HSS 2121 FINAL W-8+ EXAM QUESTIONS WITH
CORRECT ANSWERS
What was the Chaouli case? - ANSWER This was a 2005 lawsuit brought by quebec
doctors on behalf of his patient. SC ruled 4-3, long waiting lists imperils patient's rights
to "security of the person", many said this decision opened the door to private delivery
and financing of HC. Essentially, a man who needed a hip replacement was left in pain
for hours due to absence of 2 tiered system. The gov of QC responded by granting more
HC access through private providers. Private providers could now complete hip and
knee replacement surgeries but healthcare would cover the costs.
How was wait time for HC defined? - ANSWER It was defined after the 2005 Chaouli case
as there were many ways to define wait time, it could be based on when a certain
procedure had been permitted and how long it took to reschedule to procedure, from
the moment the patient was afflicted by their condition, etc.
Was the 2005 decision the start of the slippery slope to privatization? - ANSWER No, the
decision only applied to QC, SC allowed QC gov leeway to address the waiting lists and
the timelines of treatment while maintaining a single tier publicly funded health care
system. It did not rule that a parallel private insurance system is constitutionally
guaranteed. The issue was, and still remains timely access to HC.
What is health tourism? - ANSWER This is when tourists go to foreign countries to
receive medical treatment such as dental treatment which is privately covered in
canada. There was a case with an indian woman who returned to india to receive IVF
although she was told she did not qualify, which resulted in her coming back to canada
pregnant and having a multiple birth, which was expensive for the canadian HC system.
Hence, what happens often is that if medical treatment in other countries go wrong, the
canadian system bears the costs if something goes wrong.
What are examples of health tourists to canada? - ANSWER Many mothers fly to canada
to give birth in vancouver and privately pay hospitals in BC to deliver their children. This
means that since children born in canada are considered canadian citizens, they can
receive full benefits of canadian healthcare if they ever visit in canada, and take
advantage of free medicare if they ever visit canada for a surgery, without the child ever
having to pay taxes to the country. This also sends canadian mothers to the back of the
line as foreign women who are paying customers are given priority.
What is the history of private clinics in canada? - ANSWER There were series of
copeman clinics that gave non insured services and they opened in vancouver in 2005,
their memberships were of 3900 one time and 2900 yearly. These clinics also billed ohip
for certain services covered by the government while also charging their clients. The
issue is that people can pay for timely access to doctors and nurses, which is queue
,jumping. Ontarie said charging a membership fee was illegal under the canada health
act. Today, one example is for profit blood plasma clinics.
What's the problem with a 2 tiered system in canada? - ANSWER pros: It would reduce
wait lists in the public system, would allow people to but the HC they can afford, would
mean more money for govs to spend on those who really need it, and it technically
already exists for sports teams like the ottawa senators.
But sadly, there are cons: It would drain health professionals from the public system,
will only do the easy stuff, not the costly and complex procedures, when things go
wrong, cases will be shipped back to the public system, and private clinics have no
incentive/interest to work cooperatively across the continuum of care people will be
discharged from the hospital and put in a taxi and will end up somewhere other than
where they're supposed to be.
What are acute staff shortages during covid? - ANSWER This increased canadians'
awareness of staff shortages and available medical resources. Increasing procedure in
private clinics, (even if paid for by public ministries), will drain staff from the public
system. They have better working conditions and no hours, meaning there would simply
be fewer available hours overall.
What is one problem with the quality control of private clinics? - ANSWER There is no
way to evaluate the level of private care, private clinics can refuse to give data and can
refuse certain patients that have too many comorbidities. Private clinics wants clients,
meaning they will be unavailable in the north rural remote areas. They have no incentive
to promote disease prevention initiative as they make their money from treating disease,
and these clinics are not proven to be more efficient of cheaper than public ones. Some
research shows that countries with 2 tier health care such as britain and new zealand
have longer wait times than canada.
How high are the costs of health care administration. - ANSWER The USA spends more
than 25 dollars per 100 dollars on administrative costs while canada spends 2/100
dollars. This means the total cost per capita in canada is 158 compared to 667 in the
USA. this means that overall, in a 2 tiered system, people pay more on average and
healthcare depends on the size of one's wallet according to Roy Romanov
What was the case of the supreme court declining to hear BC doctor's fight for private
health care. - ANSWER The Dr. in question was DR brian may, medical director of the
cambie surgery centre in vancouver who launched a battle in 2009, 14 years ago. He
was challenging medicare laws that prohibit patients from paying for faster access to
private medically necessary healthcare. The supreme court of canada declined his last
change at appeal, revealing their support of public medicare.
How did Brian Day argue his course? - ANSWER Dr day's lawyer argued that wait times
in the public system were endangering people's right to section 7 of the charter of rights
and freedoms, the right to life, liberty and security of the person. Therefore, people had
a right to pay for faster access to medically necessary care. The Supreme court of
,canada declined his last chance at appeal, meaning they supported public medicare
and would not tolerate privatization.
What was PHAC? - ANSWER this is the public health agency of canada which was
instituted in 2004 after sars to respond to evolving threats and noutbreaks.
Who is theresa tam? - ANSWER Canada's chief public health office, she was called one
of the "new rock stars" as female experts who informed the general public on
healthcare matters.
What do canadians need to recognize going forward? - ANSWER Canadians need to
recognize that global health and the need for international cooperation exists, as this
can affect public health in canada in an interdependent world. We are interdependent
on nations around the world. Global health is public health, and there was a measles
outbreak in california's Disney world, which shows that international travel can cause
the spread of disease.
What are some new ways of delivery healthcare? - ANSWER In the USA, post Roe v
Wade, George washington univeristy installed emergency contraception vending
machines. Students could lead efforts over concerns for reproductive rights after
supreme courts struct down constitutional rights to abortion in the 2020s. There were
also extensions of safe supply distribution of detox drugs through the use of vending
machines to make substances more easily available to populations who require it.
What are current issues in HC in canada? - ANSWER - obesity
- mental health
- loneliness
- aging population
- home care and continuing care
- wait times
- indigenous health
- health human resources
- electronic health (confidentiality and ethics)
- drug coverage (national pharmacare program)
What is the SDOH? - ANSWER social determinants of health, which can intersect with
national and federal healthcare for particular cases.
, Why is there no national pharmacare program? - ANSWER Very poor and many of the
elderly were already covered by provinces. Many of the rest covered through work
health plans. Only the working poor were not covered, and they had no political bearing
as they were always busy working and had to make decisions about whether to buy their
kids expensive drugs, or shoes. countries with single payer pharmacare pay half or less
for their drugs. This is also a problem because many middle aged youth aged off their
parents' plan and were suddenly on their own in university since univeristy students did
not have full time jobs.
What was the issue with elections and new pharmacare? - ANSWER The NDP
threatened to stop voting alongside the liberals should they not institute the new
pharmacare plan. The NDP said they would continue to support the liberals, but many
provinces do not want to accept this plan.
What is a problem with access to primary healthcare in canada? - ANSWER Over 6
million canadians go without a family doctors
Who was Tara Kiran? - ANSWER A canadian doctor who surveyed over 10000 canadians
over 16 months and found deep dissatisfaction and frustration in canadians about
primary care and severe shortage of family docs. She led the OurCare initiative with the
MAP centre for urban health at St Michaels Hospital. She is also a scientist and family
doctor and her dissatisfaction report spanned 72 pages.
What is one example of how women were forgotten in society? - ANSWER Women drive
many car sales, but there is nowhere to put a purse in a car. Likewise, there are no
female bulletproof vests, covid masks were too large, cars have their pedals too far
from the feet of women, public toilets are inefficient for women who take longer in the
toilet, etc. In many big cities, women are not safe in public toilets.
What are 6 ways sex and gender are important? - ANSWER 1. There are sex specific
conditions such as pregnancy and prostate cancer
2. conditions are more prevalent by gender, in Women: more depression, eating
disorders, in men: substance abuse, schizophrenia)
3. Conditions that appear as neutral (Heart disease) manifest differently by gender.
4. women's gendered roles in society influence their health as many are expected to do
chores while also having full time jobs with lower incomes.
CORRECT ANSWERS
What was the Chaouli case? - ANSWER This was a 2005 lawsuit brought by quebec
doctors on behalf of his patient. SC ruled 4-3, long waiting lists imperils patient's rights
to "security of the person", many said this decision opened the door to private delivery
and financing of HC. Essentially, a man who needed a hip replacement was left in pain
for hours due to absence of 2 tiered system. The gov of QC responded by granting more
HC access through private providers. Private providers could now complete hip and
knee replacement surgeries but healthcare would cover the costs.
How was wait time for HC defined? - ANSWER It was defined after the 2005 Chaouli case
as there were many ways to define wait time, it could be based on when a certain
procedure had been permitted and how long it took to reschedule to procedure, from
the moment the patient was afflicted by their condition, etc.
Was the 2005 decision the start of the slippery slope to privatization? - ANSWER No, the
decision only applied to QC, SC allowed QC gov leeway to address the waiting lists and
the timelines of treatment while maintaining a single tier publicly funded health care
system. It did not rule that a parallel private insurance system is constitutionally
guaranteed. The issue was, and still remains timely access to HC.
What is health tourism? - ANSWER This is when tourists go to foreign countries to
receive medical treatment such as dental treatment which is privately covered in
canada. There was a case with an indian woman who returned to india to receive IVF
although she was told she did not qualify, which resulted in her coming back to canada
pregnant and having a multiple birth, which was expensive for the canadian HC system.
Hence, what happens often is that if medical treatment in other countries go wrong, the
canadian system bears the costs if something goes wrong.
What are examples of health tourists to canada? - ANSWER Many mothers fly to canada
to give birth in vancouver and privately pay hospitals in BC to deliver their children. This
means that since children born in canada are considered canadian citizens, they can
receive full benefits of canadian healthcare if they ever visit in canada, and take
advantage of free medicare if they ever visit canada for a surgery, without the child ever
having to pay taxes to the country. This also sends canadian mothers to the back of the
line as foreign women who are paying customers are given priority.
What is the history of private clinics in canada? - ANSWER There were series of
copeman clinics that gave non insured services and they opened in vancouver in 2005,
their memberships were of 3900 one time and 2900 yearly. These clinics also billed ohip
for certain services covered by the government while also charging their clients. The
issue is that people can pay for timely access to doctors and nurses, which is queue
,jumping. Ontarie said charging a membership fee was illegal under the canada health
act. Today, one example is for profit blood plasma clinics.
What's the problem with a 2 tiered system in canada? - ANSWER pros: It would reduce
wait lists in the public system, would allow people to but the HC they can afford, would
mean more money for govs to spend on those who really need it, and it technically
already exists for sports teams like the ottawa senators.
But sadly, there are cons: It would drain health professionals from the public system,
will only do the easy stuff, not the costly and complex procedures, when things go
wrong, cases will be shipped back to the public system, and private clinics have no
incentive/interest to work cooperatively across the continuum of care people will be
discharged from the hospital and put in a taxi and will end up somewhere other than
where they're supposed to be.
What are acute staff shortages during covid? - ANSWER This increased canadians'
awareness of staff shortages and available medical resources. Increasing procedure in
private clinics, (even if paid for by public ministries), will drain staff from the public
system. They have better working conditions and no hours, meaning there would simply
be fewer available hours overall.
What is one problem with the quality control of private clinics? - ANSWER There is no
way to evaluate the level of private care, private clinics can refuse to give data and can
refuse certain patients that have too many comorbidities. Private clinics wants clients,
meaning they will be unavailable in the north rural remote areas. They have no incentive
to promote disease prevention initiative as they make their money from treating disease,
and these clinics are not proven to be more efficient of cheaper than public ones. Some
research shows that countries with 2 tier health care such as britain and new zealand
have longer wait times than canada.
How high are the costs of health care administration. - ANSWER The USA spends more
than 25 dollars per 100 dollars on administrative costs while canada spends 2/100
dollars. This means the total cost per capita in canada is 158 compared to 667 in the
USA. this means that overall, in a 2 tiered system, people pay more on average and
healthcare depends on the size of one's wallet according to Roy Romanov
What was the case of the supreme court declining to hear BC doctor's fight for private
health care. - ANSWER The Dr. in question was DR brian may, medical director of the
cambie surgery centre in vancouver who launched a battle in 2009, 14 years ago. He
was challenging medicare laws that prohibit patients from paying for faster access to
private medically necessary healthcare. The supreme court of canada declined his last
change at appeal, revealing their support of public medicare.
How did Brian Day argue his course? - ANSWER Dr day's lawyer argued that wait times
in the public system were endangering people's right to section 7 of the charter of rights
and freedoms, the right to life, liberty and security of the person. Therefore, people had
a right to pay for faster access to medically necessary care. The Supreme court of
,canada declined his last chance at appeal, meaning they supported public medicare
and would not tolerate privatization.
What was PHAC? - ANSWER this is the public health agency of canada which was
instituted in 2004 after sars to respond to evolving threats and noutbreaks.
Who is theresa tam? - ANSWER Canada's chief public health office, she was called one
of the "new rock stars" as female experts who informed the general public on
healthcare matters.
What do canadians need to recognize going forward? - ANSWER Canadians need to
recognize that global health and the need for international cooperation exists, as this
can affect public health in canada in an interdependent world. We are interdependent
on nations around the world. Global health is public health, and there was a measles
outbreak in california's Disney world, which shows that international travel can cause
the spread of disease.
What are some new ways of delivery healthcare? - ANSWER In the USA, post Roe v
Wade, George washington univeristy installed emergency contraception vending
machines. Students could lead efforts over concerns for reproductive rights after
supreme courts struct down constitutional rights to abortion in the 2020s. There were
also extensions of safe supply distribution of detox drugs through the use of vending
machines to make substances more easily available to populations who require it.
What are current issues in HC in canada? - ANSWER - obesity
- mental health
- loneliness
- aging population
- home care and continuing care
- wait times
- indigenous health
- health human resources
- electronic health (confidentiality and ethics)
- drug coverage (national pharmacare program)
What is the SDOH? - ANSWER social determinants of health, which can intersect with
national and federal healthcare for particular cases.
, Why is there no national pharmacare program? - ANSWER Very poor and many of the
elderly were already covered by provinces. Many of the rest covered through work
health plans. Only the working poor were not covered, and they had no political bearing
as they were always busy working and had to make decisions about whether to buy their
kids expensive drugs, or shoes. countries with single payer pharmacare pay half or less
for their drugs. This is also a problem because many middle aged youth aged off their
parents' plan and were suddenly on their own in university since univeristy students did
not have full time jobs.
What was the issue with elections and new pharmacare? - ANSWER The NDP
threatened to stop voting alongside the liberals should they not institute the new
pharmacare plan. The NDP said they would continue to support the liberals, but many
provinces do not want to accept this plan.
What is a problem with access to primary healthcare in canada? - ANSWER Over 6
million canadians go without a family doctors
Who was Tara Kiran? - ANSWER A canadian doctor who surveyed over 10000 canadians
over 16 months and found deep dissatisfaction and frustration in canadians about
primary care and severe shortage of family docs. She led the OurCare initiative with the
MAP centre for urban health at St Michaels Hospital. She is also a scientist and family
doctor and her dissatisfaction report spanned 72 pages.
What is one example of how women were forgotten in society? - ANSWER Women drive
many car sales, but there is nowhere to put a purse in a car. Likewise, there are no
female bulletproof vests, covid masks were too large, cars have their pedals too far
from the feet of women, public toilets are inefficient for women who take longer in the
toilet, etc. In many big cities, women are not safe in public toilets.
What are 6 ways sex and gender are important? - ANSWER 1. There are sex specific
conditions such as pregnancy and prostate cancer
2. conditions are more prevalent by gender, in Women: more depression, eating
disorders, in men: substance abuse, schizophrenia)
3. Conditions that appear as neutral (Heart disease) manifest differently by gender.
4. women's gendered roles in society influence their health as many are expected to do
chores while also having full time jobs with lower incomes.
