioners paid by public funds –Fee-for-service Health Canada: program and regulatory organization, health protection/promotion, disease prevention, drug approval, some medical/scientific research funding Publicly Funded Healthcare  Most healthcare provides are private practitioners (eg. physio, physicians)  Money from state (fee for service)  Not for profit community health centers  Not completely publicly funded, private insurance also Insured Services Covered:  „Medically necessary‟ physician and hospital services  Surgical-dental services  Some extended health services - Most but not all essential health services. Dental care, drugs, homecare, lont term care not covered for most people in most provinces. - 70% public, 30% privately funded (you or insurance company) - Insurable Services = Fee for Service: check-up, physician bills province, provincial government pays physician, small # docs paid set salary Examples:  Examination/treatment by family doctor and most specialists  Medically necessary surgery  X-rays  Most laboratory tests  Most immunizations Extended and Uninsured Services •Covered (at least partially) in some provinces:  Ambulance services  Prescription drugs  Psychologists  Some long-term and home care  Dental care  Glasses and contact lenses - Uninsurable Service: invoice patient or insurance (eg. laser eye surgery)  Pharmacists charging dispensing fee outside hospital, dentist, some homecare/long term care, psychiatrist/counseling Governance Structures - Governance of Health Professionals  Colleges  Trade Associations - These regulate professional conduct, how province regulates profession. -Trades = unions, represent interests of group of health professionals, fee & schedule negotiations, employment conditions etc.  Eg. Medical Society of NS: not-for-profit hospital/health clinic with Board of Trustees (appointed members by provincial gov‟t to represent community interests) - Governance and funding of not-for-profit facilities  Services are offered by governed health authority [eg. Capital Health]  $ portioned out to facilities  Type of service, volume, performance evaluations must be met to keep/improve funding  Isn‟t all about patient care, about measurable outcomes  Hospital = salary, supplies/equipment, operate equipment,  Larger capital investment = special campaigns generally not covered in provincial formula - Governance and funding of for-profit facilities  Governed on behalf of shareholders  Profit making  Can‟t use HD paid through provincial plans Evolution of Medicare 3 Historical Periods: 1919 – 1957: Laying the Groundwork  1919: universal medical insurance first pitched by Liberal leader Mackenzie King (as leader of the opposition)  1945: universal medical insurance pitched by Prime Minister Mackenzie King, opposition from provinces, favored all free market health insurance, didn‟t want to foot the bill  1947: CCF introduces public insurance for hospital care in Saskatchewan  1957: First federal health care act, Act offered to cost share hospital/diagnostic services with hospitals, pay 50% of average provincial cost for services 1961 – 1984: Consolidation - Building a publicly funded healthcare system  1961: All provinces/territories sign on for hospital insurance, opposition from medical practitioners (public employees vs. entrepreneurs), loss of control over work etc.  1961: Emmett Hall appointed to head the Royal Commission on Health Services  1962: Saskechewan introduc
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