HSCI 305 Study Guide - Midterm Guide: Health Promotion, Amenable Group, Canadian Medical Association

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HSCI 305, Summer 2016
Things You Should Know For the In-Class Midterm on June 20, 2016
Topic = Roberts et al.’s control knob framework
• Roberts et al.’s three performance goals of a health care system
1. Health Status
2. Citizen Satisfaction
3. Financial Risk Protection
• The specifics of two of Roberts et al.’s control knobs in the Canadian health care system evaluated with respect to
the Roberts et al.’s three performance goals plus government financial risk protection
1. Financing-raising money that pays for health sector activities (eg. Taxes, insurance, out of pocket)
2. Payment-how funds are transferred and incentives created by these method (eg. Fee for service, blended models)
3. Regulation-use of coercion by state to alter the behaviour of actors in the health system (eg. Laws, rules, CHA)
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4. Organization- mechanisms to affect the mix of health care providers, their roles and functions, and how
providers cooperate (eg. Some private for profit clinics are not available to patients using public funding)
5. Behaviour- efforts to influence how individuals act in relation to health and health care (eg. Patients have free
choice of providers but referral networks in patients are not fully having free choice of specialist providers)
Topic = Canadian health care system general structure
• Role of provincial and federal governments
Federal government- jurisdiction in specific aspects of health care
Ex: prescription drug regulation and safety, financing and administration of a range of health
benefits and services for eligible first nations people and Inuit, public health insurance coverage for
members of Canadian armed forces, veterans, inmates in federal penitentiaries and eligible refugee
-Important responsibilities in the domains of public health, health research and health data
Provinces- primary policy responsibility for funding and administering health care
• Populations that have the poorest health or most problems with using health care and why
• The five principles of the Canada Health Act and a brief description of each
Public Administration: All administration of provincial health insurance must be carried out by a public authority
on a non-profit basis. They also must be accountable to the province or territory, and their records and
accounts are subject to audits.
Comprehensiveness: All necessary health services, including hospitals, physicians and surgical dentists, must be
Universality: All insured residents are entitled to the same level of health care.
Portability: A resident that moves to a different province or territory is still entitled to coverage from their home
province during a minimum waiting period. This also applies to residents which leave the country.
Accessibility: All insured persons have reasonable access to health care facilities. In addition, all physicians,
hospitals, etc, must be provided reasonable compensation for the services they provide.
• Why the Canada Health Act was introduced
-to replace the Hospital insurance and Diagnostic Services Act and the Medical Care Act
-required the federal govt to deduct from a provincial govt’s share of Established Programs financing the value of
all extra billing and user fees permitted to that province.
- origin of CHA can be traced to the federal govt’s concern that, despite the stipulation in the Medical Care Act
that provincial plans must allow user fees to “impede or preclude” any “reasonable access to insured services”, some
provincial govts had increasingly permitted the imposition if patient user fees by hospitals and physicians
-to ban extra billing and user charges
• Who is regulated by the Canada Health Act
-physicians, patients, sectors that delivers care (hospitals)
• Which services are covered under the Canada Health Act and which services are not covered under the Canada
Health Act
Covers: medically necessary physician and hospital services (medically necessary for the purpose of maintaining
health, preventing disease or diagnosing or treating an injury, illness, or disability; and medically required physician
services rendered by medical practitioners.)
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