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HSS1101 (145)
Lecture 11

HSS1101 Lecture 11: Lecture 11

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Health Sciences
Raywat Deonandan

Lecture 11.1: Canadian Health Care System Comparisons to USA -USA spends more on healthcare per capita -Life expectancy longer in Canada -Infant mortality rate lower in canada -USA is one of the only wealthy nations that lacks some form of universal health care -Health care costs in both countries rise faster than inflation Medicare -Medicare is the unofficial name for a publicly funded health care system -The father of Medicare is…? Tommy Douglas -Premier of Saskatchewan (1944-1961) -Federal NDP leader -Invented the version of Medicare we currently use -Voted “the greatest canadian of all time” By the CBC viewers in 2004 -Grandfather of Kiefer Sutherland Canada Health Act -Adopted in 1984 -Deals explicitly with how our health care is financed -Does not deal with how care is organized or delivered -Is a “single payer system” Also called monopsonistic Public vs. Private What is “Single Payer System”? -Characterized by one provider being able to create a market power that would buy all good and services in the healthcare market Canada Health Act -Provincial and territorial governments are responsible for the management, organization and delivery of health services for their residents -Federal bodies (e.g. Health Canada) responsible for setting and administering national principles for the health care system, and for giving services to specific groups (aboriginals, military) Canada Health Act -Provinces must satisfy the following criteria to receive federal funding for health care: -Public administration -Comprehensiveness -Universality -Portability -Accessibility 1. Public administration a. The health insurance plans must be “administered and operated on a non-profit basis by a public authority, responsible to the provincial/territorial governments and subject to audits of their accounts and financial transactions.” (section 8) i. Does not deal with health care delivery, only with the fact that the financing of health care must be public and non-profit 2. Comprehensiveness . The health care insurance plans must cover “all insured health services provided by hospitals, medical practitioners or dentists (section 9) .Provinces are allowed to insure additional services, but must at least insure those listed in the Act i.Dental services = surgical dental care in a hospital ii.Almost 100% of canadian dental care is actually paid by the individual or by private health insurance 3. Universality . All insured persons must be covered for insured health services “provided for by the plan on uniform terms and conditions” (section 10) .Universality = “applies to everyone”, i.1. Citizens and permanent residents i.Excludes those who are covered by other legislation 1. Armed forces 2. Inmates 4. Portability . Residents moving from one province or territory to another must continue to be covered for insured health care services by the “home” province during any minimum waiting period” .In other words, even though plans vary from province to province you should be able to take your plan across provincial boundaries at least for a little while 5. Accessibility . The insurance plan must provide for “reasonable access” to insured services by insured persons, “on uniform terms and conditions, unprecluded, unimpeded, either directly or indirectly by charges (user charges or extra-billing) or other means (age, health status or financial circumstances;” (section 12.a) What is a two tiered system? -One system of medicare and a parallel system of privatized care in which a patient can choose to pay out of pocket for immediate care -Risk of removing investment of the rich/affluent from Tier 1 services -Risk of sucing resources from Tier 1 services -A private clinic would contravene the “accessibility” criterion of the CHA Is there an Example of 2 tier system in canada? -Assisted reproduction clinics -In many provinces,
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