Medically-Necessary, Ceilings, and Equity with Equality in Healthcare Services

DEPUTY MINISTER'S BRIEFING NOTE
Name:
Student number:
Course director:
Course code/name:
Date:
DEPUTY MINISTER'S BRIEFING NOTE
SUBJECT: Examining the current health care services included in the publicly- funded medical basket in the province and the evaluating the necessity of the changes.
SUMMARY
* Medically-necessary health care services
* History and background of the current situation in the health care plans
* Consideration in the current health care act
MEDICALLY-NECESSARY HEALTH CARE SERVICES
What would be the term "medically-necessary health care services" mean to you? This is term is defined as the health-care supplies and or services that the members of the community need to diagnose, prevent and treat injuries, illnesses, conditions, symptoms and diseases. In case of any of the above mentioned scenarios, if a condition has debilitating side effects, signs and symptoms, this can be considered as a medically-necessary to treat. In Ontario, Medicare covers services that are perceived as medically necessary to treat one's condition (Smyth, 2003). It is expected that the services and supplies must satisfy the criteria as provided by the local and national coverage determinations as decided by the federal government and private contractors for national and private levels respectively in determining whether Medicare should pay for a particular service or item (Olson, 2012). For example, Medicare will apply the local and national level determinations in deciding whether to authorize a surgery to a person with a hip- replacement.
Supplies and services that are not listed as medically-necessary are not involved in the original Medicare both part A and B. though it is possible for some of the mentioned services to be covered by a Medicare plan it is all dependent on the benefits of that particular plan (Olson, 2012). The following is a list of some of the services termed as non-medically necessary health care services:
* When hospital supply or service exceeds length approved by Medicare
* A therapy treatment beyond Medicare's usage limit
* Administration of drugs in treatment of weight loss or gain, sexual dysfunction, fertility and cosmetic intentions
BACKGROUND
It is inappropriate to say that Canadian healthcare system is publicly funded fully as most politicians put it. This is because only seventy percent (70%) is publicly funded whole the other thirty percent (30%) is catered for privately. With focus in Ontario, medically-necessary health care supplies and services are fully catered for by the national health care system. On the other hand, patients are left to pay for most of the drugs, physiotherapy, eye and dental care among others. Much of the load is still going back to the tax payer.
The Canadian public health care insurance policy is developed in two stages. The initial stage was the Hospital Services and Diagnostics Act done in the year 1957. The provisions in this act were to establish the provincial health-care plans that would cater for hospital care. Later in the year 1966, the Medicare...