THE CANADIAN HEALTH CARE SYSTEM

1
THE CANADIAN HEALTH CARE SYSTEM

• Health care system is all of the services offered
  by all health disciplines.
• Health care is one of the largest industries in
  Canada.

2
HISTORICAL PERSPECTIVE

• British North America Act (BNA), 1867
• Canada becomes a federated state
• Outlines powers of levels of government
• Health responsibility of the provinces
• Money collected by federal government
• Federal govt. responsible for certain populations
  (First Nations, Inuit, military, immigrants,
  refugees)

3
History continued

• 1939 Saskatchewan Municipal and Medical
  Hospital Service Act
• Municipalities collect taxes for doctor services
  (1916) and hospital services (1939)
• 1947 Saskatchewan universal hospital insurance
• 1957 Federal hospital insurance act
• Emphasis on hospital care
• 1962 Sask. Medical Care Act

4
History continued

• 1964 Hall report
• Recommends Sask. Model for public insurance
• 1968 Medical Care Act (framework for medicare)
• Comprehensiveness
• Universality (availability)
• Portability
• Public administration
• Accessibility (reasonable access)

5
CANADA HEALTH ACT (1984)

• Re-affirmed the 5 principles of medicare
• Abolished user fees
• Other health professionals may provide funded
  services in some situations (nurse practitioners,
  mental health workers)
• Health is a right, not a privilege
• Federal cash transfer payments to provinces

6
Consumer Rights to Health Care

• Right to be informed
• Right to be respected as one responsible for own
  health care
• Right to participate in decisions affecting own
  health
• Right to equal access to health care

7
Types of Health Care

• Health promotion
• Disease and injury prevention
• Diagnosis and treatment
• Rehabilitation and health restoration
• Palliative care

8
Levels of Health Care

• Primary care first level of care first contact
  with the health care system health promotion,
  prevention, education, early detection and
  treatment
• Secondary care emergency care, diagnosis and
  treatment, acute care, community hospital
• Tertiary care long-term care, care of the
  dying, rehabilitation often in hospital

9
Levels of Prevention

• Primary prevention health promotion and
  protection against disease e.g. immunizations,
  health education
• Secondary prevention early identification of
  problems and prompt intervention e.g. screening
  programs development, speech, BP regular
  check-ups breast self-exam
• Tertiary prevention rehabilitation after an
  illness to an optimal level of functioning e.g.
  diabetic teaching, rehab for someone after a
  stroke

10
THE CURRENT SYSTEM

• Too many hospitals
• Focus on acute care
• Medical model
• Need to allocate resources to prevention and
  health promotion
• Less expensive care (need to cut costs)
• Include other health care providers in new roles

11
Challenges to health care in Canada

• Demographic changes (aging, homelessness)
• New technologies
• New health risks
• Shortage of health professionals
• Rising costs
• Reduced federal funding
• Need to treat illness and do health promotion

12
MANITOBA GOVERNMENT BUDGET

• Health 35
• Support to families 11.7
• Education 20
• All others 33.3

13
Trends in Health Care Reform

• Regionalized services
• Move care to the community
• Reduce hospital beds
• Increase public input in health
• Intersectoral collaboration
• Reduce inequities
• Control costs
• Models like Primary Health Care

14
ROMANOW COMMISSION REPORT (2002)

• Renewing Canadas health care system
• Commitment to principles in Canada Health Act
• Health Council of Canada
• New principle of accountability
• Targeted funding for health
• Human resources
• Primary health care focus
• Home care
• Meeting needs of special populations
• Managing drug costs
• Information technology

15
Future challenges to health care

• Increased chronic illness
• Re-emergence of infectious diseases
• World health issues (AIDS, bio-terrorism)
• Ethical issues
• Shorter hospital stays
• Rationing of health care resources
• Technology
• Genetic engineering

16
IMPLICATIONS FOR NURSING

• Supports PHC and publicly funded system
• Recruitment and retention
• Extended hours
• Specialization
• Increasing skill mix
• Part of primary care team
• Extended practice (NPs)