KINE1020 Lecture 3 - Health Care PDF

KINE1020 Click to edit Master text School styles of Kinesiology and Health Science Second levelFaculty of Health Third level Fourth level Fifth level Lecture 3 – Health Care 1 ...

KINE1020 Click to edit Master text School styles of Kinesiology and Health Science Second levelFaculty of Health Third level Fourth level Fifth level Lecture 3 – Health Care 1  For Next Week 1. Focus on your timetable and plan your study habits Even Labs start this week (TODAY!) Read lab 1 and look on eClass for your laboratory TA contact info 2. Read the syllabus before emailing [email protected] with questions 3. Download the lecture notes prior to lecture and keep up with the work 4. Guest Lecture on Monday. This is the topic for your reflection assignment (Due Nov 15). 2  EVEN Labs Start Next Week!!! Scroll to the bottom to find the laboratory info. You will only be able to see YOUR lab info Lab 1 starting next week for EVEN sections The TA contact is unique for YOUR lab If you need accommodations, please let your TA know via email. 3  What is Health? THE HEALTH CONTINUUM “Unhealthy” “Healthy” “Optimally Healthy and Fit” “Absence of Disease and/or Symptom” Rehabilitation Prevention Disease Physicians Fitness Professionals Optimum or or Wellness coach Wellness (Treat disease) Death (Enhance fitness) Health Care Professionals (Health Promotion) 10  Health is impacted by things inside and outside of your control Physical Determinants of Health https://www.sciencedirect.com/topics/medicine-and- https://www.cdc.gov/visionhealth/determinants/index.ht dentistry/determinants-of-health ml KINE 1020 KINE 1000 11  The Canadian Health Care Concept (1974 Lalonde Report) A significant Canadian Health Field concept was 12 presented in 1974 that included lifestyle and environment:  Total Health Expenditure per Capita, 2019 USA Germany Canada https://www.healthsystemtracker.org/chart- collection/health-spending-u-s-compare- Japan countries/#item-spendingcomparison_gdp-per- capita-and-health-consumption-spending-per- capita-2019 13 13  Life Expectancy Longest: Japan Shortest: Central African Republic Healthy Life Expectancy (HALE) https://apps.who.int/gho/data/view.m ain.SDG2016LEXv?lang=en 14  On average, other wealthy countries spend about half as much per person on health than the U.S. https://www.cihi.ca/sites/default/ files/document/nhex-trends- narrative-report-2019-en- web.pdf 15  Global difference in Health Spending https://yourhealthsystem.cihi.ca/hsp/inbrief#!/indicators/014/age-adjusted-public-spending-per- person/;mapC1;mapLevel2;/ 16  Universal Health Care Models https://www.theatlantic.com/international/archive/2012/06/heres-a-map-of-the-countries-that- 17provide-universal-health-care-americas-still-not-on-it/259153/  Types of Healthcare Systems Hospital health care costs paid by: Government controlled (taxes - Britain) Insurance Companies (payroll deductions) – not for profit and cover everyone even if not employed (Germany) Combination Government and Insurance (Canada) Out of pocket (developing countries) 18  Healthcare System in US There are various types of health insurance Government funded for certain groups (veterans and seniors, etc) Private insurance through the employer Out of pocket (no insurance – 8.5%) ~30 million Americans have no health insurance ADA (Obamacare) gives subsidies and payments to insurance companies to make health insurance more affordable Two-thirds of bankruptcies cite medical issues. Not just those without health insurance only 40 percent of Americans have enough saved to cover a $1,000 emergency expense (~80% in Canada) https://www.pnhp.org/single_payer_resources/health_care_systems_four_basic_models.php https://www.cnbc.com/2019/02/11/this-is-the-real-reason-most-americans-file-for-bankruptcy.html https://www.theglobeandmail.com/globe-investor/retirement/retire-planning/how-much-is-enough-for-your- 19 emergency-fund/article28460148/  Figure 1 The Canadian Health System Model is complex The Constitution of Canada- the supreme law in Canada. Outlines Canada's system of government and the civil and human rights of those who are citizens of Canada and non-citizens in Canada. Both Federal and Provincial Roles Several Federal and Provincial Organizations Reginal Health Authorities Individual Health Care Coverage Does Vary… KNOW YOUR COVERAGE…ASK YOUR PARENTS WHAT COVERAGE YOU HAVE? 20 The Lancet 2018 3911718-1735DOI: (10.1016/S0140-6736(18)30181-8)  Healthcare System in Canada In Canada, health care is regulated at the federal level, but the delivery of health care is one by the province. Each province and territory is expected to cover ‘medically necessary hospital and doctors’ services’ What is not covered? Services out of the hospital (such as): - Dentist - Eye-care - Cosmetic Surgery - Ambulance services - Prescription drugs (unless old or young) https://www.canada.ca/en/health-canada/services/health-care-system/reports- 21 publications/health-care-system/canada.html#a5  Typically, students age 25 and older loose the health care coverage they might have had with their parent’s private health care provider.. 22  11.6% Share of GDP (%) 6.8% 1975 2019 % of GDP (economy) spent on health care has gone up from 6.8% in 1975 to 11.6% in 2019 https://www.cihi.ca/sites/default/files/document/nhex- 23 trends-narrative-report-2019-en-web.pdf  Health Expenditure per Capita, by Age Group, 2017 https://yourhealthsystem.cihi.ca/hsp/inbrief#!/indicators/014/age-adjusted-public-spending-per- Sources person/;mapC1;mapLevel2;/ National Health Expenditure Database, CIHI; Statistics Canada. 24 24  Decreased from 44.7% Increased from 10% In 1970s In 1970s https://www.cihi.ca/sites/default/files/document/nhex- 25 trends-narrative-report-2019-en-web.pdf  To be eligible for OHIP You must be: Canadian or PR Live in Ontario for 153 of the previous 183 days 26  Canada’s health care system “universal coverage for medically necessary health care services provided on the basis of need, rather than the ability to pay.” i.e. hospital and physician services Termed “medicare”- a publicly funded health care system Interlocking set of ten provinces and three territorial health insurance plans Doctors can be fined $10.000 if caught selling a service that is covered by medicare for a first offence 27 http://www.hc-sc.gc.ca/hcs-sss/index-eng.php  If you want to be depressed and read the full article, here is the link: https://www.fraserinstitute.org/sites/ default/files/comparing- performance-of-universal-health- care-countries-2020.pdf Data was collected prior to COVID https://www.fraserinstitute.org/file/comp aring-performance-of-universal-health- care-coountries-2020-infographicjpg 28  Wait times in Canada Hope you are patient GP to Specialist Specialist to Total Wait time Treatment 2020 10.5 12.1 22.6 2019 10.1 10.8 20.9 … 1993 3.7 5.6 9.3 5.4 weeks for CT 11.1 weeks for MRI 3.5 weeks for Ultrasound Substantial regional differences in wait times 29 https://www.fraserinstitute.org/studies/waiting-your-turn-wait-times-for-health-care-in-canada-2020  https://www.fraserinstitute.org/sites/default/files/waiting-your-turn-2020-execsum- 30 national.pdf  Canada postponed more than 353,913 surgeries, procedures and other medical appointments in the first wave of COVID-19 Fiscal year 2019- 20: 2,256 patient deaths while waiting for surgery 6,202 deaths while waiting for diagnostic scans or appointments with specialists. 10,000 patients died while waiting on all categories of wait lists https://nationalpost.com/news/canada/more-than-2000-patients-in-canada-died-while-waiting-for-medical-care-in-2020-report https://www.secondstreet.org/2021/06/29/no-fewer-than-2300-non-covid-patients-died-on-surgical-wait-lists-in-2020/ 31  Argument for a need for private health care which incentivizes performance? 32  Advantages of Public versus Private Health Care Full Private Full Public Pro Pro Faster Care Everyone can get the SAME healthcare More Options for Procedures Care is more affordable (non-profit) Can choose doctor Better doctor-patient ratios More privacy Con Con Inequality Longer Wait Times Not all will get health care Fewer Choices Refuse to treat complex cases (to increase profit) Higher patient loads for healthcare workers Even with insurance, care may not be covered 100% More Expensive Profit may undermine patient interests (order more tests than needed for profit) 33  Pros and Cons of mixed Public-Private Health Care Full Private + Full Public Pro Con Will take some pressure off the public system and Creation of a two tiered health care system reduce wait times and improve care for the rich and poor. Freedom of choice Best professionals will move to private for better wages Government partnerships with private companies are often more costly and inefficient “Some have described it as a perversion of Canadian values that they cannot use their money to purchase faster treatment from a private provider for their loved ones. I believe it is a far greater perversion of Canadian values to accept a system where money, rather than need, determines who gets access to care.” —Roy Romanow, from the final report of the Royal Commission on the Future of Health Care (2002) 34 https://www.healthcoalition.ca/project/pro-public-health-care/ http://www.ontariohealthcoalition.ca/wp-content/uploads/AUDITORS-REPORT-December-8-9-2008.pdf  Canada has already allowed some privatization 2016 Saskatchewan passed a law allowing patients to jump the queue by paying out of pocket for diagnostic tests like MRIs and ultrasounds Patients in Ontario are being billed thousands of dollars for cataract surgeries Private health care clinics in Alberta, BC and elsewhere are charging fees for memberships and services 35 https://www.healthcoalition.ca/project/pro-public-health-care/  Should the Federal Government enforce the Canada Health Act? Withhold federal funding OR Continue to allow more for provinces that have privatization of essential allowed privatization of health care in Canada essential health care 36