HLTH102 Lecture Notes - Lecture 11: Beveridge Report, Canada Health Act, Canada Health Transfer

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HLTH 102 – Health Care Systems Notes
How much does Canada spend per person on healthcare in comparison to the
U.S.?
-Half as much!
What are the components of a health system?
What are the 3 main attributes (goals) of universal health coverage (UHC)?
1. Rooted in human rights to health, which governments are obliged to
fulfill
oGovernments tend to not be in opposition of the idea, but instead have
different views on the means to achieve it
2. Aims to ensure access to good quality health services based on need, not
on the ability to pay or other social attributes
3. Seeks to reduce the financial hardships caused by reliance on ineffectual
health systems, the volatility of markets and having to pay fees at the point of
use
What is the unfortunate irony faced by the poor and marginalized in regards
to health care?
-Poorest and most excluded are not only the most vulnerable to ill health and
premature death; they are also the least likely to have access to good quality
services or protection against financial risk
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What are the 4 main models of health care delivery, and on what aspect do
they tend to differ?
-4 main models of health care delivery:
1. The Beveridge Model
2. The Bismarck Model
3. The National Health Insurance Model
4. Out-of-Pocket Model
(Differ in areas of financing and control)
What does the Beveridge Model entail?
-William Beveridge: Designed Britain’s National Health Service
-Funded through government taxes
-Used in: Great Britain, Spain, Scandinavia, New Zealand, Hong Kong, Cuba
-National Health Services System, with some decentralized local services
-Health care provided and financed by the government (Tax payments) – You
don’t pay specialized tax, Government takes it from general revenue*
-Mostly public providers
-Low costs per capita
What does the Bismarck Model entail?
-Otto Von Bismarck: Invented welfare state in Germany
-Universal insurance system (“Sickness Funds”) – Not for profit, Doctors &
hospitals privatized
-First universal health care system, 1883
-Used in: Germany & Japan
-Government regulation, private financing
-Statutory Health Insurance (88% of population)
-Sickness Funds – Not allowed to go into debt to pay
-Paid by citizens or their workplace instead of deduction from general
revenue by gov., but you are excused if poor (don’t need to go into debt over
it)+
-Financed jointly by employees and employers
-Mostly private health provision
-Private Health Insurance (10% of population) – Choice based on income
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What does the National Health Insurance Model entail?
-Combination of Beveridge & Bismarck models
-Private-sector providers
-Government-funded insurance program – Not for profit
-Used in: Canada, Taiwan & South Korea
What does the Out-Of-Pocket Model entail?
-Common in developing countries
-Patients either pay out of pocket or don’t receive care
-Used in: Rural Africa, India, China & South America
How does the US health care system exemplify each of these 4 models?
-Bismarck Model – Private Health Insurance
-Beveridge Model – Veteran Health Administration
-National Health Insurance Model – Medicare/Medicaid
-Out-of-Pocket Model – Uninsured
What does the Affordable Care Act do?
-Primary Goal: To extend health care to 15% of Americans that had none
-Requires all Americans to have health insurance, but offers subsidies to make
coverage more affordable
oRequires businesses with more than 50 full-time employees to offer
health coverage
oCreates marketplaces – With websites akin to online travel and
shopping sites where individuals can compare prices as they shop for
coverage
oGreater restrictions on insurance companies
oExpands eligibility for the government-run Medicaid health
programme for the poor
What is the Canada Health Act (1964), and what does it do?
-Canada Health Act – Canada’s federal legislation for publicly funded health
care insurance
-Primary objective of Canadian health care policy:
o“To protect, promote, and restore the physical and mental well-being
of residents of Canada and to facilitate reasonable access to health
services without financial or other barriers”
oEstablishes criteria and conditions that the provinces and territories
must fulfill in order to receive the full federal cash contribution under
the Canada Health Transfer (CHT)
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