In 1000 words (+/- 10%), write a summary of the key points from the three sections of Part A. This should include a concise summary of: • How the public health system is both organised and funded • How your chosen country performs in terms of the WHO’s key building blocks of the health system • A potential health system reform you could implement in your chosen country to improve weaknesses in the system
Health System and Economics “Canada’s Medicare “ Health System and Economics “Canada’s Medicare “ Group members: Introduction Canada’s legislation works together with the help of federal and the provincial governments. In 1867 under the Constitution Act was set up which was made responsible for: Establishing sound health system. Maintaining health staff. Managing healthcare sectors and other charitable institutions. By 1950, the federal government passed the Hospital Insurance and Diagnostic Services Act which aimed at: Providing universal coverage for particular services of health. And 4years later it was decided that the government would fund the health sector. 5 Principles of Canada’s Health Sphere Public Administzingration: It includes the planning, organizing, directing, coordinating and controlling of government operations so as to bring out maximum benefit from the healthcare. Comprihensiveness: necessary services provided by hospitals comprehensively, for example cancer patients are treated not only medically but also psychologically. Accessibility: reasonable access to health departments and physicians without barriers of discrimination. Universality: All insured people are entitled to health services uniformly. Portability: The provincial and territorial government planned to cover all insured persons, when they move to another province or territory within and outside Canada. The percentage of GDP spent on health in comparison to that of Australia: POPULATION OF CANADA 35.85 millions Total health expenditure reached $264 billion which constituted 11.6% of gross domestic product (GDP). Report: (National Health Expenditure Trends, 2019) POPULATION OF AUSTTRALIA 23.78 millions In 2017-18, an estimated $185.4 billion was spent on health which constituted 10% of overall economic activity. The major spending went on hospitals(40%) and primary health care(34%). Author: AIHW Publication: 25 sep 2019 4 Funding and its Sources: Funding is done through Federal taxation Territorial taxation Provincial taxation Such as charging for : Charging for health premium on their residents. Sales taxes Payroll levies All these raise funds https://www.ephpp.ca/ https://www.ephpp.ca/ SHARES OF FUNDING Provincial / Territorial Government – 65% Private Sector- 30% Social Security Funds- 1% Municipal Governments- 1% Federal Direct- 4% Role of government in healthcare Not only funds are gathered for health services other provisions for Sanitation Supply of clean drinking water Education and awareness generation Control of infections Setting up free health camps Research activities are also made for the people of Canada. How expenditures for public health services, including prevention programs, are estimated (CIHI, 2009) Carlos How expenditures for public health services, including prevention programs, are estimated (CIHI, 2009) Carlos Expenditure mix (private and public) (Government of Canada, 2020a) Carlos Health promoting and financing; (CIHI, 2009) (CIHI, 2009) Carlos (CIHI, 2009) (Government of Canada, 2020b) Carlos Explaining Expenditures: The Underlying trends Demographic Health care spending is highest on seniors. Although per-person spending increases considerably with age — from $6,656 for those aged 65 to 69 to $20,793 for those aged 80 and older. Population aging is a modest driver of increasing health care costs, at about 1% per year. Technology Despite the fact that technology generally increases costs in the short term, technology can also be a major factor in reducing costs in the medium and long terms. Changes in Treatment (Utilization of Hospital Care) The past decade has seen changes in the utilization of hospital care. While there has been a slight decrease in the number of beds, there has been a modest increase in the average length of stay and a slight increase in the average amount of resources consumed by inpatients. Canada’s Universal Health Care System Canada’s Universal Health Care System Medicare Universal coverage for medically necessary health care services provided on the basis of need, rather than the ability to pay. To be eligible to receive full federal cash contributions for health care, each provincial and territorial (P/T) health insurance plan needs to comply with the five pillars of the Canada Health Act, which stipulate that it be: Publicly administered Comprehensive in coverage conditions Universal Portable across provinces Accessible (for example, without user fees). Economic Levers to achieve better health outcomes in Canada GDP It is anticipated that, overall, health spending will represent 11.6% of Canada's gross domestic product (GDP). Higher the GDP, more money can be used for better health outcomes Employment rate Higher the employment rate, more people would be able to get employer based or private health insurance. In 2017, private insurance was estimated to account for 12 percent of total health spending. Economic Levers to achieve better health outcomes in Canada Encourage cost-effective investment in preventive health Canada’s state and territory governments can routinely trial and evaluate prevention initiatives. Improving Poverty Rate Estimates place the cost of poverty on the Canadian health care system to be $7.6 billion. Enacting policies to end poverty is the best step forward legally, morally and economically. References CIHI. (2020). How has health spending growth changed over the last 40+ years? | CIHI - Retrieved on 04/08/2020. Canadian Institute for Health Information. https://www.cihi.ca/en/how-has-health-spending-growth-changed-over-the-last-40-years CIHI, C. I. F. H. I. (2009). National Health Expenditure Trends 1975-2009. In Health (San Francisco) (Issue October). Government of Canada. (2020a). Canada’s Health Care System - Canada.ca - Retrieved on 04/08 . https://www.canada.ca/en/health-canada/services/health-care-system/reports-publications/health-care-system/canada.html#a7 Government of Canada. (2020b). Programs and policy development – Public Health Agency of Canada - Canada.ca - Retrieved on 04/08/2020. Government of Canada. https://www.canada.ca/en/public-health/programs.html Marchildon, G., & Matteo, L. Di. (2011). Health Care Cost Drivers : The Facts, Spending and Workforce. Canadian Institute for Health Information, 1–33. 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://doi.org/10.1016/S0140-6736(18)30181-8 Health promotionChronic disease prevention Infectious disease prevention and control Health security Aboriginal Head Start in Urban and Northern Communities (AHSUNC) program Public Health Surveillance Laboratory science leadership and services Emergency preparedness and response Canada Prenatal Nutrition Program (CPNP)Canadian Diabetes Strategy (CDS) Public Health Scholarship and Capacity Building Initiative National Collaborating Centres for Public Health (NCCPH) Community Action Program for Children (CAPC) Healthy Living Fund Communicable diseases and infection control Public Health Scholarship and Capacity Building Initiative Innovation StrategyCanadian Breast Cancer InitiativePublic Health SurveillanceBiosecurity Nutrition North CanadaFederal Tobacco Control Strategy HIV and Hepatitis C Community Action Fund (CAF) Border and travel health Preventing Gender-Based Violence: The Health Perspective Integrated Strategy for Healthy Living and Chronic Disease – Cancer National Collaborating Centres for Public Health (NCCPH) Integrated Strategy for Healthy Living and Chronic Disease – Cardiovascular Disease Program Strengthening the Canadian Drugs and Substances Strategy (Harm Reduction Fund) International Health Grants ProgramBlood Safety Men’s HealthInternational Health Grants Program Evidence for health promotion and chronic disease and injury prevention Immunization Economic Action Plan 2015 Initiative - Brain Health Immunization Partnership Fund National Collaborating Centres for Public Health (NCCPH) Foodborne and zoonotic diseases Fetal Alcohol Spectrum Disorder (FASD) – National Strategic Projects Fund National Collaborating Centres for Public Health (NCCPH) Integrated Strategy for Healthy Living and Chronic Disease – Enhanced Surveillance for Chronic Disease Infectious Diseases and Climate Change Fund - Adapting to the Impacts of Climate Change Integrated Strategy for Healthy Living and Chronic Disease – Joint Consortium for School Health Integrated Strategy for Healthy Living and Chronic Disease – Observatory of Best Practices Health promotion and chronic disease prevention