General Information Quiz

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Questions and Answers

What concept explains how previous policy decisions influence present and future healthcare reforms?

  • Incremental change
  • Path dependency (correct)
  • Accountable governance
  • System integration

The COVID-19 pandemic did not influence primary health care delivery in Canada.

False (B)

Name one challenge posed by the rapid expansion of virtual visits during the COVID-19 pandemic.

Complicated traditional in-person interactions

Path dependency makes radical healthcare reforms _______ due to political and financial costs.

<p>difficult</p> Signup and view all the answers

What has been favored in Canada regarding healthcare reforms due to institutional barriers?

<p>Incremental small changes (A)</p> Signup and view all the answers

Match the following aspects of health care with their descriptions:

<p>EHRs = Electronic health records facilitating data management Team-based care = Collaborative approach to improve patient outcomes Integrated approaches = Holistic methods combining various health services Incremental changes = Gradual reforms rather than radical shifts</p> Signup and view all the answers

Professional and political ideologies tend to promote radical change in healthcare.

<p>False (B)</p> Signup and view all the answers

How has the perception of health professionals shifted during the COVID-19 pandemic?

<p>Towards integrated and digital approaches to care</p> Signup and view all the answers

Which of the following is NOT one of the five characteristics of the TAPIC framework?

<p>Sustainability (B)</p> Signup and view all the answers

Vertical equity means treating individuals with similar needs in the same manner.

<p>False (B)</p> Signup and view all the answers

What is the Bismarck model primarily based on?

<p>Social Health Insurance Model</p> Signup and view all the answers

In the TAPIC framework, one of the characteristics is __________, which involves holding parties responsible and monitoring their performance.

<p>Accountability</p> Signup and view all the answers

Match the following key features with their related concepts:

<p>Horizontal equity = Treating people with the same needs the same Vertical equity = Treating people with different needs differently Progressive financing = Higher income individuals pay a larger percentage Bismarck model = Social Health Insurance Model</p> Signup and view all the answers

What is the primary funding mechanism in the Bismarck model?

<p>Employee and employer premiums (B)</p> Signup and view all the answers

Participation in the TAPIC framework refers to the need for stakeholders to be meaningfully engaged.

<p>True (A)</p> Signup and view all the answers

Explain how progressive financing contributes to economic inequality in healthcare systems.

<p>It requires higher income individuals to pay a larger percentage of their income, which lessens financial inequities.</p> Signup and view all the answers

Which component of health expenditures grew faster than others from the mid 1990s to the 2010s?

<p>Drug costs (A)</p> Signup and view all the answers

Health care spending in Canada has steadily increased as a percentage of GDP since the post-war era.

<p>True (A)</p> Signup and view all the answers

What effect does aging have on health care spending in Canada?

<p>Aging increases spending per individual, especially from ages 60-80, although the overall impact is small.</p> Signup and view all the answers

Spending on long term care has been growing since the _____.

<p>1970s</p> Signup and view all the answers

Between which years was inflation-adjusted per capita healthcare spending notably increasing?

<p>1997 to 2010 (B)</p> Signup and view all the answers

The general inflation rate has had a larger impact on health care costs than population growth.

<p>False (B)</p> Signup and view all the answers

What term describes the phenomenon of decreasing costs of dying due to longer life expectancy?

<p>Compression of morbidity</p> Signup and view all the answers

Match the types of health expenditures with their definitions:

<p>Hospital costs = Inpatient and outpatient care, emergency services, and specialized treatments Drug costs = Prescription medications, vaccines, and medical supplies Long term care = Services in nursing homes and residential care facilities Physician services = Consultations, surgeries, and specialized treatments</p> Signup and view all the answers

What is a challenge posed by private financing in public health care systems?

<p>Erosion of universal coverage (C)</p> Signup and view all the answers

The 1995 Chaoulli decision allowed patients to purchase private insurance for services not covered by the Canada Health Act.

<p>False (B)</p> Signup and view all the answers

What was the primary focus of the 2021 Cambie decision?

<p>The right of providers to bill both the government and patients.</p> Signup and view all the answers

Private financing in health care systems leads to __________ access to essential medical services.

<p>unequal</p> Signup and view all the answers

Match the roles of private financing with their definitions:

<p>Complementary = Covers gaps like co-payments Substitutive = Replaces public coverage for specific patients Supplementary = Provides faster services with priority access</p> Signup and view all the answers

How did the Supreme Court rule in the 1995 Chaoulli decision regarding the Quebec charter?

<p>Violating the Quebec charter (C)</p> Signup and view all the answers

What is a major feature of a universal pharmacare system?

<p>Universal access to necessary medications (D)</p> Signup and view all the answers

The Cambie decision allowed the purchasing of private insurance to solve wait times for all patients.

<p>False (B)</p> Signup and view all the answers

Canada has universal drug coverage for all of its citizens.

<p>False (B)</p> Signup and view all the answers

What has been a significant barrier to accessing medications for Canadians?

<p>Out of pocket costs</p> Signup and view all the answers

What is one way that private financing can exacerbate financial inequalities in health care?

<p>Through out-of-pocket costs.</p> Signup and view all the answers

John Stuart Mill’s harm principle states that governments should only intervene in people's freedoms to prevent _____ to others.

<p>harm</p> Signup and view all the answers

Which of the following best describes the current Canadian pharmacare system?

<p>It consists of 100+ provincial programs targeting specific demographics. (B)</p> Signup and view all the answers

What is one reason why universal pharmacare is considered cost-effective?

<p>Centralized purchasing for price negotiation</p> Signup and view all the answers

Match the concepts with their correct descriptions:

<p>Vertical equity = Ensuring equal access regardless of social status Horizontal equity = Providing equal access for those in the same situation Out of pocket costs = Direct payments made by individuals for medications National drug formulary = A list of approved medications based on evidence</p> Signup and view all the answers

Canadians have had access to universal pharmacare since the 1990s.

<p>False (B)</p> Signup and view all the answers

What are the primary concerns of healthcare financing?

<p>All of the above (D)</p> Signup and view all the answers

Private delivery of healthcare is primarily accountable to public officials.

<p>False (B)</p> Signup and view all the answers

What is the impact of healthcare financing mechanisms on health system equity?

<p>They influence the distribution of resources and financial burdens within the system.</p> Signup and view all the answers

Public delivery of healthcare is characterized by __________ ownership.

<p>state</p> Signup and view all the answers

Match the types of financing mechanisms with their descriptions:

<p>Progressive financing = Higher contributions from wealthier individuals or groups Regressive financing = Lower contributions from wealthier individuals while poorer pay a higher percentage Neutral financing = Equal financial contributions regardless of income Centralized financing = Funds managed by a single entity for distribution</p> Signup and view all the answers

Which of the following describes private healthcare delivery?

<p>For-profit entities (D)</p> Signup and view all the answers

Governance in health systems only influences the financial aspects of healthcare delivery.

<p>False (B)</p> Signup and view all the answers

What is the TAPIC model in health system governance?

<p>A framework that addresses Transparency, Accountability, Participation, Integrity, and Cooperation.</p> Signup and view all the answers

Flashcards

Healthcare Financing

The process of collecting, pooling, and allocating funds to pay for healthcare services. It involves determining who pays for healthcare, how much they pay, and who receives the funds.

Financing Mechanism

The specific methods used to collect and distribute healthcare funds. Examples include progressive, regressive, or neutral financing, as well as centralized or fragmented financing.

Public Delivery

Healthcare services provided by state-owned hospitals or government-funded institutions. Accountability is directed towards the public or elected officials.

Private Delivery

Healthcare services provided by privately owned businesses or organizations, including for-profit entities. Providers are accountable to their owners and shareholders, focusing on profitability and organizational goals.

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Governance Dimension

The decision-making process and institutional structure that regulate healthcare activities. It involves managing relationships between financing agencies, beneficiaries, and service providers.

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TAPIC Model

A framework for health system governance that emphasizes the roles of Transparency, Accountability, Participation, Inclusiveness, and Collaboration.

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Universal Access

Ensuring that everyone has access to quality healthcare services, regardless of their income, location, or social status.

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Equitable Access

Ensuring that healthcare services are distributed fairly, taking into account the needs of different populations.

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Path Dependency

The idea that past policy decisions significantly influence future policy choices, making radical change difficult. Basically, the choices we made yesterday limit the options we have today.

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How Path Dependency Affects Healthcare

Path dependency in healthcare means that past decisions about how healthcare is structured and delivered (like focusing on physician-led care) make it hard to change the system radically. It's easier to make small, incremental changes.

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Incremental Change

Small, gradual changes made to a system over time, rather than a complete overhaul.

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Radical Change

A complete and sudden transformation of a system, usually requiring significant effort and risk.

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Health System Financing

The way a country pays for healthcare. This includes taxes, premiums, out-of-pocket costs, and other sources of funds.

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Financing's Impact on Equity

How healthcare funding affects access to care for different groups of people. Unequal funding can lead to disparities in health outcomes.

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Financing's Impact on Efficiency

How effectively healthcare funds are used to provide quality care and achieve health goals. Inefficient systems waste money and resources.

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Financing's Impact on Quality

The impact of funding on the quality of healthcare provided. Adequate funding is essential for high-quality care.

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What are the main categories of health expenditures in Canada?

These categories include hospital costs, drug costs, long-term care spending, and physician payment services.

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How has overall health care spending in Canada changed since the post-war era?

Total health care spending has consistently increased, particularly after the mid-1990s, considering population growth and general inflation.

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What is the difference between health expenditures adjusted for population growth and general inflation and health expenditures as a percentage of GDP?

Comparing adjusted expenditures shows the per capita change, while spending as a percentage of GDP reflects the proportion of the economy dedicated to healthcare.

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What are the trends in spending for each of the major health expenditure categories?

Hospitals saw a contraction in the 1990s, rapid growth in the 2000s, and have remained flat since. Pharmaceuticals grew rapidly from the mid-1990s until the 2010s but have stabilized. Long-term care has been growing gradually since the 1970s. Physician spending was flat in the early 1990s, grew significantly until 2015, and has been flat since.

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How does aging affect health care spending in Canada?

While aging has a small impact on overall spending, it increases per individual as they approach the end of life stages, requiring more care and services.

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What is the compression of morbidity?

This refers to the decreasing duration of illness and disability in the later stages of life, which can help reduce overall healthcare costs.

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Why should we focus on average utilization and costs of services rather than just aging?

To better understand the impact of healthcare spending, we should look at the average volume of services used and their average costs, rather than just focusing on the overall impact of aging.

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What is a significant factor contributing to the trend in healthcare spending despite the small impact of aging?

The cost of dying is decreasing as people live longer, leading to a compression of morbidity and potentially lower overall healthcare costs.

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TAPIC

A set of principles for good governance in healthcare, focusing on transparency, accountability, participation, integrity, and capacity, promoting access to affordable, appropriate, and accountable care.

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Transparency (TAPIC)

Open communication about healthcare processes and information sharing in a timely manner.

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Accountability (TAPIC)

Being held responsible for healthcare performance with mechanisms to monitor results.

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Participation (TAPIC)

Meaningful engagement of stakeholders in shaping healthcare policies and practices.

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Integrity (TAPIC)

Operating honestly and fairly in healthcare, with ethical conduct and values.

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Capacity (TAPIC)

Having the necessary resources (financial, personnel, infrastructure) to deliver effective healthcare.

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Horizontal Equity in Health Care Financing

The principle that people with the same needs should be treated equally in healthcare financing.

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Vertical Equity in Health Care Financing

The principle that people with different needs should be treated differently in healthcare financing, prioritizing those with greater needs.

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Equity in Financing

Ensuring healthcare's accessibility by addressing financial disparities. This means distributing resources fairly, considering both vertical (based on income) and horizontal (based on needs) equity, and adopting financing models that minimize financial inequities and maximize affordability.

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Pharmacare Inequities

Issues within Canada's current system where medication affordability often restricts access. This includes a significant portion of the population lacking drug coverage, causing people to skip medication due to out-of-pocket costs.

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Universal Pharmacare System

A healthcare model where everyone has access to necessary medications. This includes comprehensive public coverage integrated into the healthcare system, with minimal or no out-of-pocket costs.

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Key Features of Universal Pharmacare

Universal pharmacare systems, like those in the UK and Sweden, offer universal access, centralized purchasing, and a national drug formulary. This ensures medications are based on proven safety, efficacy, and cost effectiveness.

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Harm Principle and Healthcare

John Stuart Mill's principle suggests that governments should only intervene in healthcare when it prevents harm to others, ensuring individual liberty and freedom of choice.

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Cost-Effectiveness of Universal Pharmacare

Universal pharmacare, besides being equitable, can be more cost-effective than fragmented systems. This is due to centralized purchasing power leading to price negotiation and optimized drug usage.

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National Drug Formulary

A list of approved medications based on scientific evidence of safety, efficacy, and cost effectiveness. This helps ensure the best and most cost-effective drugs are available to everyone.

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Negative Liberty

The freedom from interference by others, even if it means potentially harming oneself or others.

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Positive Liberty

The freedom to act and pursue one's goals, requiring government intervention to ensure equal opportunity and access to resources.

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Out-of-Pocket Costs

Healthcare expenses paid directly by patients, often exceeding their financial capacity, and can exacerbate existing inequalities.

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Private Financing in Healthcare

Funding healthcare through private sources, such as insurance companies or individual payments.

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Complementary Private Financing

Private financing that fills gaps in public healthcare coverage, like co-pays without directly raising provider fees.

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Substitutive Private Financing

Private financing that replaces public coverage for specific individuals who are ineligible or choose not to participate in public insurance.

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Supplementary Private Financing

Private financing that offers faster or better healthcare services, giving paying individuals priority access.

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Chaoulli Decision (1995)

A landmark case in Quebec that ruled against the ban on private healthcare insurance, acknowledging the right to purchase private insurance for services already covered under the Canada Health Act, but limited to Quebec's Charter of Rights.

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Study Notes

Summary of General Information

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