NSE 112 Lecture Notes - Lecture 5: Canada Health Act, Old Age Security, Unemployment Benefits

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11 May 2018
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Week 5 objective: the Canadian Health Care Delivery System
1. Social safety net
- Canada has a network of national, provincial/territorial social programs called the social
safety net.
- Social safety net is need to protect the most vulnerable
- A key component of Canada’s social safety net is Medicare: set of 10 provincial and 3
territorial insurance scheme that provide access to hospital and physician services.
What ae other programs in the social safety net?
Provincial social assistance programs provide income support: Ontario
Works, ODSP, Federal Unemployment insurance, Old Age security. Etc.
2. Evolution of Canada’s Health care system
- Pre-1867
Emphasis was on local communities and essential services
Responsive to crises
Centralized care to local churches and families
Programs; poor sanitation, infectious disease.
- British North America Act, 1867
Birth of Canada
Act gave certain powers to the federal and provincial governments (only 4
provinces at time)
Responsibility for health, education & social services given to the provinces
Federal government has some health responsibilities: health care for indigenous
persons, Canadian Forces, veterans; pharmaceutical safety.
- Late 19 th early 20 th century
Industrial revolution led to population moving from rural to urban settings
Led to crowded living conditions, poor housing, poor sanitation,
increased disease
Patients who should not pay or health care depended on charity
Growth of charitable and voluntary health agencies
1916: Federal Government gives municipalities ability to use tax dollars to pay
for physicians
1930: Great Depression (people could not pay medical & hospital bills>growing
realization that there needed to be a way to pay for these services)
1940: Provinces inspired to create a prepaid medical and hospitalization
insurance plan.
“father of Medicare” (1947) Tommy Douglas: introduce public
universal hospital insurance plan.
Medicare became a backbone of safety net
1961- all provinces had coverage for hospital care
1984- Canada health act
- 1940s-1960s
Expansion of the social safety net
Establishment of the first universal social programs in Canada in addition to
Medicare
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Old age security, Canadian Pension Plan, Guaranteed Income
Supplement
1957: Hospital Insurance & Diagnostic Services Act
Provided federal funds for provinces that established universal health
insurance
- Evolution of Medicare (1961~
- 1961, all provinces & territories were providing coverage for inpatient hospital care
- By 1972, all provincial & territorial insurance plans extended coverage to include
medical services provided outside hospitals
- All Canadians now had free access to hospital and medical care
Costs were shared between federal & provincial/ territorial governments until
1977
1977: federal government began block transfers o funds, resulting in decreased
contributions
Provinces responded with extra-billing & user fees (created a 20titred system that
threatened accessibility)
3. Canada Health Act, 1984
- Extra billing a threat to universality and access of medical insurance program
- Federal government’s response was to enact the Canada Health Act in 1984
- 5 principles
1. Public administration
2. Comprehensiveness
3. Universality
4. Portability
5. Accessibility
- Provinces may ignore principles but may have federal dollars withheld (Canada’s health
act banned extra billing and user fees)
1. Public Administration:
A public authority (is accountable to the provincial or territorial government
for decision making on benefit levels and series) administers and operates the
health insurance plan of a province or territory on a non-profit basis
2. Comprehensiveness:
The health care insurance plan of a province or territory must cover all
insured health services provided by hospitals and physicians. (may decide to
cover other service other health care providers: for example, prescription
drugs are covered in BC but not in Ontario)
3. Universality:
Entitles all insured residents of a province or territory to be insured by the
provincial or territorial health care insurance plan
4. Portability:
Residents are entitled to a certain level of coverage when they are in another
province or territory within Canada, or when they travel within Canada or
abroad. (when temporary of the country, Canadians are covered as well but
there is limit. That is way you are encouraged to take out supplementary
health care insurance)
5. Accessibility:
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Document Summary

Week 5 objective: the canadian health care delivery system: social safety net. Canada has a network of national, provincial/territorial social programs called the social safety net. Social safety net is need to protect the most vulnerable. Provincial social assistance programs provide income support: ontario: evolution of canada"s health care system. Works, odsp, federal unemployment insurance, old age security. Pre-1867: emphasis was on local communities and essential services, responsive to crises, centralized care to local churches and families, programs; poor sanitation, infectious disease. Late 19 th early 20 th century. Industrial revolution led to population moving from rural to urban settings. Father of medicare (1947) tommy douglas: introduce public universal hospital insurance plan: medicare became a backbone of safety net, 1961- all provinces had coverage for hospital care, 1984- canada health act. 1940s-1960s: expansion of the social safety net, establishment of the first universal social programs in canada in addition to. Old age security, canadian pension plan, guaranteed income.

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