The Canada Health Act and the Future of Health Care Systems in Canada (original) (raw)
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11. Strengthening the Foundations: Modernizing the Canada Health Act
The Governance of Health Care in Canada, 2004
Highlights • The Canada Health Act (CHA) has served Canadians extremely well but needs to be updated to serve the needs of Canadians into the 21st century. • The CHA should maintain the prohibitions on extra-billing and user charges. These are the key mechanisms ensuring equity in Medicare. There is no evidence that a greater role for private financing would improve either efficiency or equity in Medicare. • The CHA appropriately prevents experimentation with private financing but neither impedes nor encourages reform or innovation in the delivery of health care. We think the CHA should be reformed to actively encourage innovation and evidence-based reform in the delivery of care. • Universality is a fundamental principle, and should be maintained. • The criterion of non-profit public administration should be amended to "public governance and democratic accountability" to emphasize the importance of good governance and accountability of decision makers at all levels in Medicare.
Addressing Ten Unhelpful Myths about the Canada Health Act and Why it Matters
Since its enactment in 1984, the iconic Canada Health Act (CHA) has been at the centre of a polarized de- bate on whether universal coverage should be expanded or restricted in Canada. This discussion on the future direction of Canadian medicare has been vexed by prevailing myths about the CHA. These myths are un- helpful in that they perpetuate misleading notions about the ambit and impact of the CHA. This article decon- structs 10 of the more common myths to get at the realities of the CHA and the extent to which it sets national standards and constrains — or does not constrain — provincial health reform and innovation. Understanding the realities of the CHA is becoming a critical litmus test for the courts as they interpret the CHA and the pro- vincial laws and regulations, which were established in conformity with five criteria — public administration, comprehensiveness, universality, portability, and accessibility). Separating myths from realities also allows practitioners and scholars to better understand the limits of the CHA.
The Enforcement of the Canada Health Act
McGill Law Journal, 1996
The commitment to comprehensive and universal health care, as reflected in the Canada Health Act (CHA), is often regarded as a defining characteristic of our country. Today, Medicare in Canada faces a number of challenges which pose a serious threat to its survival. Overlooked in the political debate about the future of Medicare has been the potential to achieve social justice through the existing statutory framework of the Act. The author examines whether the basic criteria laid down in the CHA are capable of giving rise to legal liability and proposes a legal strategy for enforcing the terms of the Act. To this end, the feasibility of a legal claim against both federal and provincial governments is examined in turn. The author discusses the many hurdles that must be overcome in order for an individual to successfully bring a claim against the government. The author concludes that the CHA can function as both a political and a legal document. In terms of legally enforcing the CHA’s criteria, liability is likely to be restricted to the federal government, since the Act is probably not enforceable against the provinces. A successful claim would have the effect of inducing greater vigilance with respect to meeting the criteria of the CHA. Ultimately, however, it is argued that regardless of whether an individual legal claim is successful, it is the political value of litigation that could make a challenge worthwhile. The result of such litigation would be to raise public awareness of the challenges facing Medicare and, thus, lead to political change. In this way, the CHA can serve a dual purpose and prove to be an effective tool for ensuring the integrity of the Medicare system.
Health System of Canada: Introduction
Reference Module in Biomedical Sciencies, 2014
With a population of 35 million people spread over a vast area, Canada is a highly decentralized federation. Provincial governments have most of the responsibility for the governance, organization and delivery of health services although the Government of Canada has an important role in maintaining high level standards for universal health coverage through the Canada Health Act as well as pharmaceutical regulation, health research and data collection. With 70% of total health spending financed by federal, provincial and territorial governments, most are used to provide universal access to hospital and physicians services as well as more targeted coverage for prescription drugs and long-term care. In the last decade, provincial and territorial governments have focused on reorganizing their regional delivery systems and improving the quality, timeliness and patient experience with acute, chronic care and primary care medical services. While Canada's system of universal coverage for Medicare has been effective in providing deep financial protection, the narrow scope of coverage has resulted in gaps in coverage and equitable access.
International Encyclopedia of Public Health, Volume 1, edited by Kris Heggenhougen and Stella Quah, pp. 381-391, 2008
Federalism and Health Care in Canada: A Troubled Romance?
2017
Canadian federalism fragments health system governance. Although the Constitution has been interpreted as providing shared jurisdiction over health generally, with respect to health care specifically, the courts have interpreted the Constitution as giving direct jurisdiction to the provinces. The Federal role in health care is therefore indirect, but nevertheless potentially powerful. For example, the Federal government has used its spending powers to establish the Canada Health Act (CHA), which commits funding to provinces on condition they provide first-dollar public coverage of hospital and physician services. However, in recent times, as federal contributions have declined, the CHA has been weakly enforced. Further, the failure to broaden the CHA to include prescription drugs, dentistry, and other important aspects of health care have contributed to Canada’s abysmal record on aboriginal health and its increasingly poor rankings in international comparisons. Progress requires enf...
International Journal of Health Services, 1992
Having achieved equality of access to health care, Canadian policymakers are setting new policy goals, within resource constraints. primarily to achieve equity of access to health. Across the country, provincial royal commissions have explored a number of policy options to achieve this goal. These options are reviewed and critically analyzed within the context of such challenges in health policy as insufficient access to high-technology care and the limits of medical care, and such external challenges as economic and demographic trends, federal-provincial disputes, and ideolo$ical beliefs. Particular attention is given to the implications of a broader definition of health and the concept of regional health authorities. Based on the provincial reviews, the authors conclude that Canada wants to achieve equitable access to health. With the shift of health policy away from the formerly protected arena of medical care, achieving equitable access to health will require both an alteration of priorities and values and considerable political will. Canada will be forced to meet these new challenges to maintain current achievements and to make its system even more successful. Canada's system of universal medical and hospital insurance, now known generically as Medicare, is considered one of the best in the world. It has achieved high levels of health status with minimal restrictions on patients or providers, and enjoys wide public support. Like many other health care systems, however, it faces increased challenges from changes in the social, political, and economic environment. As Aaron Wildavsky (1) has pointed out, the solution of one set of problems leads to the creation of new dilemmas; the challenge for policymakers is to select which set of problems they prefer. Formerly, the objective of Canada's health care system was equality of access to medical care. This objective has largely been achieved. However, class disparities in health remain, although these have been substantially reduced from the pre-Medicare period. The policy success has forced Canadian policymakers to This work was supported by Health and Welfare Canada, National Health Research and Development Program, Grant No. 660&3007-63.