PUBH2000 - Health system in Canada Assignment 2 Answer

Introduction

The publicly funded healthcare system in Canada is flexible. In response to advancements in both medical and society, reforms have been in place for the past 40 years and still are now. The fundamentals are still the same, though. In other words, universal coverage is given based on need, not ability to pay, for medically necessary care. The fundamental principles of equity and equality, which are evident in Canadians' willingness to share resources and responsibilities, are reflected in the country's health care system, which has undergone major modifications since it was first established. This system has evolved along with changes in the nation's population, economic climate, and healthcare industry.

This task focuses on exploring the health care system of Canada. The role of government and funding system of the health care system of Canada has been evaluated in this task in a detailed manner.

Role of Government in the Health Care System

The Canadian Constitution, which assigns duties to the federal, provincial, and territorial governments, essentially dictates how Canada's healthcare system is organised. The majority of the burden for providing health and other social services falls on state and territorial governments. The Commonwealth is also in charge of serving particular demographic groups with services. Including personal, corporate, sales, payroll, and other revenues, general revenues from federal, state, and territorial taxes are used to pay for publicly financed healthcare (Allin & Rudoler, 2019). States may also charge people for health insurance premiums in order to pay for publicly funded medical treatments, but they are not permitted to restrict access to medically necessary medical services by prohibiting nonpayment of premiums.

The creation and management of national policy for the system under the Canadian Health Act are among the duties of the federal government in the field of health care. Financial support for governments and territories; a number of additional duties, such as financing or offering primary and auxiliary services to particular groups of people. These groups include:

• Native Americans who reside on reservations
• Inuit, active members of the Canadian Forces
• Qualified veterans
• Inmates of federal prisons
• Select categories of asylum seekers

The Canada Health Care Act lays out the requirements for health insurance plans that provinces and territories must fulfil in order to be eligible for the full range of federal cash benefits for medical assistance. Access to medically necessary hospital and physician services must be made reasonably available by states and territories. Additionally, the legislation forbids additional fees and royalties (Martin et al., 2018). A claim for covered medical services made by a doctor that exceeds the sum reimbursed or payable by the state or territorial health insurance for that treatment is referred to as an extra claim. Charges are the costs for approved medical treatments that the state or territory's health insurance plan permits and that are not due.

Structure of Health Care System

Canadian Medicare is the country's decentralised, publicly funded healthcare system. The 13 states and territories in the nation are primarily responsible for funding and managing healthcare. The federal government provides per capita cash assistance, and each has its own insurance plan. However, all citizens and permanent residents have free access to hospital and physician treatments that are required for medical reasons. Certain groups are offered insurance by states and territories to cover costs for treatments that are not covered, like outpatient prescription medicines and dental care. The majority of Canadians, about two thirds, also have private health insurance.

The P/T Universal Health Care Program is co-funded by the federal government and is available to qualifying First Nations and Inuit peoples, Canadian military personnel, veterans, resettling refugees, some asylum applicants, and prisoners. It oversees a variety of services for particular clients. government prison. It also supervises a number of national public health functions, sponsors health research and some information technology systems, and regulates the efficacy and safety of medical equipment, pharmaceuticals, and natural health products (Smith-Bindman et al., 2019). Under P/T law, most providers run their own operations. They are registered with regional oversight organisations that make sure that high standards for instruction, preparation, and care are met (such as Colleges of Physicians and Surgeons). Ombudsmen who represent patients are present in the majority of federal states.

Figure 1: Health system in Canada

Source: (Smith-Bindman et al., 2019)

Funding Model of Health Care System

In Canada, public health insurance programmes supported by the provinces and territories are collectively known as Medicare. It is universal and is based on the guidelines of the Health Canada Act of 1984. The federal and provincial governments of Canada provide the majority of the money for the country's healthcare system. Approximately 23% of public money is given by the federal government through the Canada Health Transfer (Wilson et al., 2020). Over the past 20 years, the percentage of publicly supported health care in Canada has stayed steady at around 70%. Private money is used to cover the remaining costs, primarily through co-pays and private insurance. Public financing for Canada Health Transfer increased from 21% in 2012 to 23.5% in 2019.

The federal government can offer targeted support for health care in addition to annual payments to federal states via CHT. But the allotted monies aren't required to keep funding indefinitely. They usually just cover a certain amount of time. This kind of transfer to states and territories has no legal foundation, unlike CHT and other sizable federal transfers. Instead, agreements are made between the federal government and each state governing the transfer of funds and their intended use (Montesanti et al., 2018). Federal budgets for 2017 include $ 11 billion in state support for ten years, beginning in 2017 and 2018, with a focus on the two disciplines. With the exception of Quebec, all states have committed to a shared statement of health priorities, and each state and the federal government have signed bilateral agreements. The 2004 agreement serves as the foundation for the asymmetrical agreement with the federal government of Quebec.

Makeup of the Workforce

Canada has a low resident-to-doctor ratio globally. The ratio of primary care doctors to residents is, nevertheless, higher than the norm for OEC member nations and, like the United States, lower than that of several other high-income nations. 51% of all health professionals are general practitioners. 74% of primary care doctors and 23% of those who practised alone in 2007 reported engaging in group or interprofessional practise. More than half of them receive commission payments for more than 90% of their professional income (Unruh et al., 2022). Most people who work for pay combine different payment options.

Broad Health System Performance Indicators

There are conflicting findings regarding Canada's performance in comparative studies of health system performance, and there is some indication that Canada's position has fallen over time. In the rankings for life expectancy at birth, for instance, Canada decreased from second to seventh place between 1990 and 2010, and from fourth to tenth place when compared to 19 comparable countries. Canada has achieved success, at least in some circumstances. Years of disability and stroke mortality have been good in Canada. Many people are perplexed about how Canada's healthcare system is performing globally as a result of these contradictory outcomes.

Primary healthcare is a substantial source of funding for state and local governments, and it is also one of their most effective policy instruments. The provision of financing and resources that raise the pay of caregivers, their quality of life at work, or their level of job satisfaction is frequently linked to desirable advances in the structuring and delivery of healthcare services. Contractual pacts with service providers are additional policy levers. funding medical professional education programmes that identify the variety and availability of medical resources for primary healthcare. Creating or altering governance frameworks, rules, and legislation (James et al., 2019). Except for the variety of regulated primary health care practitioners, the latter is hardly employed to further primary health care reform. Formal agreements between medical societies and governments or ministries of health frequently contained significant policy improvements. A range of funding, physician costs, and organisational approaches are incorporated into the majority of state and territorial primary health care systems under construction.

The majority of Canada's healthcare services are managed and provided by the provinces and territories, and all of their health insurance programmes must adhere to the national standards outlined in the Health Canada Act. Each state's and territory's health insurance programme pays ahead and without a direct cost at the time of service for medically necessary hospital and doctor services. Federal funding and tax transfers are used to pay for these services by state and territorial governments.

Conclusion

The organisation of the Canadian healthcare system is fundamentally set forth in the Canadian Constitution, which delegated responsibilities to the federal, provincial, and territorial governments. State and territory governments are primarily responsible for delivering health care and other social services. The Canada Health Care Act outlines the conditions that provinces and territories' health insurance programmes must meet in order to be qualified for the full spectrum of federal cash benefits for medical assistance. Each has its own insurance plan and receives cash help from the federal government per person. However, hospital and doctor visits that are necessary for medical reasons are free of charge for all citizens and permanent residents.

References

Allin, S., & Rudoler, D. (2019). The Canadian health care system.International Profiles of Health Care Systems, 27-35. https://nightingale.instructure.com/users/11895300/files/215834362/download?download_frd=1&verifier=wmsEEQggVgjvqzjQ0ixeuFZoYKEFPG3DQhCOB4hK#page=25

James, M. T., Levey, A. S., Tonelli, M., Tan, Z., Barry, R., Pannu, N., ... & Hemmelgarn, B. R. (2019). Incidence and prognosis of acute kidney diseases and disorders using an integrated approach to laboratory measurements in a universal health care system.JAMA Network Open,2(4), e191795-e191795. https://jamanetwork.com/journals/jamanetworkopen/article-abstract/2729807

Martin, D., Miller, A. P., Quesnel-Vallée, A., Caron, N. R., Vissandjée, B., & Marchildon, G. P. (2018). Canada's universal health-care system: achieving its potential.The Lancet,391(10131), 1718-1735. https://www.sciencedirect.com/science/article/pii/S0140673618301818

Montesanti, S., Robinson-Vollman, A., & Green, L. A. (2018). Designing a framework for primary health care research in Canada: A scoping literature review.BMC family practice,19(1), 1-8. https://bmcfampract.biomedcentral.com/articles/10.1186/s12875-018-0839-x

Smith-Bindman, R., Kwan, M. L., Marlow, E. C., Theis, M. K., Bolch, W., Cheng, S. Y., ... & Miglioretti, D. L. (2019). Trends in use of medical imaging in US health care systems and in Ontario, Canada, 2000-2016.Jama,322(9), 843-856. https://jamanetwork.com/journals/jama/article-abstract/2749213

Unruh, L., Allin, S., Marchildon, G., Burke, S., Barry, S., Siersbaek, R., ... & Williams, G. A. (2022). A comparison of 2020 health policy responses to the COVID-19 pandemic in Canada, Ireland, the United Kingdom and the United States of America.Health Policy,126(5), 427-437. https://www.sciencedirect.com/science/article/pii/S016885102100169X

Wilson, C. R., Rourke, J., Oandasan, I. F., & Bosco, C. (2020). Progress made on access to rural health care in Canada.Canadian Family Physician,66(1), 31-36. https://www.cfp.ca/content/66/1/31.short

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