Week 5 Lecture - Health Care in Canada and Issues of Health Care Reform

≥Week 5; Chapter 2: Health Care in Canada and Issues of Health-Care Reform (pp. 26-42) 1. I can name and describe the main points of seminal documents concerned with health care in Canada. The British North America Act (1867): ● Year: Enacted in 1867 (now part of the Constitution Act, 1867). ● Main Points: ● Established the framework for Canada's federal system and the division of powers between federal and provincial governments. ● Healthcare was not explicitly mentioned, but this act laid the constitutional foundation for provincial control over matters of "hospitals, asylums, and charitable institutions." The Lalonde Report (A New Perspective on the Health of Canadians, 1974): ● Year: Released in 1974. ● Main Points: ● Authored by Minister of National Health and Welfare, Marc Lalonde. ● Introduced the concept of the determinants of health, emphasizing the importance of lifestyle and prevention in healthcare. ● Highlighted the need to focus on health promotion and prevention, not just healthcare delivery. ● Helped shift the healthcare focus from illness treatment to health promotion and disease prevention. The Epp Report (Achieving Health for All, 1986): ● Year: Released in 1986. ● Main Points: ● Led by Dr. David Epp, this report aimed to improve the overall health of Canadians. ● Promoted the idea of "Health for All" by the year 2000, emphasizing health equity, social determinants of health, and community-based health promotion. ● Recommended policies and strategies to address health inequalities in Canada. The Ottawa Charter for Health Promotion (1986): ● Year: Adopted at the First International Conference on Health Promotion in 1986. ● Main Points: ● A global document but highly influential in Canada. ● Outlined key principles for health promotion, including building healthy public policy, creating supportive environments, strengthening community actions, developing personal skills, and reorienting health services. ● Emphasized the importance of prevention and a holistic approach to health. The Canada Health Act (1984): ● Year: Enacted in 1984. ● Main Points: ● Outlined the principles that underpin the Canadian healthcare system, including universality, comprehensiveness, accessibility, portability, and public administration. ● Ensures that healthcare services are available to all Canadian residents regardless of their ability to pay. ● Requires that all medically necessary hospital and physician services be publicly funded. ● Prohibits extra billing by healthcare providers and user charges by provincial/territorial governments. 2. I can name and give examples of the five pillars of the Canada Health Act (1984). (1) Public Administration - Each provincial & territorial health insurance plan must be administered & operated on a not-for-profit basis by a public authority – e.g. the Regional health authority (2) Comprehensiveness - The health care insurance plan of a province or territory must cover all insured services provided by hospitals, physicians, or dentists & be available to all provincial or territorial residents with equal opportunity (3) Universality - All insured residents are entitled to 100% coverage of insured health services provided by their respective provincial or territorial health insurance plan on uniform terms & conditions. (4) Portability - Residents moving from one province or territory to another continue to be covered for insured health services by their home jurisdiction during any waiting period (5) Accessibility - Protects all insured people from extra charges for health care - Guarantees reasonable access to insured hospital, medical, & surgical-dental care on uniform terms & conditions - Access without discrimination on the basis of age, health status, or financial circumstances - Reasonable access means access to services when & where they are available, as they are available 3. I can explain the differences between medical, behavioral and social environmental approaches to health care. - - Medical: Focus was on curing diseases, did not consider other aspects Behavioural: The behavioral approach was an idea that health was in individual control, and led to education on how to be healthy. This often led people to be blamed for poor health (victim blaming). This approach neglected to recognize socioeconomic, sociocultural, environmental, and geographic barriers to making healthy lifestyle choices. Social Environmental: Builds on the behavioral perspective that humans’ chosen interaction with biology, lifestyle, environment, and health care (or access to care) is a legitimate factor determining health and health outcomes. Combined social and environmental contexts 4. I can explain the organization of the Canadian health system including the responsibilities of different levels of government and different points of access to health care.