Textbook Notes (363,062)
Canada (158,169)
HLTA02H3 (135)
Chapter 10

Chapter 10

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University of Toronto Scarborough
Health Studies
Toba Bryant

Chapter 10: Health Care Systems in Evolution- Mary E. Wiktorowics Diverging Premises of Health Care Systems Legislative and political structures that guide democratic reform in Canada and US shape approaches to social policy and health care sector represents one of most significant areas of divergence Political and historical forces influences design and delivery of health care in Canada and US: ideological perspective, political authority and modes of financing and delivery Ideological Perspective Most countries have common goals regarding health care: o Social protection: enable those with fewer resources to access health care o Redistribution: redistribute health care costs among individuals, employers and society o Efficiency: ensure efficiency in production and consumption of health services Health care in US based on private health insurance and also public insurance: Medicare for those on social security and Medicaid for those on social assistance o 45 million uninsured and several million underinsured because their health insurance does not cover all health care services Canada has universal system of public health insurance- provincial public insurance plans develop contracts with private non profit health care institutions (hospitals, practitioners) to provide care Differences between Canada and US resulted from different ideological conceptions and political institutional processes which legislation developed National health insurance symbolizes divide between liberalism and socialism; free market and planned economy o Canada based on principles like peace, order and good government o US: life, liberty, pursuit of happiness Perspective of public health insurance adopted by most industrialized nations reflects Rawls Theory of Justice: those who design rules put themselves behind a veil of ignorance where their position in resulting distribution is unknown Political Institutions and Historical Perspective Health care emerged as political issue in Canada and US as early as 1930s, not until 1960s that basis of each system formulated through their respective legislative processes U.S Policy reforms based on new laws must be passed by majority of member in Senate and House of Representatives and support from president Regions across US represented in Senate (each state has 2 seats) and House of Representatives (seats assigned based on population), only 2 major political parties: Republicans and Democrats Democrats that proposed national system of universal health had to modify plan to appeal to coalition of groups (unions and labour movement) resulting in abandon of tenets which proposal for health reform was based Interest groups (American medical Association) and private health insurance companies oppose legislation that change conditions under which they practise- they influenced the elected members of Senate, House of Reps and president that oppose to the changes Shift in labour movement to businesses offering fringe benefits instead of supporting govt run health insurance and tax reform resulted in advocates of national health insurance shift focus from general population to those who were largely excluded from workforce- elderly and low-income people Public health system targets to people not expected to work and designed around private but tax- subsidized insurance system for employees and families Employer sponsored insurance excludes large numbers of low and middle income workers Canada www.notesolution.com
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