13 January 2010

Healthcare corner #2 - History

todays class was a dry but very important session on: the history of canadian health care.

the most brief history highlight list i can create (its still interesting though):
1945 - post-WWII canada puts forth a bill for national health insurance. it gets shot down.

1947 - under the guidance of Tommy Douglas, the province of saskatchewan creates the first compulsory state-sponsored universal hospital insurance program in north america.

1957 - the canadian federal government creates 50-50 cost sharing between federal and provincial governments for the hospital insurance programs now going on in several provinces.

1962 - again under the guidance of tommy douglas, the province of saskatchewan creates the first compulsory state-sponsored universal medical care insurance program in north america. because this now involves all arenas of health care the doctors of saskatchewan strike due to fear of lost wages and in protest of government meddling in their profession.

1966 - the canadian federal government creates 50-50 cost sharing between federal and provincial governments for the medical care insurance programs now going on in several provinces.

1984 - after several permutations of programs for covering medical insurance for its citizens, canada passes the definitive "Canada Health Act" whose principles are still the foundation for their system today.

1993-1997 - due to recession, the health care budget was frozen or reduced for the first time since the canada health act was adopted.

2003 - 10-year health care plan to inject more money ($17.3 billion) into the health care system.

2004 - the public health agency of canada was established (disturbing to me that this happened so late. in fact, the SARS outbreak is what spurred the need for the agency to be created).

2005 - a quebec resident who didnt want to wait on the waiting list for a hip replacement sues the government to be able to have the right to buy private health insurance for procedures/care that is covered under the public insurance. he wins in the case called "the chaoulli decision."
okay, so thats about as brief as i could make it. a few extra points:

- the canada health act has five conditions: public administration, comprehensiveness, universality, portability, and accessibility. the act itself is fairly short (like 14 pages but only one of the columns on each page is in the english, the other is in french) and you can find it here, if you want to read the legal jargon yourself.

- the term "medicare" definitely does not reference the same thing in canada as it does in the u.s. here, "medicare" is simply the unofficial name for canadas publicly funded universal health insurance system.

- the CBC has a neat little archived video/audio area with a few clips related to canadian medicare history. if youre bored you should check it out; they are each quite short. we watched clip #7 in class, which is a clip i highly recommend. the people are from 1962 saskatchewan but they could easily be americans today (minus the wacky hair/outfits and the accents). if you watch it, youll see what i mean. other clips i thought were worthwhile: #1, 8, 9.

- an anecdote: before we went back to MI for christmas, i called our insurance company to buy travel insurance. being pregnant, i wasnt going to get caught with some huge medical bill from the u.s. if there were some reason that forced me to go to the hospital while i was back. canadian health insurance does actually cover its citizens internationally (part of the "portability" function of the canada health act) but the rate of international reimbursement varies and since the u.s. has notoriously high (or perhaps exorbitant?) health care costs, there is no way the canadian health insurance could or would cover all of your bill.

anyway, our insurance guy knew that we were american, so when i called for travel insurance for travel back to my "home country" he was confused about why we needed to buy the insurance. he wondered why we wouldnt we just be using our american insurance? i told him, "well, we dont have jobs in the u.s. and we dont live in the u.s. how would we have insurance there? we live in canada and are covered under the canadian health insurance." he understood the last part, but still couldnt believe that we had NO insurance whatsoever from america when we stepped back onto our soil. i said nope, none at all, so...please sell me some. and we did end up getting travel medical insurance for those days we were back in MI (total cost for dave and i: $54). to clarify, our insurance guy is younger (uh, and clearly not too "with it") so maybe he doesnt really care about what is going on politically in the u.s., but if he has heard about the american health care debate...i wonder what he thinks the debate is about? maybe its not a totally rare confusion that some canadians have?

1 comment:

Mary Ann said...

I'll stop, I promise. But, according to the NY Times, the # is up to $22,000,000. I just think that's wonderful.