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PubMed2003

[Social disparities in dental health: measuring risks and health needs].

Our aim was to compare the dental health level of the general population to that of beneficiaries of universal health coverage (CMUC) in order to define their needs and to measure the dental health risk associated with precariousness. The study sample was composed of requests for prior approval in eight administrative regions. Accordingly, 3118 patients covered by the CMUC and 3310 beneficiaries of the general fund stricto sensu were examined by the fund's salaried dental advisors (chirurgiens-dentistes-conseils) and enrolled in the study. With a similar average DMF index, CMUC recipients had more missing teeth than was found in the general population. In the DMF index, this greater number of missing teeth was compensated by fewer filled teeth than in the general population. The F/DMF index allows a better functional evaluation of dental health. The risk of not receiving conservative care is increased by one and half to three in destitute individuals. The overall results suggest that CMUC recipients fail to obtain sufficient early dental care.

Adult↗
PubMed2003

Dirigo Health--a universal health care coverage plan in Maine: implications for Massachusetts.

On June 18th, Maine governor John Baldacci signed into law a comprehensive health care initiative know as Dirigo Health. Dirigo is Latin for "I lead", the state motto. Dirigo is often referred to as Maine's new universal coverage law. The law seeks to achieve universal access to coverage by integrating access, cost, and quality initiatives. While Dirigo responds to and takes advantage of particular circumstances in Maine, it has naturally drawn a great deal of interest from other states seeking to deal with similar problems. This issue brief provides an overview of Dirigo Health and outlines areas that might inform the health policy debate in Massachusetts (and perhaps other states as well).

Cost Control↗
PubMed1998

[The right to health care services under Quebec law].

The main goal of the Canada Health Act is to guarantee that Canadian residents have reasonable access to a comprehensive and universal health care plan. However, reduced federal funding for health care and increases in health care costs due to technical and scientific developments have created unprecedented financial pressures on provincial health care systems. The right to health care, once perceived as one of the pillars of Canadian society, may be imperiled. This article will provide a detailed analysis of the nature and scope of the right to health care from mainly a legal, but also from a political, perspective. Based on the premises that the Canada Health Act is basically a financial agreement between the Federal and provincial governments and that it does not enshrine a substantive right on which individuals may claim services, the author explores the nature and scope of this right under Québec legislation. Indeed, the Québec Health and Social Services Act has, since the 1960s, included various provisions that establish a right of access to health care services. This right, however, is fraught with regulatory, organizational and financial limits. The first part of this paper examines relevant regulation from an historical perspective, highlighting the relationships between federal and Québec provincial legislation. In the second part, the author explores exhaustively the principal provisions relevant to the right to health care. This entails the analysis of administrative regulations as well as of the responsibilities of the various provincial, regional, institutional and professional authorities involved. Ultimately, as this study will demonstrate, the availability of health care services depends more on a vague process than on a legal right to health care. This conclusion is further confirmed by the analysis of the adjudication process of patient complaints provided under the Québec Health and Social Services Act and by the limited case law on the right of access to services. Even though judges are generally favorable to patients claims, court interventions remain ad hoc and a posteriori. But if the right of access to health care seems limited, its scope is nonetheless important. The right to health care acts as an obstacle to the current dismantling of health care services and to government withdrawal from this field. It also places limits on abusive, arbitrary and discriminatory decision-making and obliges public authorities to take into closer consideration patients' rights in formulating its health care policy and budgets. This protective role of the right to health care is currently illustrated by the politicians' insistence that the ongoing health care reform is not affecting the quality or quantity of available services.

Health Care Reform↗