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Chapter 7

SOC375 Chapter 7: Oct. 17/19- Chapter 7 (LECTURE & TEXTBOOK)

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Kwame Boadu

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Chapter 7- Health Care
- Among people aged 75+, nearly 3/4s of those who live outside institutions report good to excellent health
- Earl Caadia poli defied health as a resoure hih gies people the ailit to aage ad ee to
change their surroudigs
o By this definition, more than 90% of people aged 65+ have good enough health that they can live on
their own in the community
- Healthcare system- the medical and social services that provide healthcare support to Canadians; support that
ranges from health promotion, to health maintenance, to long-term chronic care
Three Models of Healthcare
- Models used to simplify and describe complex social systems odel does’t perfetl represet the sste,
ut it desries the sste’s asi strutures, functions, and values
- The medical model
o Favours surgery, drug therapy, and rehabilitation through physical therapies with a focus on the
treatet of diseases ad ijuries, usuall i the phsiia’s offie, a hospital, or other healthare
Physicians have considerable control over organization of healthcare and the work of other
healthcare professionals doctor most influential
o Medical history, physical examination, and diagnostic tests provide the bases for the identification and
treatment of a specific illness focused on the physical and biological aspects of diseases/conditions
o The type of services that are covered and how the payment system is organized influences how the
system operates
Hospital and physician visits included in the Canada Health Act are covered services
Most family physicians and many other health professionals still get paid for each patient visit
o Health insurance system promotes the medical model funnels most healthcare dollars to doctors and
hospitals; places medical profession at the center of the healthcare system
- The social model
o Healthcare model that includes personal and family counselling, homecare, and adult daycare programs
as part of the system, and tries to keep older people in their own homes
Care often takes place in the community (ex. home, drop-i eter, or ousellor’s offie
Doctor is part of a healthcare team that includes other service providers (ex. nurses,
physiotherapists, counsellors, etc.)
Grown in importance as more older people need continuing care or long-term care
o Long-term care (LTC)- social and medical services, including formal services, home or institutional care,
and family care, for people who have chronic illnesses or functional disabilities/limitations
Combines medical and nursing care with social and community services treatment in home,
community or institutions, not hospitals (attempts to keep people out of institutions)
Continuum of care support options (including physiotherapy, etc.)
Often a person and family will use both community services and homecare
o Canadian healthcare system has begun to shift from the medical to the social model of care
- The health promotion model
o Healthcare model that focuses on self-care and preventing disease through lifestyle change, increased
knowledge about healthy behaviour, and environmental improvement
Also iludes atios that ost people do’t assoiated diretl ith healthare e. orkplae
safety regulations, pollution control, etc.)
Any preventative activity that keeps them out of the healthcare system
Legislation, public health promotion campaigns, programs, and projects
Could save the healthcare system money in the long run people are taking responsibility of
their own health thus, staying healthier longer
Ex. participACTION government program launched in 1971 to try and curb obesity in Canada
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Used mass media to try and raise awareness promotes active living, sponsors health
promotion activities, and hosts a website that lists health promotion events
Closed in 2001, but then reinstated in 2007 to cope with rising obesity rates and
declining activity among most Canadians
People with more education and better income, and those who take part in leisure-time
physical activity tend to know about the program
Challenges to the Healthcare System Today
- In 1957, the Canadian government put in place a hospital insurance system that covered the entire population;
by 1972, all provinces/territories belonged to a national medical insurance program
- Canada Health Act (1984) descried the principle of the Canadian healthcare system:
o Universal coverage
o Access to services
o Portability people can get the benefits in any part of Canada
o Comprehensive services, such as outpatient and hospital care
o Administration by non-profit public agency meant to serve the interests of Canadians, regardless of
socioeconomic status, etc.
The provincial and federal governments share the cost of the healthcare system
Provinces have jurisdiction over the provision of healthcare
- Canadians worry that high-quality healthcare will be less and less available over time feel concerned about
costs, access to service, and quality of care
o Curret sste does’t full isure LTC
o System also emphasizes medical and institutional care, the 2 most expensive types of services
- Current challenges:
o Care shifting from institution to community
o Privatization of services and long-term care
o Wait times have been increasing for some services (which has led to loss of confidence in the system)
o Quality of care
o Sustainability of the healthcare system
The Father of Mediare
- Thomas Clement Douglas (Tommy Douglas), 1904-1986
o Premier of SK for 18 years (1944-1961)
o Enacted a provincial version of Medicare in SK in 1962
o Voted i 4 The Greatest Caadia
The Cost of Healthcare Today
- In 2009, Canada spent $182.1 billion, or about $5,401 per person on healthcare
- Almost 100% of Canadians are covered to some degree
o All Canadians have access to some form of public support for pharmaceuticals
- Canada among the nations with the greatest per capita expenditures
o Largel due to Caada’s relatiel large older populatio
- Older people accounted for 44% of all provincial and territorial government healthcare spending
- Women use more resources than men women generally live longer than men, thus with more chronic disease
- Private and public expenditures on the rise
- 38% of all healthcare funds goes to hospitals or other institutions; 13.4% goes to physicians; 14.6% for
prescribed drugs
o These 3 expenses together account for 2/3s (66%) of all funds spent on healthcare in Canada
- Projections indicate that healthcare costs will rise annually especially due to aging of the baby boomers
Wh “eiors’ Healthare Costs More Tha That of Youger People?
- Older people have more health problems
- Healthcare use increases by age
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