Health Policy: Midterm Exam Review Notes
Health: a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity Health policy refers to decisions, plans, and actions that are undertaken to achieve specific health care goals within a society. An explicit health policy can achieve several things: it defines a vision for the future which in turn helps to establish targets and points of reference for the short and medium term. It outlines priorities and the expected roles of different groups; and it builds consensus and informs people.
Reading: “Myth: Medicare Covers All Necessary Health Services” Canada has about a 70:30 mxi of publicly and privately purchased health services, with the proportion of services not covered publicly seems to be on the rise other nations insure as much as 90% of health services with public money whether a health service is covered by medicare depends on where the service is provided and who provides it some services funded in one province may not be funded in another province, likewise a service that may be covered when preformed in the hospital may not be covered if provided in the community or the home (ex. Psychologists) the legislation on medicare is set out in the Canada Health Act to receive federal contributions to their healthcare programs, provinces must comply with the minimum requirements which includes providing first-dollar coverage of “medically necessary” hospital and physician services the definition of medical necessity is left somewhat open to interpretation by the provinces, but there is a general agreement that some health services are “medically necessary” and that others are not the Canadian Health Act sets the minimum requirement, provinces can provide coverage of more services at their discretion hospitals attract about 30% of the total healthcare bill – this number has been shrinking over the last few years advocates for integrated healthcare argue that coverage should follow services, regardless of location dental care is a good example, 94% is paid for out of pocket or through private insurance in mental health there has been a shift from treating patients in the community rather than in the hospital … this may lead to continued dwindling of public coverage for mental health services mental health services are not considered “medically necessary” in the CHA… yet according to the World Health Organization, improving mental health is a crucial aspect of the overall health and well-being of individuals home health care is another example, all provinces cover some core services while other service are public insured in select jurisdictions access to outpatients prescription drugs also varies, each province decides who is eligible for public coverage (based on age or income) about 40% of pharmaceuticals in Canada are covered under public insurance this has prompted calls for a national universal drug program … some provinces have already moved in this direction in conclusion medicare does not cover all aspects of healthcare in this country
Reading: “Myth: Canada’s System of Healthcare Financing is Unsustainable” medicare is Canada’s taxpayer-financed insurance plans for hospital and physician care health system trying to meet the growing needs of an aging population those who argue the system is unsustainable point to public funding and administration as part of the problem, rather than the solution their proposed remedy is- Canadians can accept less-comprehensice public health insurance, with more services being paid for out-of-pocket or by private insurance this ignores the facts about which costs are rising, and by how much; the ability of medicare to adapt; international evidence; and, most importantly, the wants and needs of Canadians it is important to measure healthcare spending increases in relation to GP because it helps us to understand how costs are increasing relative to our ability to pay them...
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