NURS- 1001 Understanding the Canadian Healthcare System

• Evolution of health care system

• Healthcare reform

• Indigenous health

European Settlers

5th Century

• Infectious diseases

• Poor sanitation

• Public health laws

British North America Act 1867

• Constitution act

• Self-governing

• Public health

• Public policy

• When Canada became a self-governing country

Urbanization

• Social programs

  • Childrens aids society (1891)

  • Red Cross (1896)

  • Victoria Order Nurses (1897)

  • Mental Health Association (1918)

• Municipality Act 1916

  • Tax revenue to pay physicians

  • Before this physician's salary was paid by people

Tommy Douglas

• Premiere of Saskatchewan

• Gave rise to universal healthcare

Medicare

• Hospital Insurance & Diagnostic Services Act (1957)

• Medical Care Act (1966)

• Federal-provincial Fiscal Arrangements and Establishment Programs Financing Act (1977)

Canada Health Act

“ to protect, promote, and restore the physical and mental well-being of residents of Canada and to facilitate reasonable access to health services without financial or other barriers” (Health Canada, 2011)

• Prevent any further billing, and stop the divided between those who can and can't afford healthcare

• Covers the costs of services directly related with healthcare

• Excludes armed forces, inmates, RCMP

Canada Health Transfer

“The largest major federal transfer to provinces and territories. It provides long-term predictable funding for health care and supports the principles of the Canada Health Act (CHA). The transfer is made on an equal per capita basis, to provide comparable treatments for all Canadians, regardless of where they live.” (Government of Canada, 2011)

Governance of Healthcare

• Federal- assist in financing, creating national health promotional

• Provincial/Territorial -manages healthcare facilities,

• Professional -self-regulating professionals

Canadas Healthcare

• Nursing workforce

• Universal care

• Canada Health Act (5 principles that prevent extra billing)

Areas of Care

• Primary -Health promotion, mental health promotion (physicians, NP, nurses)

• Secondary - specialized care in a hospital, long-term care etc, funding based on budget rather than service. Assessed by medical professional

• Tertiary -specialized care for complicated health issues

WHY ARE WE CONCERNED WITH THE PRIVATIZATION OF HEALTHCARE?

Privatization

• Staffing

• Funding

• New regulations

• Health inequities

• Pressure off the public system?

• Wealthier people get better healthcare, best doctors would work here

Ontario Health Coalition

• The Power of Peoples Referendum

• Activist coalition that is trying to preserve the Canadian healthcare system

• Ontario citizens can vote on public or privatization of the healthcare system

Health Care Challenges

• Aging population

• Chronic disease

• Fiscal constraints -Health services becoming expensive (new tech, new drugs, reform)

• Access to treatment/wait times -training and training more healthcare professionals

Health Care Reform

• Kirby Report (2002) -Assesd problems/solutions with the canadian healthcare system. Recommended gov paying for canadians services even in other ocuntries

• Romanow Report (2002) - promoted in primary care, recommended increase funding and changes to the system

• 10 Year Plan to Strengthen Healthcare (2004)

Future of Health Reform

• Patient wait times

• Primary Healthcare -Increase the boundaries of practice for physicians (no more doctors only having to practice where they are licensed)

• Pharmacare -By funding pharmacare we can prevent future costs of healthcare and deteriorating health

Healthcare Trends

• Artificial intelligence -multiple health applications, Ai flag health risks, develop new drugs and treatments, and create strategies for health

• Telehealth -remote options

• Wearable devices -collects health data that patients and physicians can use, empowers patients to perform healthier habits

• Electronic health records -Centralized data in patient reports that allows phsyicans to work together (e.g public health records)

• Mental health care -mental health apps, online group therapies, telehealth

Indigenous Health

• Infectious diseases

• Segregation

• Systemic Racism

• Treaties

  • Medicine Chest Clause Treaty 6 (1876)

  • Indian Act (1876)

  • Indian Health Policy (1979)

  • Health Transfer Policy (1989)

Self Governance & Determination

“Self-government negotiations are one way to work together in partnership toward this goal and advance Indigenous rights and principle of international law” (Government of Canada, 2020)

• Approach to Implementation of the Inherent Right and the Negotiation of Aboriginal Self-Government (1995)

Joyce Echanquan

• 37 mother of 7 who died of pulmonary ademia

• Came in hospital distruaght and in pain

• Staff at hospital did believe her and thought she was going through drug withdrawal

• Posted video of her being harassed by hospital satff to facebook

Brain Sinclair

• Racism again

• Sat in wheelchair for 34 hours before staff relized he died

• Thought he was homeless or an alcoholic

Importance of Indigenous Health

• Ongoing racism and discrimination

• Overcome barriers

• Reduce stigma

Smudging

• Ceremony involving various plants

• The burning of one or more medicines (tobacco, sage, sweetgrass, cedar)

• Inhale the smoke

Relevance to Nursing

• Complexity of Canadian health care system

• Nursing role is evolving

  • Key stakeholders and policymakers

Summary

• Canadas healthcare evolved over time into a universal system. Free of additional charges for hospitalization or primary care

• Canada Health Act governs the delivery of heallthcare nationwide, provinces must deliver care based on the 5 principles

• Healthcare reform determines changes in policy to improve future of healthcare, major reform for primary care, potential privatization, pharma care

• Emerging health trends influence healthcare reform

• Indigenous health must be addressed to overcome racism and discrimination

• Self-governance gives indigenous communities the power to control policy, economic, political, and cultural affairs within the community

• Important for nurses to understand the healthcare system to act as advocates in policy change

Midterm Exam

• 2 hours

• In class

• 50 multiple choice

• 25% of final grade

• Lecture, reading & seminar content

• Knowledge application questions