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Health Economics lec 04 HLTB03

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Health Studies
Dan Silver

Lec- 04-Health Economics & Health Care System SOCIAL MEDICINE  Concerned with the conditions in society that produce illness and death  Health and illness cannot be understood by referring only to biological phenomena and medical knowledge  Instead, human health and illness are imbedded in economic social and cultural contexts  Branch concerned with condition that produce illness&death  Factors: nutrition, poor housing, are all safe working conditions  Material and social conditions that produce illness and mortality include:  Social class  Economic cycles  Socially produced stress  Production processes  Working conditions SOCIAL DETERMINANTS OF HEALTH  General concept that health and illness are not defined by medicine and certain other things influence our health  Health is more than a biological condition it is also affected by  The set of social and economic factors that influence the health status of individuals, communities, and populations  These factors, which include income, food, housing, employment, social exclusion, and access to health services, enable people to improve and increase their control over their health THE CANADIAN HEALTH CARE SYSTEM Medicare: whole public and finance system of insurance Single player: each provincial government  The most prized of all of Canada’s social policies  Central to Canadians’ views of what is necessary for a high quality life  Canada has a publicly financed system of public health care insurance known as “Medicare”  Medical and hospital care  Provides universal coverage  No direct out-of-pocket costs  Publicly administered  Publicly financed but privately run  Non-profit  Single Player  Different coverage depending on province and territory  Health care has changed a lot (transitioned)  Ex. After WW2 we had key indicators of an unhealthy population so government put forward a universal medical care  Many men were not healthy enough: but legislation did not agree; then Saskatchewan initiated it MEDICARE  The “single payer” is each provincial governments The Canadian Health Care System: Two Key Points  There is not a single Canadian health care insurance system but instead 13 provincial and territorial medical care and hospitalization insurance systems which all receive federal government resources  The Canadian Health Care System has been in constant transition The Canadian Health Care System: Timeline  Before Medicare, health care in Canada was mostly privately delivered and funded  1945 – The federal government put forward a plan for itself and provincial governments to share the costs of a universal medical care and hospital services insurance program  The federal government’s initial plan to have a universal medical care and hospital services insurance program was motivated by  The failure of the market to ensure adequate access to necessary medical and hospital care  Evidence of the poor health of the Canadian population  A high number of recruits during World War II were too sickly for military or industrial service  But the initial federal legislation was not enacted because the federal and provincial governments could not agree on taxation issues  1947 – Saskatchewan introduced the first province-wide publicly financed and administered hospitalization insurance program  1957 - The federal government introduced the Hospitalization Insurance and Diagnostic Services Act  1961 – All provinces and territories agreed to provide publicly funded inpatient hospital and diagnostic services  1962 – Saskatchewan introduced the country’s first publicly financed and administered medical care insurance system  1966 - Medical Care Services Act  1968 – Universal access to medical care outside the hospital setting  1972 – All the provinces signed on to the Medical Care Services Act  1984 – Canada Health Act  Included the principles laid out in the federal hospital and medical insurance acts  Added provision that prohibited extra-billing and user fees for insured services The 5 Principle of Medicare 1. Comprehensiveness: provinces need to insure all medically necessary services are covered eg. Emergency surgery, what the docs decides 2. Universality: provinces must entitle all people who are citizens and all who are entitled to universal terms and conditions 3. Portability: moving from one place to another i.e having insurance 4. Accessibility: access without finance eg. Rich people and poor people should have same hospital 5. Public Administration Goal of Canadian Health Care  To provide universal coverage for medically necessary health care services  To provide care on the basis of need, rather than the ability to pay Federal Government  Sets and administers the Canada Health Act  Acts as a focal point for disease prevention and control  Emergency response to infectious diseases  Food safety and nutrition  Regulation of pharmaceuticals, consumer products, pest management  Funding for health research  Delivers services to specific groups  Aboriginal peoples  Serving members of the Canadian Forces and Royal Canadian Mounted Police  Eligible veterans  Inmates in federal penitentiaries  Refugee protection claimants Provincial and Territorial Governments  Deliver most of Canada’s health care services  Provide medically necessary hospital and doctor’s services are free of charge  Provide services to workers injured on the job PRIMARY HEALTH CARE  Provides direct provision of first-contact health care services  This includes prevention and treatment of common disease and injuries, basic emergency services, referrals to a coordination with more specialized services SECONDARY SERVICES  Specialized care may be received at a hospital, long-term care facility, in the home or community  Examples include: mental health care, palliative and end of life care, healthy child development, rehabilitation services, health promotion SUPPLEMENTARY SERVICES 
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