Health Sciences 3400A/B Lecture Notes - Lecture 4: Health Policy, Health Equity, Health Care In Canada
17 Dec 2016
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Health Policy Lecture Four
• Social Determinants of Health: The social determinants of health are the economic
and social conditions – and their distribution among the population – that influence
individual and group differences in health status
• Colonialism: the policy or practice of acquiring full or partial political control over
another country, occupying it with settlers, and exploiting it economically. It is both
an ideological and economic structure of oppression and dominance
• Health Equity: refers to the study of differences in the quality of health and
healthcare across different populations. Studies inequities that may include
differences in the presence of disease, health outcomes, or access to health
between populations with a different race, ethnicity, sexual orientation or
socioeconomic status
• Intersectionality is concerned with the intersections between aspects of social
difference and identity as related to meanings of race, ethnicity, gender, class,
sexuality, age, ability etc. and forms of systemic oppression such as racism, classism,
sexism, homophobia, ableism)
Health Equity
• Three dimensions of equity in health care:
o Availability of Services
▪ How services are provided to communities, the differences in
geography, the availability of health care workers, affordable
services, cultural norms, language barriers etc.
o Accessibility of Services
▪ How is a health system designed to meet the needs of patients?
Are patients informed, can they make educated choices and
decisions? How does geder or rae effet a patiets aility to
communicate with a health care worker?
o Acceptability of Services
▪ Are services provided in a way that meets the needs of distinct
cultural, social and ethnic groups?
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Fierlek’s Cotet
• Health are i Caada has a ioi status as a ajor opoet of Caadia
citizenship, and it rightfully ought to be debated widely in the public realm. We
cannot debate health care, however, if we do not understand how health care
orks.
• To ake reasoned policy choices Canadians must understand how their health
are syste orks ad hat, therefore, the refor optios are…Caadias
cannot be expected to engage fully in the debate over health care unless they
can comprehend how the system works dynamically in both its policy and
politial eiroets
Funding Healthcare
• Fierlbeck
o It is iportat to keep i id that disussios oer health are fudig
are not simply about the allocation of money and the regulation of
services, but rather about the interplay of human relations, the
resolution of political struggles, and the kind of values that democratic
soieties reflet through their puli poliies
o Canada has a mixed public-private system
▪ A system where the private sector delivers healthcare services
and the public sector is responsible for financing those services
o A good health care system has the following qualities
▪ cost containment
▪ efficiency
▪ equity
▪ universality
▪ comprehensiveness
▪ responsiveness
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Six Pillars of Healthcare
• Cost Containment
o The capacity of a system to control expenditures
• Efficiency
o Refers to the amount of quality of goods and services provided relative to
the amount of money spent
• Equity
o Equitable access to health care by those who are in need of it, regardless
of income (vertical equity)
▪ Also possible to think about equity on consumption of resources
(horizontal equity)
• Universality
o All residents of a jurisdiction are covered by some form of health
insurance that gives them reasonable access to necessary health service
• Comprehensiveness
o Refers to what services are covered by insurance programs and how they
are covered
▪ Fully, partially etc
• Responsiveness
o Issue of choice available to health care users and discussions about
autonomy
Connection between Financing healthcare and policy
• Health policy attempts to find a balance between these six factors by allocating
funds to each area in a way that ensures a balance
• The attept to fid a perfet alae etee all desirale attriutes i health
policy has been descried as a holy grail
o The interesting policy experiments will be those that will be able to
protect one element (such as efficiency) without destroying others (such
as equity)
Financing and Delivery
• Financing refers to the way in which health services are funded (i.e. where the
revenue for these services comes from)
o Delivery refers to the ownership and motivation of the organizations that
are funded from these revenues
find more resources at oneclass.com
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Document Summary
It is both an ideological and economic structure of oppression and dominance: health equity: refers to the study of differences in the quality of health and healthcare across different populations. Studies inequities that may include differences in the presence of disease, health outcomes, or access to health between populations with a different race, ethnicity, sexual orientation or socioeconomic status. Intersectionality is concerned with the intersections between aspects of social difference and identity as related to meanings of race, ethnicity, gender, class, sexuality, age, ability etc. and forms of systemic oppression such as racism, classism, sexism, homophobia, ableism) Health equity: three dimensions of equity in health care, availability of services. Fierl(cid:271)e(cid:272)k"s co(cid:374)te(cid:454)t: (cid:862)health (cid:272)are i(cid:374) ca(cid:374)ada has a(cid:374) i(cid:272)o(cid:374)i(cid:272) status as a (cid:373)ajor (cid:272)o(cid:373)po(cid:374)e(cid:374)t of ca(cid:374)adia(cid:374) citizenship, and it rightfully ought to be debated widely in the public realm. Issue of choice available to health care users and discussions about autonomy. In fact there are four models of financing.
