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Chapter 9

Chapter 9

3 Pages
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Department
Health Studies
Course Code
HLTA02H3
Professor
Toba Bryant

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Chapter 9: Cracks in the Foundation- Georgina Feldberg & Robert Vipond
The Demographic and Social Origins of North American health and health care (1700-1900)
History of health care in North America begins with informal healing traditions emerged in pre-
colonial and colonial periods and predominated until late 19th century
Prior to 20th century, few Canadians visited doctors or hospitals- were for the destitute and dying
Lack of formal regulation allowed for diverse and widespread participation in healing practices
that were often informal or rooted in domestic economy
oHome births assisted by family and neighbours
oMothers taught daughters how to grow and brew common and essential remedies
oBritish North America (BNA) Act (1867) shaped constitutional framework of Canadian
federation
Reflected contemporary experiences with disease and unimportance of scientific
medicine
Throughout 19th century, diseases such as TB, cholera, typhoid, smallpox associated with filth and
decay instead of germs
Structures of Canadian govt and BNA Act reflected immediacy of health hazards pose by
infections and state of health knowledge
oRecognized economic significance of infections and implications for trade and military
therefore federal govt responsible for quarantines and marine hospitals
oProvinces and cities responsible for interventions against infection (ie. Sanitation)
oAct created relationship between control of infections, public health and state but ignored
curative medicine
Later 19th century- modern or allopathic biomedicine
oKocks postulates (bacterium caused TB, not being filthy) allow focus on microbes that
caused diseases rather than social and physical conditions
oMale and class dominance emerged in medical practice
oHospitals became centres of care
Early decades of 20th century, North Americans recognized need to reshape and regulate medical
practice
oMedical schools sought affiliation with universities
oWomen, who played big role in informal caregiving excluded from education and practice,
many went to U.S. to study medicine (ie. Emily Stowe, Canadas first woman doctor)
Insuring health (1900-1980)
End of WWI, most European nations and England recognized public need for access to hospitals
and medical care established some form of govt-administered health insurance. Canada and
U.S. did not
Entry in Canadian Medical Association (CMA) Journal warned that govt insurance plans would
undermine spirit of charity in medicine, turn physicians to civil servants and create private
practice
After the Depression, medical practices declined in 1930s. In 1934, CMA accused provincial and
municipal govt of failing to provide necessary medical care for indigent and unemployed
After WWII, plans for national health insurance emerged
o1945, PM King and President Truman introduced national health insurance plans that
failed
1957, Canada implemented Hospital and Diagnostic Services Act in response to growth of
hospitals, treatment centres and hospital care costs. Only 60% of services were covered (both in
Canada and U.S.)
1961, Premier Douglas (Saskatchewan) introduced insurance plan
oPhysicians practiced on individuals and to bill by service, but govt pays for bill instead of
patient or insurance company
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Description
Chapter 9: Cracks in the Foundation- Georgina Feldberg & Robert Vipond The Demographic and Social Origins of North American health and health care (1700-1900) History of health care in North America begins with informal healing traditions emerged in pre- colonial and colonial periods and predominated until late 19 century Prior to 20 century, few Canadians visited doctors or hospitals- were for the destitute and dying Lack of formal regulation allowed for diverse and widespread participation in healing practices that were often informal or rooted in domestic economy o Home births assisted by family and neighbours o Mothers taught daughters how to grow and brew common and essential remedies o British North America (BNA) Act (1867) shaped constitutional framework of Canadian federation Reflected contemporary experiences with disease and unimportance of scientific medicine th Throughout 19 century, diseases such as TB, cholera, typhoid, smallpox associated with filth and decay instead of germs Structures of Canadian govt and BNA Act reflected immediacy of health hazards pose by infections and state of health knowledge o Recognized economic significance of infections and implications for trade and military therefore federal govt responsible for quarantines and marine hospitals o Provinces and cities responsible for interventions against infection (ie. Sanitation) o Act created relationship between control of infections, public health and state but ignored curative medicine th Later 19 century- modern or allopathic biomedicine o Kocks postulates (bacterium caused TB, not being filthy) allow focus on microbes that
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