PREFACE
Individualsworkinginanyfacetofhealthcareshouldunderstandthecomponentsofhealthand wellnessandhowhealthcareisdeliveredinCanada.Thisuniquetextwillprovideavaluable overviewofandfoundationforunderstandingtheseimportantandchallengingconcepts.This bookwillalsobenefitindividualswantingtobetterunderstandtheessentialsofhealthcare deliveryinCanada.
Whilebynomeansexhaustive, HealthandHealthCareDeliveryinCanada,ThirdEdition, discussesmanycomponentsofhealthandhealthcaredelivery.Thechaptersinthisedition havebeenupdatedandrearrangedbeginningwiththehistoryofhealthcareinCanada.The proceedingchaptersdiscusstheresponsibilitiesofthevariouslevelsofgovernment,thecostof healthandillness,thecurrentstateofhealthhumanresourcesandtheimpactofpopulation healthinitiativesfromtheperspectiveofthedeterminantsofhealth.Theconceptsofhealth andillnessfollowwhichleadstoanexaminationofthelegalandethicalaspectsofhealthcare. Thelastchaptertakesacriticallookatcurrentissuesinhealthcareaswellasfuturetrends.
Thebook’scontenthasbeencarefullyselectedinordertohighlightessentialmaterial.The chapterrelatetoandexpandoncontentinthepreviouschapter.Commonthreadssuchasthe determinantsofhealth(inparticulartheeffectsofthesocialdeterminantsofhealth)arecarried throughoutthebookandmaterialflowsinanorderlyandunderstandablemanner.Throughout thiseditionmoreemphasisonthehealthcarechallengesandneedsofIndigenouspeopleof Canada.
Itisimportanttonotethatthisbookprovides ageneraloverview,asnapshotofhealthand healthcaredeliveryinCanada,recognizingalsothateachjurisdictiondelivershealthcaredifferently,andthatchangesareongoing,thuscurrencyinsomeareasisrelative.
Bytheendofthisbook,studentswillbeabletosay, “IunderstandhealthcareissuesinCanadaandhowdifferentlevelsofgovernmentoperateintermsofhealthcaredelivery.Iunderstandhowourhealthcaresystemisfundedandthefutureissuesfacinghealthandhealthcarein Canada,” and,mostimportant, “IunderstandthesystemthatIamchoosingtoworkin.” IntendedtoaccompanypostsecondaryintroductorycoursesinCanadianhealthcaredelivery, thisbookoffersstudentsafoundationwithwhichtheycaneasilymoveforwardtoother,more specificallyfocusedcourses.
CONTENT
Chapter1 (TheHistoryofHealthCareinCanada)providesthereaderwiththehighlightsinthe historyofourhealthcaresystem.Theseincludetheeventsleadinguptotheimplementationof the CanadaHealthAct,whichisthefoundationofthehealthcaresysteminCanada.Students areencouragedtoexaminetheprinciplesofthisActintermsoftheirrelevanceinthetwentyfirstcentury.Newtothischapterisanexpandedsectiondiscussingthehistoryofthehealthand healingpracticesofIndigenousPeoplesinCanadafromthe “precontact” eratopresentday. Chapter2 (TheRoleofHealthCanadaandOtherFederalandInternationalHealthAgencies) and Chapter3 (TheRoleofProvincialandTerritorialGovernmentsinHealthCare)focuson thedivisionofpowersandtheimplementationofhealthcarefromfederalandprovincialor territoriallevels.
Chapter2 exploresrecentchangesintheorganizationalstructureofHealthCanadasuchas thenewlycreatedOpioidResponseBranchandtheCannabisLegalizationandRegulation branch.
Chapter3 followsthreefamilies twoofwhomarenewtoCanadaaddressingthechallenges andbarrierstheyfacesettlinginanewcountryandunderstandinganewhealthcaresystem. MoststudentsarelikelytohavehadsomeexposureeitherdirectorindirecttoindividualsseekinganewlifeinCanadaandwillbebetterabletorelatetoandappreciatethechallenges involvedwithsuchthingsasfindingaphysician,navigatingthehealthcaresystem,andunderstandingwhatiscoveredundertheirprovincial/territorialplan.Thischapterhighlightssome variationsintheprovincialandterritorialhealthcareplanshowhealthcareisdelivered,and howthesedifferencesaffectthefamilies.Forexample,in2019thegovernmentofOntariochangedthestructureandfunctionalaspectsofhowhealthcareisdelivered.Educatorsareencouragedtoexpandonhealthcaredeliveryintheirownjurisdictionswhilecomparingitwiththose ofotherjurisdictions.
Chapter4 (TheDollarsand “Sense” ofHealthCareFunding)looksatcurrentfinancial issues,wherethemoneyforhealthcarecomesfromwhereitgoes,andalsoexamineswhat “strings” thefederalgovernmentattachestoitsfundingfortheprovincesandterritories.This chapterincludesadiscussionaboutthetargetedfundingformentalhealthandhomecareservicesdesignatedbythefederalgovernmentinthe2017budget,andthespecificfunding arrangementsmadebyeachjurisdiction.Themajorcostdriversregardingprescriptiondrugs andthecurrentstatusofaproposednationalpharmacareprogramarealsoaddressed. Chapter4 examinesthesoberingfactthatreal-lifehealthcaredecisionsaresometimesmadebasedon whoqualifiesfortreatmentunderaprovincialorterritorialplanandwhodoesnot andwho willopttopayforservicesout-of-pocket.
Chapter5 (PractitionersandWorkplaceSettings)providesthestudentwithaclearpicture ofthecurrentstateofourhealthhumanresources whodeliversthecare,inwhatsetting,and underwhatcircumstances.Itexamineshowthedeliveryofprimaryhealthcarehaschanged acrossCanadaintermsofprimaryhealthcareteamswhichoperateundernumerousdelivery modelsandtheexpandingrolesandresponsibilitiesofvarioushealthcareproviders.
Chapter6 (TheEssentialsofPopulationHealthinCanada)explainshowthegovernment andotherhealthcarestakeholdersevaluatethehealthofCanadians,identifyriskfactors,implementstrategiestodealwithcurrenthealthproblems,andpredictproblemsthatarelikelyto ariseinthefuture.Populationhealthinitiativesarediscussedfromtheperspectiveofthedeterminantsofhealth,particularlythesocialdeterminantsandtheirsometimes-devastatingeffects onvulnerablepopulationgroups.
Chapter7 (HealthandtheIndividual)providesthestudentwithanunderstandingofthekey conceptsofhealth,wellness,illness,disease,anddisability.Inthisedition,spiritualandemotionalwellnessareemphasizedalongwithholisticinterventionsandmodelsofwellness.The conceptoftheIndigenous “wholistic” theoryframeworkwhichincorporatesthemedicinewheel alongwiththew/holisticconceptofunderstandingthenatureofbalance,harmony,andlivinga goodlife.Amongotherthings,studentsareencouragedtoexaminetheirownhealthbeliefsand healthbehavioursandtoconsiderhowthesecontributetomaintaininghealth.
Chapter8 (TheLawandHealthCare)analyzeslegalissues,clarifyingprovincial,territorial, andfederalboundariesintermsoflegislationandthelaw.Considerablediscussionisdevotedto currentlawsregardingconfidentialityandconsenttotreatment.Includedinthischapterisa discussionsurroundingthelegalaspectsofmedicalassistanceindyingandtheuseofbothmedicalandrecreationalcannabis.
Chapter9 (EthicsandHealthCare)highlightsethicalprinciplesandpointsoutthathealth careprofessionalsareheldtoahigherlevelofethicalaccountabilitythanarethoseinmany otherprofessions.Thischapteralsodiscussesthefinelinethatsometimesdividesethicsand health-relatedlegalissuessuchasmedicalassistanceindyingandtheuseofcannabis.Thestudentwilllearnwhythisboundaryissofragileandhowtopractiseinamoralandethicalmanner.LegalimplicationsretardingthecurrentopioidcrisisinCanadaarealsodiscussed
Chapter10 (CurrentIssuesandFutureTrendsinHealthCareinCanada)discusses importantchallengescurrentlyfacingCanada ’shealthcaresystem,suchasthestateofmentalhealthservices,managingcareforCanada’ sagingpopulation,theshortageofhuman healthresources,andtheincreasingneedforhomecareservices.Thischapteralsocontains anexpandeddiscussiononthehealthofIndigenousPeopleofCanada,disparitiesthataffect theirhealthandwell-being,currentchallengesmanyIndigenouspopulationgroupsface, andhealthcareservicesavailable.
Additionally,thischapterexploresotherissuesthatwillimpactthefutureofhealthcarein Canada.Thisincludestherisksandbenefitsinvolvingthesafety/securityofelectronichealth informationandtheimpactofsocialmediaonhealthcare.
HowcanCanadamaintainadequatehealthcareservicesinthefaceofcomplexmedical problems,increasinglyexpensivedrugs,advancingandcostlytechnology,andlessfunding? Willelectronicmedicalrecordsandelectronichealthrecordsbeimplementedatanationallevel, andhowandwhenwillthisimplementationtakeplace?Althoughnoconcreteanswersexist,the studentwillbepreparedtolookahead,awareofthesignificantobstaclesthatweasanation mustovercomeifweareindeedtosalvagepubliclyfundedhealthcareforall.
LEARNINGFEATURES
Eachchaptercontainsseveraluniquefeaturesmeanttostimulatestudentinterest.Learningoutcomesoutlinetheobjectivesforthechapter.Keytermsdefinechallengingconcepts. Chaptersummariesandreviewquestionsunderscorekeyelements.
Additionalfeaturesincludegeneralinterest, “ThinkingItThrough,”“DidYouKnow?,” and “CaseExample” boxes.Thesefeaturesencouragethestudenttothinkthroughfacts,pointsof interest,andactualsituationsandtoanswerquestionsthatpromoteexplorationofpersonal views,generaldiscussion,and,insomecases,furtherinvestigation.AdditionalEvolve® online resourcestoaccompanythetextcanbefoundat http://evolve.elsevier.com/Canada/Thompson/ health.
ACKNOWLEDGEMENTS
Writingabookofthisnaturecannotpossiblyoccurinisolation.Ioweagreatdealtosomany people,includingthoseworkingwiththeCanadianInstituteforHealthInformationandHealth Canada.ThanksalsotoJudithSurridge,BScNWoman’sCollegeHospital,andDr.James McArthurforsharinghisknowledgeandexpertiseregardingtreatmentsandsupportsavailable forthosemisusingopioidsandotherdrugs.
IoweadebtofgratitudetoLyndaCranston,substantiveeditor,forhermeticulousreview, organizingandeditingofnumerouschapters,andtoEllenHawmanforherassistancein researchingandcitingresourcesthroughoutthebook.I’dalsoliketoacknowledgeLyleGrant forhisdetailedandexpertlegalreviewof Chapter8
SpecialthankstotheElsevierteamthathavebeensupportivethroughoutalleditionsofthe textbook.AveryspecialthankyoutoSandyMatos,DevelopmentEditor,forherpatience, knowledge,andsupportthroughoutthewritingandpreparationofthethirdedition.
IwouldlikealsotoacknowledgeandthankElsevier’sreviewers,whoprovidedhelpfulcomments,constructivecriticism,andsuggestionsforimprovementsduringvariousstagesofthe manuscript.Iamgratefulfortheadviceandrecommendationsprovidedtome,muchofwhich wasusedtopreparethisthirdedition.
ValerieD.Thompson
REVIEWERS
SharonDemers,RNBN,CAE Instructor
PracticalNursingQualificationRecognitionProgram AssiniboineCommunityCollege Winnipeg,MB
TracyHoot,RN,BScN,MSN,DHEd AssociateDean SchoolofNursing ThompsonRiversUniversity Kamloops,BC
LaureenLarson,MHRD,PMP,BVTEd,BScN,RN
OccupationalHealthNursingAcademicChair – AddictionsCounselling, HealthInformationManagement,OccupationalHealthNursing, andPsychiatricNursingPrograms;IndigenousNursing andInter-ProfessionalEducationServices SchoolofNursing
SaskatchewanPolytechnic Saskatoon,SK
TammieMcParland,RN,PhD,CCNE DirectorandAssistantProfessor FacultyofEducation&ProfessionalStudies SchoolofNursing NipissingUniversity Nipissing,ON
KathlynPalafox,BSN,BCPID AcademicInstructor
WestCoastCollegeofMassageTherapy NewWestminster,BC
AndriaPhillips,RNMScNCCNE SessionalLecturer SchoolofNursing FacultyofHealth YorkUniversity Toronto,ON
ProfessorKariRivest,MRT(R),BSc MedicalRadiationTechnologyProgram SchoolofHealthSciencesandEmergencyServices CambrianCollege Sudbury,ON
BeverleyRobinson,MASocialWork
Lecturer
SchoolofContinuingStudies
McGillUniversity
Montreal,QC
IsabelleWallace,RN,BScN,MScN
Director
DialogueNB Moncton,NB
LeadAnalyst,IndigenousPolicyandResearch
NewBrunswickHealthCouncil-ConseildelasanteduNouveau-Brunswick Moncton,NB
ChrisWatkins,RPN,DipPN,BScPN,MN
AssistantProfessor
PsychiatricNursingProgram
MacEwanUniversity
Edmonton,AB
SpecialFeatures,xix
1 TheHistoryofHealthCareinCanada,1
EvolutionofHealthCare:An Overview,2
DivisionofResponsibilitiesfor Health,2
TheOriginsofMedicalCarein Canada,3
TheHistoryofHealingPracticesof IndigenousCanadians,3
TheDevelopmentofHospitalsin Canada,7
TheRoleofVolunteerOrganizations inEarlyHealthCare,8
TheConceptofPublicHealthIs Introduced,10
TheRoleofNursinginEarlyHealth Care,10
TheIntroductionofHealth Insurance,11
FirstAttemptstoIntroduceNational HealthInsurance,11
Post–WorldWarII:ThePolitical Landscape,12
ProgressTowardPrepaidHospital Care,12
ProgressTowardPrepaidMedical Care,13
SignificantEventsLeadingUptothe CanadaHealthAct,14
EventsFollowingtheIntroductionof the EPFAct,14
The CanadaHealthAct (1984),16
CriteriaandConditionsofthe Canada HealthAct,16
Interpretingthe CanadaHealth Act,20
AdditionalComponentsoftheAct,21
CONTENTS
Afterthe CanadaHealthAct: CommissionedReportsand Accords,21
SocialUnion,23 CommissionedReports,24 Accords,27
OtherInitiatives,30 References,32
2 TheRoleoftheFederalGovernmentin HealthCare,35
HealthCanada:Objectivesand Responsibilities,36
HealthCanadaOrganizationand Structure,37 MinistryLevel,37
OrganizationalStructureofHealth Canada,38
BranchesofHealthCanada,38 AgenciesofHealthCanada,45
TheCanadianInstituteforHealth Information,45
CanadianInstitutesofHealth Research ,46
TheCanadaFoodInspection Agency,47
PatentedMedicinePricesReview Board,47
PublicHealthAgencyofCanada,47
GlobalOrganizationsCollaborating withHealthCanada,48
PublicHealthThreats:Nationaland InternationalResponse,50
Pan-AmericanHealthOrganization, 50
OrganisationforEconomic Co-Operationand Development,51 References,55
3 TheRoleofProvincialandTerritorial GovernmentsinHealthCare,57
ProvincialandTerritorialHealthCare Plans,58
DivisionofPowers,58
StructureoftheHealthPlans:An Overview,59
RegionalizationInitiativesAcross Canada,61
BritishColumbia,62
Alberta ,62
Saskatchewan,63
Manitoba,63
Ontario,63
Quebec,64
NewBrunswick,65
NovaScotia,65
PrinceEdwardIsland,65
NewfoundlandandLabrador,65
NorthernRegions,65
NorthwestTerritories,66
Yukon,66
Nunavut,66
WhoPaysforHealthCare?Provincial/ TerritorialRoles,67
HealthCarePremiums,67
PayrollTax,67
OtherSourcesofFunds,68
DistributionofFunds,68
PrivateandPublicHealth Insurance,69
ProvincialInsurancePlans,69
InsuredandUninsuredServices,73
PrivateHealthCare,74
HospitalServices ,75
MedicalServices,76
AmbulanceServices,78
InsuredHealthCareProvidersOther ThanPhysicians,78
ExtendedHealthCareServices,79
AssistiveDevicesandMedical Products,80
DrugPlans,80 References,83
4 TheDollarsand “Sense” ofHealthCare Funding,85
FundingVersustheDeliveryofHealth Care,86
LevelsofHealthCareFunding,86
FederalHealthTransfer Payments,87
NegotiatingFunds:Health Accords,88
FederalGovernmentCostsforDirect HealthCare,88
ProvincialandTerritorialCostsfor DirectHealthCare,89
TrendsinHealthCare Spending,89
TheCostofPoorHealth,89
ExpendituresforHospitals,90
HospitalFundingMechanisms,91
Cost-ReductionStrategies,96
ContinuingCareinCanada,99
DemographicsandChallenges,99
AlternativeLevelofCare,100
ContinuingCare:Options,100
HomeCare,100
ResidentialCare,100
PrivateResidences,100
Long-TermCareFacilities (NursingHomes),100
TheRisingCostofDrugs,102
MajorCostDriversforDrug Expenditures,102
DrugInsurance,103
Brand-NameandGeneric Drugs,103
ControllingtheCostofPatented Drugs,103
HealthHumanResources,104
OtherHealthCareCost Drivers,108
Technology,108
Outsourcing,109
ElectronicHealthRecords,109
Conclusion,109 References,111
5 PractitionersandWorkplace Settings,113
CategoriesofHealthCare
Providers,114
ConventionalMedicine,114
ComplementaryandAlternative Medicine,114
RegulationofHealthCare Professions,117
TitleProtection,117
PerformingControlledActs,120
DelegatedActs,121
ComplaintProcess,122
EducationalStandards,122
LicencetoPractise,123
NonregulatedProfessionsand Occupations,123
MainstreamHealthCare
Providers,124
Physicians,124
Nurses,127
PhysicianAssistants,129
Pharmacists,130
Midwives,130
OptometristsandOpticians,131
OsteopathicPhysicians,131
Podiatrists(Chiropodists),131
PersonalSupport Workers,132
Psychologists,133
Speech-LanguagePathologistsand Audiologists,133
RespiratoryTherapists,134
Physiotherapists,134
OccupationalTherapists ,134
AdministrativeRoles,135
LaboratoryandDiagnostic Services,136
AlternativePractitioners,137
VolunteerCaregivers,137
PracticeSettings,137
CareintheHomeandthe Community,137
Clinics,139
PrimaryHealthCare:Issuesand Trends,142
TheOngoingShortage,142
PrimaryHealthCare Groups,143
TelephoneHelplines,146
CommunityHealthCentres,146
References,149
6 EssentialsofPopulationHealthin Canada,151
PopulationHealth,151
IntroductionofPopulationHealth toCanada,153
TheLalondeReport,1974,153
Alma-AtaConference,1978 ,153
OttawaCharterforHealth Promotion,1986,154
TheEppReport,1986,155
ThePublicHealthProgram Initiative,155
TowardaHealthyFuture:TheFirst ReportontheHealthof Canadians,1996,155
NationalForumonHealth, 1994–1997,156
DeterminantsofHealth,157
1.IncomeandSocial Status,157
2.SocialSupportNetworks,159
3.EducationandLiteracy,160
4.EmploymentandWorking Conditions,161
5.SocialEnvironment,162
6.PhysicalEnvironment,163
7.PersonalHealthPracticesand CopingSkills,163
8.HealthyChild Development,164
9.BiologyandGenetic Endowment,165
10.HealthServices,165
11.Gender,166
12.Culture,167
ThePopulationHealthApproach:The KeyElements,168
ThePublicHealthAgencyofCanada Template,168
KeyElement1.FocusontheHealthof aTargetPopulation,169
KeyElement2.Addressthe DeterminantsofHealthandTheir Interactions,169
KeyElement3.Use Evidence-InformedDecision Making,170
KeyElement4.IncreaseUpstream Investments,170
KeyElement5.ApplyMultiple Strategies,171
KeyElement6.CollaborateActions SectorsandLevels,171
KeyElement7.Engagethe Public,172
KeyElement8.Demonstrate AccountabilityforHealth Outcomes,172
PopulationHealthPromotion Model,172
PopulationHealthinCanadaand Abroad,173 References,175
7 HealthandtheIndividual,179
Health,Wellness,andIllness:Key Concepts,181
Health,181
Wellness,181
Illness,185
Disease,185
Disability,185
HealthModels,187
MedicalModel,187
HolisticModel,187
IndigenousWholisticTheoryfor Health,188
WellnessModel,189
InternationalClassificationof FunctioningDisabilityand Health,189
ChangingPerceptionsofHealthand Wellness,189
PastApproaches,190
ThePsychologyofHealth Behaviour,191
HealthBeliefModel,191
TranstheoreticalModel,193
Social–EcologicalModel,193
ProtectionMotivationTheory,193
TheHealth–IllnessContinuum,193
SickRoleBehaviour,195
StagesofIllness:InfluenceonPatient Behaviour,197
Self-ImposedRiskBehaviours,199
TheHealthofCanadians Today,199
LeadingCausesofDeathin Canada,200 References,204
8 TheLawandHealthCare,207
LawsUsedinHealthCare Legislation,208
ConstitutionalLaw,208
StatutoryLaw,208
RegulatoryLaw,208
Common(Case)LawandCivilLawin Canada,209
ClassificationsofLaw:Publicand PrivateLaw,209
TheLaw,theDivisionofPower, andtheJurisdictional Framework,213
WorkplaceSafety,214
DrugsandtheLaw,215
Cannabis(Marijuana),217
HealthCanada’sEmergency Powers,219
HealthCareasaRight,220
MedicallyNecessary:WhatDoesIt Mean?,220
TheCanadianCharterofRightsand Freedoms,221
TheLaw,theConstitution,and End-of-LifeIssues,222
MedicalAssistanceinDying,222
TheLegalityofPrivateServicesin Canada,224
IndependentHealthCare Facilities,225
InformedConsenttoTreatment,226
TypesofConsent,227
WhoCanGiveConsent,229
ConsentforDeceasedOrgan Donation,230
TheHealthRecord,230
TheImportanceofAccurate Recording,231
OwnershipofHealth Information,231
StorageandDisposalofHealth
Information,232
FederalLegislationandPrivacy Laws,232
Confidentiality ,234
Security,234
ElectronicHealthInformation Requirements,235
HealthCareProfessionsandthe Law,236
RegulatedHealthCare Providers,236
Unions,HealthCare,andLegal Implications,236
NonregulatedHealthCare Providers,239
OtherLegalIssuesinHealthCare,239
TheUseofRestraints,239
PatientSelf-DischargeFroma Hospital,239
GoodSamaritanLaws,239
Whistleblowing,240
References,242
9 EthicsandHealthCare,245
WhatIsEthics?,246
MoralityandMorals,246
Values,247
SenseofDuty,248
EthicalTheories:TheBasics,248
TeleologicalTheory,249
DeontologicalTheory,249
VirtueEthics,249
DivineCommand,250
EthicalPrinciplesandtheHealthCare
Profession,250
BeneficenceandNonmaleficence,250
Respect,251
Autonomy,251
Truthfulness,251
Fidelity,251
Justice,252
Patients’ RightsinHealth Care,252
RightsinHealthCare,253
DutiesandRights,254
AutonomyandthePatient,254
Truthfulness,256
ParentalRights,Ethics,and theLaw,257
RightsandMentalCompetence,257
EthicsatWork,258
TheCodeofEthics,258
End-of-lifeIssues,260
Euthanasia,261
EthicalPrinciplesandMedical AssistanceinDying,263
PreparationforEnd-of-Life Decisions,264
PalliativeCare,266
AllocationofResources,266
OrganTransplantation,266
FinancesandResources,267
OtherEthicalIssuesinHealth Care,269
Abortion,269
PrematureDeliveries,270
GeneticTesting,270
References,273
10 CurrentIssuesandFutureTrendsin HealthCareinCanada,275
MentalHealthandAddiction,277
StructureandImplementationof Services ,277
Community-BasedServices,278
MentalHealthPractitioners,278
TheStigmaofMentalIllness,279
MentalHealthandAddiction Disorders,280
DrugMisuse,280
MentalIllnessand Homelessness,281
MentalIllnessandEmployment,284
TheFutureofMentalHealth Care,285
CaringforanAgingPopulation,286
What’sNext?,288
HomeandContinuingCcare,290
TheProblems,290
RecipientsofHomeCare,290
AccessingHomeCareServices ,290
TheFuture,291
DrugCoverage,292
Funding,292
TheFuture,292
Cannabis,292
IndigenousHealthCare,293
Demographics,293
HealthDeterminantsand Challenges,294
AddressingSomeSpecificIssues,294
RelatedOrganizations,296
TheWayForward,298
InformationTechnologyand ElectronicHealthRecords,299
CanadaHealthInfoway,299
TheFinancialSustainabilityof HealthCareinCanada,304
SocialMediaandHealthCare,304
Risks,306
References,307
Appendix:DeclarationofAlma-Ata,311 Glossary,315 Index,327
SPECIALFEATURES
CHAPTER1
DidYouKnow? (p.5)
Box1.1 ResidentialSchools(p.6)
ThinkingItThrough (p.6)
Box1.2 InnovationinNewfoundland:The CottageHospitalSystem(p.7)
DidYouKnow? (p.9)
ThinkingItThrough (p.9)
ThinkingItThrough (p.14)
ThinkingItThrough (p.14)
Box1.3 LegislationLeadinguptothe Canada HealthAct (p.15)
Box1.4 EligibilityforHealthCareunderthe CanadaHealthAct (p.16)
Box1.5 ThePrimaryObjectiveofCanadian HealthCarePolicy(p.16)
Box1.6 The CanadaHealthAct:Criteriaand Conditions(p.17)
CaseExample1.1 (p.17)
CaseExample1.2 (p.18)
CaseExample1.3 (p.19)
CaseExample1.4 (p.19)
CaseExample1.5 (p.19)
CaseExample1.6 (p.19)
ThinkingItThrough (p.20)
CaseExample1.7 (p.21)
Box1.7 AlternativeHealthCareStrategies (p.22)
Table1.1 TheGoalsofPrimaryCareReform (p.23)
Box1.8 ThreeMajorReportsontheStatusof HealthCareinCanada(p.24)
ThinkingItThrough (p.27) DidYouKnow? (p.29)
CHAPTER2
ThinkingItThrough (p.38)
DidYouKnow? Jordan’sPrinciple(p.40)
Box2.1 TheFirstEverFoodGuideforFirst Nations,Inuit,andMetis(p.42)
DidYouKnow? (p.42)
DidYouKnow? HealthCanadaGives PermissionforNewProduct(p.44)
ThinkingItThrough (p.44)
Box2.2 CanadianInstitutesofHealth Research(CIHR)InstitutesAcrossCanada (p.46)
ThinkingItThrough (p.48)
DidYouKnow? (p.48)
Box2.3 TheWorldHealthOrganization:The Six-PointAgenda(p.49)
ThinkingItThrough EthicalUseofVaccines (p.54)
CHAPTER3
CaseExample3.1 (p.57)
CaseExample3.2 (p.58)
CaseExample3.3 (p.58)
Box3.1 The ConstitutionAct:AClarification (p.58)
CaseExample3.4 LevelsofCare(p.61)
Box3.2 RegionalHealthAuthorities: ADefinition(p.61)
ThinkingItThrough (p.68)
CaseExample3.5 (p.70)
CaseExample3.6 (p.70)
CaseExample3.7 (p.71)
Box3.3 ReciprocalAgreement(p.71)
ThinkingItThrough TheArrivalofaSyrian Family(p.71)
DidYouKnow? (p.72)
Box3.4 PrivateClinics:Concerns(p.75)
Box3.5 Uninsured(Chargeable)Versus InsuredPhysicianServices(p.77)
ThinkingItThrough (p.77)
CaseExample3.8 (p.78)
CaseExample3.9 (p.78)
CaseExample3.10 (p.81)
ThinkingItThrough (p.82)
CHAPTER4
Box4.1 EqualizationPaymentsEmbeddedin theCanadianConstitution(p.88)
Table4.1 ProvincialandTerritorialHealth SpendingperCapita:2017(Estimated) (p.89)
ThinkingItThrough (p.90)
ThinkingItThrough (p.93)
Table4.2 NationalAverageCostof ProceduresandConditionsforInpatients ofAllAgeGroups,BasedontheAverage TotalLengthofStay,2014–2015(p.95)
CaseExample4.1 (p.96)
CaseExample4.2 (p.101)
CaseExample4.3 (p.102)
CaseExample4.4 (p.105)
CHAPTER5
Table5.1 SomeofCanada’sHealthCare Providers(p.115)
ThinkingItThrough (p.116)
Table5.2 RegulatedHealthCareProfessions inEachProvinceandTerritory(p.118)
Box5.1 RegulatedProfessions:Common Elements(p.120)
ThinkingItThrough (p.121)
CaseExample5.1 (p.122)
CaseExample5.2 (p.123)
CaseExample5.3 (p.123)
CaseExample5.4 (p.126)
CaseExample5.5 (p.128)
DidYouKnow? (p.132)
ThinkingItThrough (p.133)
CaseExample5.6 (p.138)
CaseExample5.7 (p.138)
ThinkingItThrough (p.139)
DidYouKnow? (p.140)
CaseExample5.8 (p.142)
CaseExample5.9 (p.145)
ThinkingItThrough (p.146)
CaseExample5.10 (p.146)
CaseExample5.11 (p.147)
CHAPTER6
Box6.1 PopulationHealthVersusPublic Health(p.152)
DidYouKnow? (p.152)
Box6.2 Alma-AtaDefinitionofPrimary HealthCare(p.154)
ThinkingItThrough (p.154)
ThinkingItThrough (p.154)
CaseExample6.1 (p.155)
Box6.3 SocioeconomicStatus Explained(p.156)
Box6.4 StrategiesforImprovingtheHealthof Canadians(p.157)
ThinkingItThrough (p.158)
DidYouKnow? (p.159)
CaseExample6.2 (p.160)
CaseExample6.3 (p.160)
ThinkingItThrough (p.160)
DidYouKnow? (p.161)
ThinkingItThrough (p.162)
ThinkingItThrough (p.163)
DidYouKnow? (p.164)
DidYouKnow? (p.165)
DidYouKnow? (p.166)
ThinkingItThrough (p.168)
ThinkingItThrough (p.168)
Box6.5 AnAgingPopulation:An ExampleofPopulation-Based Surveillance(p.170)
CHAPTER7
Box7.1 Health:AnEvolvingDefinition (p.181)
ThinkingItThrough (p.184)
ThinkingItThrough (p.185)
Box7.2 PeopleWithDisabilities:RightsAre FormallyRecognized(p.186)
DidYouKnow? TerryFox:AContinuing Legacy(p.186)
ThinkingItThrough (p.188)
ThinkingItThrough (p.191)
CaseExample7.1 (p.191)
CaseExample7.2 (p.194)
CaseExample7.3 (p.195)
DidYouKnow? MedicalAssistanceinDying inCanada(p.195)
CaseExample7.4 (p.196)
CaseExample7.5 (p.197)
ThinkingItThrough (p.198)
Box7.3 StagesofIllness(p.198)
Table7.1 LifeExpectancyatBirth, 2014–2016(p.200)
DidYouKnow? CalculatingInfantMortality (p.200)
CHAPTER8
Box8.1 EqualityofCareforHearing ImpairedPeople(p.210)
CaseExample8.1 (p.211)
Box8.2 StrategiesforAvoidingLegal Problems(p.212)
CaseExample8.2 (p.213)
DidYouKnow? (p.216)
CaseExample8.3 (p.216)
ThinkingItThrough (p.216)
DidYouKnow? (p.218)
ThinkingItThrough (p.218)
ThinkingItThrough (p.222)
ThinkingItThrough (p.224)
CaseExample8.4 (p.225)
ThinkingItThrough (p.225)
CaseExample8.5 (p.228)
DidYouKnow? (p.230)
Box8.3 Confidentiality:AnAge-Old Concept(p.234)
CaseExample8.6 (p.235)
CaseExample8.7 (p.240)
CHAPTER9
CaseExample9.1 (p.247)
CaseExample9.2 (p.248)
ThinkingItThrough (p.248)
CaseExample9.3 (p.249)
ThinkingItThrough (p.250)
ThinkingItThrough (p.251)
CaseExample9.4 (p.252)
DidYouKnow? (p.253)
Box9.1 AModernVersionoftheHippocratic Oath(p.255)
ThinkingItThrough (p.256)
CaseExample9.5 (p.256)
ThinkingItThrough (p.259)
DidYouKnow? (p.261)
DidYouKnow? MedicalAssistanceinDying (p.261)
CaseExample9.6 TheLatimerTragedy (p.262)
ThinkingItThrough (p.262)
ThinkingItThrough (p.264)
CaseExample9.7 (p.265)
CaseExample9.8 (p.267)
ThinkingItThrough (p.268)
CaseExample9.9 (p.268)
ThinkingItThrough (p.268)
ThinkingItThrough (p.271)
ThinkingItThrough (p.271)
CHAPTER10
ThinkingItThrough (p.280)
ThinkingItThrough (p.285)
CaseExample10.1 (p.288)
DidYouKnow? (p.289)
ThinkingItThrough (p.289)
DidYouKnow? (p.290)
ThinkingItThrough (p.291)
DidYouKnow? (p.293)
Box10.1 TheSiouxLookoutMenoYaWin HealthCentre(p.297)
DidYouKnow? (p.297)
ThinkingItThrough (p.300)
CaseExample10.2 (p.303)
