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HLST 1010- Midterm Exam Guide - Comprehensive Notes for the exam ( 29 pages long!)


Department
Health Studies
Course Code
HLST 1010
Professor
Dennis Raphael
Study Guide
Midterm

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York
HLST 1010
MIDTERM EXAM
STUDY GUIDE

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HLST 1010 study guide
Lecture 1
System: a group or combination of interrelated, interdependent, or interacting elements forming a
collective entity; a methodical or coordinated assemblage of parts. Because a system is composed
of interrelated parts, if one part of the system breaks down, then usually, another part of the
system is affected, or breaks down also.
Public: Funded by the government via tax-payers’ dollars. ‘Public dollars’: money generated by
taxes that is used to fund shared services and commodities (eg. Roads, libraries).
Private: users pay for services out of their own pocket.
For profit: service providers make profits through the fees they charge for their services.
Not-for-profit: service providers do not make a profit from the services they provide.
1961: Saskatchewan Medical Care Insurance Bill. 1962: Saskatchewan’s doctors’ strike.
1967: National Medicare introduced with the Medical Care Act
1984: Canada Health Act
Canada’s healthcare system is publicly-funded and privately-delivered.
The government funds the healthcare system through tax dollars; hospitals and doctors work
independently of the government and deliver their services privately (i.e. doctors are not
employees of the state). Liberalism” comes from the word ‘libre’ and includes:
What is included in Canada’s HC system? All ‘medically necessary’ services. Hospital-based
care. Any care provided by a physician, or by a healthcare physician provided in a publicly-
funded medical facility. Some procedures and medications that are not considered ‘medically
necessary’ (e.g. ambulance services). Some services that are not provided in a hospital,
community health centre, or by a doctor (e.g. dental care).
Tensions in the system: 1. Tension between federal and provincial governments over jurisdiction
and responsibility. 2. Private practice / public payment: In the fee-for-service model, tension b/w
those requiring payment and those paying the bill; i.e. Between “egalitarian ends and market-
based means” (p. 280) . 3. Questions regarding which services are “medically necessary”.
Lecture 2:
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Liberalism” comes from the word ‘libre’ and includes: Personal freedom: Absence of coercion;
individuals pursue own interests.- Limited government intervention in society. - Equality of
rights- everyone abides by the same rules. Traditionally, liberal thinking emphasized the idea of
equality of opportunity. Recently, political economists have deconstructed this, emphasizing
instead the need for equality of outcome.
Socialism: Motivated by a dislike of the consequences of the market economy that are inherent in
the liberal vision”. Assets are owned by the community; benefits distributed to all. Aspires to a
higher degree of ‘equality of result’”. Goal is to make the government more accountable.
Neoliberalism: emphasizes individual choice in the marketplace combined with limited
government involvement in the economy”. A style of economic governance that began in the
1970s and 1980s; particularly embraced in the U.K., parts of Western Europe, U.S.A., & Canada.
Also embraced by the World Bank and the IMF via structural adjustment programmes.
Neoliberal policies: have “affinities with inequality and lower social cohesion. May lead to more
unequal health outcomes between socioeconomic groups within countries.
What do these ideologies have to do with health and health care? Different ideologies direct
and guide policies and decision-making within different countries.
Liberal Welfare states: U.K., United States, Canada, Australia (Anglo-American): greater
market reliance; ‘gatekeepers’.
Social Democratic states: Scandinavian countries: Sweden, Norway, Denmark:
decommodification, socialist perspective.
Corporatist/ Familist states: Germany, France, Italy: class and status-based insurance
schemes; reliant on family.
It originated with a Baptist minister who had progressive ideas regarding creating a world in
which everyone had equal opportunity and equal access to what they needed to live well.
Canada Health Act sets out 9 requirements that provincial governments must meet in order to
achieve their full health care transfers from the federal government.
Universality All residents in the province have access to public health-care insurance and
insured services on uniform terms and conditions. By pooling risks, the more people Medicare
covered, the more the risk-sharing would be cost-effective.
Comprehensiveness Medicare must insure all services that are “medically necessary”. These
can vary from province to province and over time. Provincial governments define the services.
Accessibility Insured persons must have reasonable and uniform access to insured health
services, free of financial or other barriers. No one may be discriminated against on the basis of
such factors as income, age, and health status.
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