HLTC03 LECTURE 7.docx

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2 Apr 2012
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LECTURE 7
Canadian health care system
Overview
o Canadian health care system
o Federal
Federal health care legislation- uses the spending power to support programs to insure there are
national standards in care. Where ever you are at. To have effective delivery. Seeing the doc is
covered.
o 1958 hospital and diagnostic services act
Act that implemented the cost sharing. Each government is responsible for half of the
services. It is cheaper this way. Then private
This was to insure that each province is getting their care
Federal cost-sharing (50%) hospital and physical services with the provincial government
o 1966 medical care act
Enshrined principle of public payment for private medical practice of FFS( fee for
service)
Private medical practice became norm
No coverage for other health care providers
They send the bill to government, and the government pays the bills. This is why we
have OHIP numbers.
Private practice for public payment
Let doctors have the private practice, and we will pay them for their services. This
was this plan!
At this time federal and provincial put In 50 percent each
o 1977 established programs financing
Shifted from shared cost funding to block grant system
Federal transfers for health care split into two components:
1.Cost transfer conditional on provinces' compliance with federal
conditions of eligibility/ Medicare principles
2.Unconditional transfer - tax points - revenue based on income tax yield of
federal basic tax in a province.
At this time governments were scared of deficits - b/c of that time oil
prices. They decides they needed to wage and price control. And they
made sure health care doesn’t exceed other spendings.
The federal governments made decisions that did not make the
provincial government happy - there were a lot of tensions
o 1984 Canadian health act
Cash component conditional on provinces' compliance with Medicare principles
Reduce federal payment to provinces that allowed physicians to extra-bill their patients
The federal government had a role to play that these national standards are put
forward or we do not have the promise of MEDICARE components (5)
David petersin - he eliminated the additional fees that households have to play
towards their health care. The medical association went on strike, not a lot of
doctors went on strike some did and they withdrew their services.
They achieved the extra-billing.
o 1995 Canadian health and social transfer
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