FNHA Vision Care Program: A Case Study

The federal government is responsible for the delivery of primary health care services on-reserve as well as for funding the province for programs and services (Lavoie, 2013). Conversely, the province is responsible for primary health care services off-reserve, as well as hospital and physician services. While these jurisdictional boundaries seem to be clear in theory, in practice, they have been proven to be ambiguous and complex, and at times even self-serving (Lavoie, 2013; Kelly, 2011). This has contributed in an alarming burden of illness among First Nations communities that have economic, political and social implications for all Canadians. A study of these ambiguities and complexities as well as their consequences first requires a scan of the historical policies that have led to the current state of affairs in the healthcare of First Nations people.

The health of Aboriginal people in Canada is both a tragedy and a crisis (Aboriginal Affairs and North Development Canada, 2010). Aboriginals have a higher rate of death among aboriginal babies, twice the national average, higher rate of Infectious diseases example gastrointestinal infections to tuberculosis, and chronic and degenerative diseases such as cancer and heart disease are affecting more aboriginal people than they once did (AANDC, 2010). Availability of important medical facility is not enough to accommodate the growing medical needs of Aboriginals. A socioeconomic and cultural issue also hinders the access of aboriginals to access health care in the community.

Health care expenditure accounted for an estimated 11% (214.9 billion) of Canada’s GDP in 2014 (CIHI, 2014). Canada boasts a universal, cost-effective and fair health care system to its citizens (Picard, 2010). However, despite great claims and large expenses incurred Canada’s health care system has been reported inefficient in it’s delivery to the population (Davis, Schoen, & Stremikis, 2010; Picard, 2010). As inconsistencies exist in health care delivery across the country, choosing priorities for the health of the Canadian people becomes of vital importance. In Ontario, progress toward a better health care system has been stated to be moving forward by putting the needs of the “patient’s first” (Ministry of Health and Long-Term Care [MOHLTC], 2015). This policy brief will give a background of health care issues in Canada related to Ontario. Three evidence-based priorities will be suggested for Ontario’s health policy agenda for the next three to five years. Furthermore, through a critical analysis of these issues a recommendation of the top priority issue for the agenda will be presented.

The National Aboriginal Community Controlled Health Organisation (NACCHO) was established in 1992, as the new national ACCHS umbrella organisation replaced the NAIHO. Many Indigenous communities have recognized their own independent since the 1970’s. In 1975, The Community-controlled health services (ACCHs) and an

This paper will discuss the Canadian healthcare system compared to the United States healthcare system. Although they’re close in proximity, these two nations have very different health care systems. Each healthcare system has its own difficulties, and is currently trying to find ways to improve. Canada currently uses the Universal Health Care system; which provides healthcare coverage to all Canadian citizens (Canadian Health Care, 2007). The services are executed on both a territorial and provincial basis, by staying within the guidelines that have been enforced by the federal government (Canadian Health Care, 2007).

The purpose of this paper is to give an overview of two federally and/or state funded programs. The programs that will be discussed are Medicare and Medicaid. In this paper will be information about who receives Medicaid/Medicare, the services offered by these programs, and those long term services that are not.

However, whilst optometrists could manage these conditions, they had to always record the clinical situation and the advice that was given to the patient within the patient’s record, as well as making the patient’s medical practitioner aware of what action was taken. This is to ensure good practice and to legally protect ourselves, as well as being a GOC requirement. “The decision whether to manage or refer is currently based on the judgement of the optometrist, taking into account the patient’s personal circumstances and clinical needs”. (Needle, J.

This campaign was the fight for government assisted health care for all. The government of Canada officially passed the Medical Care Act in 1966, which created a universal health care system for all Canadians. This was a significant step in Canadian history as many countries at that time, and still today, lack laws of equality like this one. For this reason, Canadians find great pride in the fact that all people in Canada have equal access to medical care. However, this law did not easily come about, it took much time and persuasion to even be considered. Tommy Douglas began the fight for universal health care for all Canadians in 1961 when he left the Cooperative Commonwealth Federation in Saskatchewan to be a part of the federal government (Colyer, et al, 2010, p.326). Douglas had the idea of giving all Canadians universal health care after he had succeeded in doing this for the people of Saskatchewan. After proving his outrageous idea of medical care being partially paid for by the government, it was easy to convince the rest of Canada. For only a small fee each month, Saskatchewan residents had their medical bills partially paid for and after only two years provincial debt was reduced by twenty million dollars (Colyer, et al, 2010, p.326). These same rules were implemented in the rest of Canada as a result of the 1966 Medical Care Act (Health Canada, 2012, online). As a result, Canadians were now supported by the government when they needed medical help. Consequently, universal health care brought both pride and equality to Canada because very few countries had the same luxuries that Canadians now

This paper will focus on the Central West LHIN because the LHIN provides services according to the regions in Ontario. The Central West LHIN’s mandate is to “plan, integrate, fund and monitor the local health care system for the regions of Brampton, Caledon, Dufferin, Malton, North Etobicoke and Woodbridge with over 840,000 local residence” (Together, making …, 2014, para. 1). The Central West region is a very diverse community with people from different cultural background.

Health care for First Nations people, specifically for those who live in reserve communities receiving federally run services, has been founded on colonial ideology. This allowed and influenced the beginning of dependency of the First Nations people upon the European policy makers (Browne and Fiske 2001).

While many may argue that the Canadian health care system provides equal treatment to every Canadian, evidence shows that this is not the case. There are major discrepancies within the system regarding Indigenous people that need to be addressed including several factors such as: housing issues, stereotypes Aboriginals face and the lack of Aboriginal doctors.

Since the 1970’s, many Indigenous communities have established their own independent, community-controlled health services (ACCHs) and an over-arching representatives advocacy body, the National Aboriginal Controlled Community Health Organisation (NACCHO previously NAIHO) was formed in 1975.

     In the past, Canada’s government-funded, universally accessible, health care system has been praised and admired both at home and abroad as one of the finest in the world. A great source of pride and comfort for many Canadians is that it is based on five fundamental principles. Principles that are a reflection of the values held by Canadian citizens since the formation of Medicare in 1966. These principles were reinforced in the Canada Health Act, (CHA), of 1984 and state that the Canadian system is universal, accessible, portable, comprehensive and non-profit.

Access to the communities is provided year round by Wasaya Airline and airstrips that are maintained by the Ontario Ministry of Transportation. Of course, each Aboriginal community is unique with its own set of traditions and ways of healing but my observation after working within the communities for over ten years is that they all suffer from improperished conditions and substandard housing. The local economies are primarily based upon government services (Indian and Northern Affairs) (INAC) and small business. Most of the reserves have six hundred people or less, and each community has a nursing station. The nursing stations are well-maintained functional buildings built in or about the early 1960’s and are maintained by Health Canada. First Nations and Inuit Health (FNIH) maintains responsibility for primary care services in the majority of the northwest Ontario reserve communities. In the north, nurses are the primary care givers working in an extended scope of practice, and client care is centrally coordinated by nurses working within interdisciplinary teams. The majority of the nursing and medical staff working for FNIH in the Sioux Lookout zone are Caucasian and do not come from local communities. This could outwardly appear as a reinforcement of power relations in the racial identities. There is only very limited cultural training given to employees when they are employed by FNIH. Medical advice and

The facility is collaborating closely with the patient?s optometrists who serve as the primary care doctors. If a surgery is necessitated, the doctor of optometry (OD) will then direct the patients to the expertise of the eye surgeons of PCLI to address specialized treatments. In Spokane alone, they have built a strong network of about 150 family optometrists. For a period of time, PCLI has managed their operations with eleven satellite clinics, seven surgeons, several surgical assistants, patient counselors and a resident physician at every clinic (Swayne, et al., 2013). However, due to continued growth in the industry with significant market potential, stiffer competition is slowly escalating. In fact, intense rivalry from other laser eye surgery centers in Canada as well as other larger laser eye care centers in the nation who are charging less for Lasik eye surgery are becoming a huge challenge for PCLI. The facility is very much aware that there is an enormous possibility that they will lose a huge number of patients to the aforementioned competitors. With that, there is an intense pressure to reduce overhead costs to survive in a competitive landscape. It is imperative for the facility to reevaluate its market efforts and its services operations process and focus on new management strategy, capacity utilization, cost control and marketing