Chapter 6 HLTC03 Notes.docx

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12 Apr 2012
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Chapter 6 HLTC03 Notes
Introduction
About 47 million Americans lack health care insurance coverage
Under Medicare, Canadians share the cost of risk and health is provided on the basis of need,
not income
Health care is the most expensive social program
o Conflict exists b/n different levels of gov’t concerning funding
An important determinant of Medicare is Canadian federalism
History of Public Health Care in Canada
Political interest in public health care began as early as 1919 under liberal leader William Lyon
Mackenzie King as a platform for election
In 1947, Saskatchewan Premier Tommy Douglas and his Co-operative Commonwealth
Federation (CCF) established the 1st universal hospital health care plan in Canada
o Had support of physicians and hospitals due to assurance of getting paid
In 1950s, the federal and provincial governments were co-operating more
o Single-payer system arose from inter-governmental co-operation
1966, Medical Care Act passed, where federal and provincial governments share 50-50 of health
care costs
Look @ Box 6.1
Federalism: Catalyst for Innovation?
Federalism is a critical element in the development of health care in Canada
o It has constrained and facilitated policy change
Federalism divides political authority b/n federal and regional/sub-national governments and is
considered to be the property of constitutions
o This means that federalism is based on state power
o In other words, political authority is decentralized
Section 91 and 92 of the Constitution Act
The Canadian Constitution contributed to, and intensified, the rivalry b/n the federal and
provincial governments by investing responsibility for health care provision in the provincial
governments
Neither the federal nor provincial governments have exclusive constitutional responsibility for
health care
Sections 91 and 92 present the exclusive and shared responsibilities of each government in
health care
Health and social services in the 19th century were responsibility of charitable or religious
organizations
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