HSCI 305 Lecture Notes - Lecture 11: Canada Health Act, Prescription Drug, Optometry

105 views9 pages

For unlimited access to Class Notes, a Class+ subscription is required.

HSCI 305
DAY 11
November 23, 2017
Learning from Other Health Systems
In the news…
- Coquitlam’s Riverview
o Reopening
o Only adding 11 more beds
o Spending lots of money $101 million
- Doctors prescribing opioid
o Has increased in Canada
- Annual check ups for healthy people may be harmful
o Might lead to unimportant issues
Stress
Anxiety
Unnecessary treatment
International Comparisons Performance
Which of the following has the best health care system?
a. United Kingdom
b. Germany
c. Canada
d. Singapore
e. Cuba
- None are the best all have pros and cons
Key messages:
- Canada a top spender
- Above OECD average
- Higher private share
- Improvements since 1970s
- Average performance overall
Charts
- Same or next day appointments are difficult to get in Canada
- Access to after-hours care continues to be below average in Canada
- Canadian doctors report improvements to timely care, but patients don’t agree
- Canadians report more timely access to mental health care than those in other countries
o 1 in 4 surveyed Canadians say they experienced emotional distress and that its
difficult to cope with
- Wait times are longer than average in Canada for all elective surgeries
- Few Canadians face cost barriers to care covered under Canada Health Act
find more resources at oneclass.com
find more resources at oneclass.com
Unlock document

This preview shows pages 1-3 of the document.
Unlock all 9 pages and 3 million more documents.

Already have an account? Log in
- More Canadians face cost barriers to dental care and prescription drugs
- Despite cost barriers, use of prescription drug is higher in Canada than in most other
countries
- Younger adults report greater financial barriers to drugs and dental care
- Canadians like their usual physicians but don’t think the system works well
- Canadians report better experiences with their regular doctors than 11-country average
- Canadians more likely to receive medications reviews
- Two-way communication between special and regular doctors can be improved in most
countries
- No country outperforms us across the board
- Canadian doctors are using more IT but still less than their peers
o More Canadian family doctors than ever before are using information technology
~ ~ ~ BREAK ~ ~ ~
International Comparisons Health system structure and organization
International comparisons: Hospital food
a. England
b. Poland
c. France
d. Indonesia
e. Richmond
Which country’s health system is oldest?
a. Canada
b. United Kingdom
c. Germany
d. Japan
e. United States
Let’s start with Canada
- Health system and public/private insurance role
o Gov’t role – regionally-administered universal public insurance program that
plans and funds (mainly private) provision
o Public system financing provincial/federal general tax revenue
o Private insurance role - ~67% of Canadians buy complementary coverage for
non-covered benefits (e.g., private rooms in hospitals, drugs, dental care,
optometry)
- Provider ownership
o Primary care private
o Hospital public/private mix (proportions vary region,) mostly not-for-profit
- Provider payment
o Primary care payment mostly FFS (~45-85% depending on province), but some
alternatives (e.g., capitation) for group practices
find more resources at oneclass.com
find more resources at oneclass.com
Unlock document

This preview shows pages 1-3 of the document.
Unlock all 9 pages and 3 million more documents.

Already have an account? Log in
o Hospital payment mostly global budgets, case-based payment in some provinces
(does not include physician costs)
- Primary care role
o Registration with GP required not generally, but yes for some capitation models
o Gatekeeping yes, mainly through financial incentives varying across provinces:
e.g., in most provinces, specialists receive lower fees for patient not referred
- Benefit design
o Caps on cost-sharing no
o Exemptions & low income protection there is no cost-sharing for publicly
covered services; protection for low-income people from cost of prescription
drugs varies by region
England
- 1946 National Health Service Act
o Services were provided free at the point of use
o Services were financed from central taxation;
o Everyone was eligible for care
- Tripartite system:
o Hospitals Services:
Regional Hospital Boards administer majority of hospital services
Individual hospitals nested within them under Hospital Management
Committees
o Primary Care
GPs independent contractors paid for each person on their list
Dentists, opticians and pharmacists also generally provided services are
independent contractors
Local Councils/Trusts administered contracts and payment, maintained
lists of practitioners and patients
o Community Services:
Local authorities responibile for maternity and child welfare clinics, health
visitors, midwifes, health education, vaccination & immunization and
ambulance services, environmental health services were the responsibility
of local authorities
Continuation of the role local gov’t had held under the Poor Law
Health system and public/private insurance role
- Gov’t role – national health service (NHS)
- Public system financing general tax revenue (includes employment-related insurance
contributions)
- Private insurance role - ~ 11% buy supplementary coverage for more rapid and
convenient access (including to elective treatment in private hospitals)
Provider ownership
- Primary care mainly private, limited number of NHS owned practices with salaried
physicians
- Hospital mostly public, some private
Provider payment
find more resources at oneclass.com
find more resources at oneclass.com
Unlock document

This preview shows pages 1-3 of the document.
Unlock all 9 pages and 3 million more documents.

Already have an account? Log in

Get access

Grade+
$10 USD/m
Billed $120 USD annually
Homework Help
Class Notes
Textbook Notes
40 Verified Answers
Study Guides
1 Booster Class
Class+
$8 USD/m
Billed $96 USD annually
Homework Help
Class Notes
Textbook Notes
30 Verified Answers
Study Guides
1 Booster Class