What is healthcare delivery
the manner in which med services are organized, managed and provided
What is healthcare financing
the manner in which funds are raised, pooled, mobilized and used to purchase healthcare services
Canadian financing and delivery
- most publicly funded but privately delivered
- “free” at point at use, delivered by private providers
What is policy
- set of interrelated decisions taken by a political actor or group of actors concerning the selection of goals and means of achieving them within a specified situation where these decisions should, in principle, be within the power of these actors to achieve
- can also include not changing anything
Policy cycles
- pattern, in creating policies
What is legislation
body of rules that regulates the promotion and protection of health, health services, and equitable distribution of available resources and legal position of all parties concerned….
- most policies are not legislation/laws… can easily be changed
- hard to change, legacies
federalism
- political system
- powers of gov split
- specific authorities/responsibilities assigned to fed and prov = DIVISION OF POWERS
when division of powers established
- british North America act (1867)
Fiscal federalism
- health care is primarily prov domain
- federal gov contributes fiscal support (through Canada Health Transfer)
- CHT sets out rules and national minimum standard for prov/terr insurance plans for provinces to receive CHT
federal role
- fiscal transfers
- healthcare services to some groups
- provide and fund other health related functions
Health Canada
- help Canadians maintain and improve health
- ensure high quality health services accessible and works to reduce health risks
- federal institution, federal minister of health
PHAC
- public health, emergency preparedness, responses to infectious and chronic disease control/prevention
CIHR
- biomedical
- clinical
- health systems and services
- social, cultural, and environmental factors and pop health research
Patented Medicine Prices Review Board
- protect consumers from price gouging
stats canada
- produce stats for federal, provincial, and regional use
- not limited to health
Indigenous Services Canada
- public health and health promotion services on-reserve and in Inuit communities
- primary care on reserve in remote and isolated areas, where no provincial services readily available
provincial roles
- health insurance plans
- hospital care
- physician care
- some extent - institutional and community care
- negotiation of fee schedules with health professionals
why decentralized
- prov/terr responsibility for funding and delivery
- many organizations operate at arms length from provincial governments
- status of phsycians as contractors
what is the Canada Health Act
- federal legislation
- objective of health policy
- mostly about health care financed
what is the criteria of CHA
- Public administration - provincial health care insurance non profit basis
- comprehensiveness
- Universality - insured persons and insured health services
- Portability - can move and be covered
- Accessibility - reasonable access
Conditions of CHA
- Information - provide info to federal minister of health
- Recognition - that federal financial contributions
what is medically necessary
- not defined
- prov/terr define it
issues with CHA
- focus on physician or hospital to the exclusion of other
- doesn’t address services outside medicare…
- doesn’t encourage interdisciplinary approaches
- doesn’t deal with ownership of health facilities
What are the three I’s
- Interests - agendas of groups
- Ideas - knowledge or beliefs
- Institutions - formal and informal rules
