Chapter 01: The Canadian Health Care System

Chapter 01: The Canadian Health Care System

McCleary: Ross-Kerr and Wood’s Canadian Nursing Issues and Perspectives, 6th

Edition

MULTIPLE CHOICE

• Which government act delineates the roles and responsibilities for health and health care at

the provincial, territorial, and federal levels of government?

• British North America Act of 1867
• Constitution Act of 1982
• Canada Health Act of 1984
• National Medicare Act of 1966

ANS: A

The British North American Act of 1867 outlines the roles and responsibilities at all levels of government for health and health care.

• In 1867, the British North America Act (BNA Act) clarified that provincial responsibilities

for health care included which of the following?

• Hospitals
• Public policy
• Pharmaceutical safety
• Health research

ANS: A

The BNA Act clearly stated that the provinces were responsible for public health, including hospital care, whereas the federal government was responsible for the public policy aspects of health, such as pharmaceutical safety.

• The aging baby boomer population has resulted in continued demands on the provision of

nursing care for older persons. Which of the following statements is true?

• There are adequate numbers of regulated nurses to care for older persons.
• The demand for continuing care is decreasing.
• Chronic and age-related diseases are the fastest growing category of care.
• The world’s population over 65 years of age is slowly shrinking.

ANS: C

The aging baby boomer population is expected to significantly burden the health care system in terms of chronic and age-related diseases. The demand for nursing care for older persons is increasing.

• The first mandatory universal hospital insurance plan in North America was introduced by

which Canadian Premier?

• Tommy Douglas
• Joey Smallwood
• Justin Trudeau
• John A. MacDonald

ANS: A

Premier Tommy Douglas of Saskatchewan in 1947.(Ross-Kerr and Wood's Canadian Nursing Issues & Perspectives, 6th Edition Lynn McCleary) (Test Bank all Chapters) 1 / 4

• The Canada Health Act (1984) is rooted in five guiding principles. Which of the following

statements reflect the principle of universality?

• Residents are not charged “out of pocket” costs for health services.
• Residents can receive the same service in every province or territory.
• Residents have reasonable access to health services.
• Residents receive the same health service benefits.

ANS: D

Universality refers to the principle that all insured residents of Canada regardless of age, gender, ethnicity, or income will receive the same health care benefits.

• Which province has the right to health care embedded in its legislative framework?
• Newfoundland
• British Columbia
• Quebec
• Ontario

ANS: C

Quebec has the right to health care embedded in its legislative framework.

• Which province was the first to institute a hospital insurance plan that was financed

entirely by the province?

• Alberta
• Manitoba
• Saskatchewan
• British Columbia

ANS: C

In 1947, the province of Saskatchewan, under the leadership of Premier Tommy Douglas, instituted a hospital insurance plan that was entirely financed by the province.

• Which Act in 1966 ensured access to health care based on need regardless of ability to

pay?

• Canada Health Act
• Medical Care Act
• Hospital and Diagnostic Services Act
• Public Health Act

ANS: B

The Medical Care Act of 1966.

• There was much variation among the provinces in relation to user charges and extra billing

during the 1970s. Which province allowed physicians to opt in or out of the plan?

• Prince Edward Island
• Quebec
• Alberta
• Manitoba

ANS: B

Quebec allowed physicians to opt in or out of the plan, and New Brunswick, Nova Scotia, Prince Edward Island, and Saskatchewan also allowed physicians to extra-bill. 2 / 4

• Although a number of provinces have conducted experiments in privatization of health

care services, these experiments violate which of the following principles of health care legislation in Canada?

• Accessibility
• Universality
• Portability
• Public administration

ANS: D

Many organizations, health analysts, and individuals have opposed privatization because it violates one of the five basic principles on which health legislation in Canada was founded, that is, public administration.

• One of the key features of the Canadian medicare approach that differentiates it from other

national health programs is which of the following?

• Fee for services
• Privatization
• Decentralization
• Flexibility

ANS: C

Medicare is highly decentralized, with each province or territory retaining control over the provision and allocation of select health services.

• Despite the lack of planning for change at the system level, which following principle

driving health care reform has had some positive effects on the provision of health care?

• A move toward the provision of more community-based services
• An increase in the number of acute care hospital beds
• A greater emphasis on the medical cure model
• A retention of the physician-centred and hospital-based health care model

ANS: A

Principles driving health care reform that have had positive effects include more community-based services, attempts to provide care to people on either an outpatient or home-case basis, and the placement of greater emphasis on health promotion at all levels of care.

MULTIPLE RESPONSE

• The Canada Health Act sets the requirements for select publicly funded financed health

services, but the following groups are exempt from services under the Act. (Select all that apply.)

• Canadian Armed Forces
• Health care workers
• Royal Canadian Mounted Police
• Members of Parliament
• Federal inmates
• School-aged children

ANS: A, C, D, E 3 / 4

Exempt from coverage under the Canada Health Act are members of the Royal Canadian Mounted Police and Canadian Armed Forces (both active and eligible veterans), members of Parliament, as well as eligible Indigenous groups and refugees and all federal inmates.

• The roles of different levels of government are affirmed in the Constitution. Which of the

following statements are true regarding provincial–territorial jurisdiction responsibilities?(Select all that apply.)

• Establish a national pharmaceutical program.
• Manage acute care hospital services.
• Arrange payments for physician services.
• Develop a health care insurance plan.
• Develop transfer payment arrangements.
• Enforce relevant Acts such as the Canada Health Act.
• Finance diagnostic services in acute care.
• Arrange payments for nursing services.

ANS: B, C, D, G, H

Provincial–territorial jurisdiction responsibilities affirmed under the Constitution include financing and managing acute health care hospital services; arranging for payments and copayments for physician, diagnostic, and nursing services; and developing and implementing the health care insurance plan for their jurisdictions. Federal responsibilities include establishing and enacting national agendas in core areas such as consumer health and safety and pharmaceuticals, financing through transfer payment arrangements, and enforcing relevant Acts and legislative documents, especially the Canada Health Act.

• The United Nations Development Program Sustainable Goals are a call for global action

and include which of the following? (Select all that apply.)

• Good health and well-being
• Sustainable cities and communities
• Reduce, recycle, and reuse
• Affordable and clean energy
• Climate action
• Immunization compliance
• No poverty
• Senior care

ANS: A, B, D, E, G

The United Nations Development Program Sustainable Goals include good health and well-being, sustainable cities and communities, affordable and clean energy, climate action, and no poverty.

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