Module 1: Canadian
Health Care System
Concepts in Health Care
Overview & Objectives
●Canada’s Health Care System
● Canada Health Act
● Federal Roles & Responsibilities
●Economic Sustainability in HC
● Privatization Debate
Canada Health Act (CHA)
●The Canada Health Act is federal legislation that puts in
place conditions by which individual provinces and territories
in Canada may receive funding for health care services.
●There are five main principles in the Canada Health Act.
●Public Administration
●Comprehensiveness
●Universality
●Portability
●Accessibility
●
Public Administration
●All administration of provincial health insurance must be
carried out by a public authority on a non-profit basis. They
also must be accountable to the province or territory, and
their records and accounts are subject to audits.
Comprehensiveness
●All necessary health services, including hospitals, physicians
and surgical dentists, must be insured.
Universality
●All insured residents are entitled to the same level of health
care.
Portability
●A resident that moves to a different province or territory is
still entitled to coverage from their home province during a
minimum waiting period. This also applies to residents which
leave the country.
Accessibility
●All insured persons have reasonable access to health care
facilities. In addition, all physicians, hospitals, etc, must be
provided reasonable compensation for the services they
provide
Canadian Health System
●Determined by the Canadian Constitution
●Publicly funded
●Revenue raised through federal, provincial and territorial
taxation
●Physicians – mostly fee-for-service, therefore independent
professionals
●Hospitals are private nonprofit corporations
●Health Canada--
http://www.hc-sc.gc.ca/hcs-sss/pubs/system-regime/2011-hcs-s
ss/index-eng.php#a5
Roles of Federal Government 1
● Setting and administering national principles under CHA
● Financial support to provinces and territories
● Health protection and regulation
● Consumer safety and disease surveillance and prevention
● Funding and delivery of healthcare to certain groups:
1. First Nations living on reserves
2. Inuit
3. Serving members of Canadian Forces
4. Eligible Veterans
5. Inmates in Federal Penitentiaries
6. Some refugee claimants
Roles of the Federal Government
2
●The federal government is also responsible for health
protection and regulation (e.g., regulation of pharmaceuticals,
food and medical devices), consumer safety, and disease
surveillance and prevention.
● It also provides support for health promotion and health
research.
●In addition, the federal government has instituted health-
related tax measures, including tax credits for medical
expenses, disability, caregivers and infirm dependants; tax
rebates to public institutions for health services; and
deductions for private health insurance premiums for the self-
employed.
What you need to know..
▶ Canada relies on a public insurance model
◦ The Federal government sets and administers National principles
under the Canada Health Act (1984)
⚫ Provides financial support to provinces/territories
⚫ But does not deliver services to the majority of the population
⚫ What are the exceptions?
▶ Delivers direct health services to veterans, First Nations people
on reserves, military & RCMP personnel and federal
inmates, refugee protection claimants (I million people)
Provincial and Territorial
Responsibilities
●Administer and deliver most of Canada’s health care
●Must adhere to principles under Canadian Health Act (CHA)
●Planning and funding of care in hospitals and other facilities
●Services provided by health professionals
●Planning and implementation of health promotion and public
health initiatives
●Negotiation of fee schedules for health professionals
Sustainability of Canada’s
Healthcare System
●Issues affecting the long term effectiveness and quality of
our healthcare system
● Aging population
● Growing costs of technology, equipment, wages to healthcare
workers, etc.
● New and more expensive diagnostics and treatments (especially
drugs)
● More demanding ‘consumers’
● New diseases
● People living longer with chronic diseases, disabilities and
illnesses
● More health services not covered by provincial healthcare
Canadians and Disease
●80% of disease burden in Canada is chronic disease
management.
●Our current medical system is based on funding and
treating acute illnesses/diseases
●Health care outcomes in Canada are worse now than 20
yrs ago when compared to other countries (Canadian Nurses
Association (CNA) president, Judith Shamian)
What could be influencing this?
●Obesity
●Chronic disease – no vaccination
●Inactivity
●Environmental factors
●Increased stress – economic and social issues
Essential Concepts for
Sustainability in our HC System
●The needs of Canadians
●The services required to satisfy those needs
●The availability of resources required to provide those
services
●Commission on the Future of Health Care in Canada (2003).
Canada’s health care system must
be sustainable in the following
areas
●Resourcing
●Financing
●Health Human Resources
●Infrastructure
●Research
●Measuring and reporting
●Public support
The Debate – What to do?
●Opposing ideological positions on how healthcare should be
delivered and paid for.
●“Health care costs are being pushed to levels that can’t be
sustained” Globe and Mail, Dec. 1, 2011
●What do you think Canada should do to make our health care
system sustainable?
Possible Solutions:
●Increase ●pretend • Be careful
privatization nothing is with money,
of delivery of wrong shift
services and priorities and
options for where money
people to pay is spent but
for their own preserve
care equal access
and equity in
treatment
Private vs Public Healthcare
●Many politicians and health policy makers are arguing for
increasing Canadians’ access to private healthcare
●What are the pros and cons of allowing private healthcare
when considering the sustainability of our healthcare system?
●What about using a business model approach to healthcare?
●Globe and Mail series on Healthcare in Canada
●Health Care Reform
●Doctor's Flat Fee for Service
●TD Advice
Sustainability: Why do we care?
● Will affect us as:
● Consumers
● Taxpayers
● Children, parents
● Educators
● Health care providers
● As a society we need to address these issues before we have no say
or choice in the matter.
Consolidating Learning
●Generate ideas & ask questions
● For example – What are the five principles of the CHA? What do
you think Canada should do to make our health care system
sustainable? Who does the federal government deliver direct
health services to?
●Capture your thoughts (on paper, online, aloud…)
●Review
●Share with a peer
●Generate action items for follow-up…
Summary
●Sustainability is to maintain a system, to keep going.
●Our public medicare system is threatened, if we deal with
the issues positively, we will have the opportunity to
maintain a universal healthcare system that all Canadians
can reap the benefits.
●We can also prevent health care from crowding out all
other important programs.
References
●Government of Canada. (2020). Canada Health Act.
Retrieved September 8, 2022 from
●https://www.canada.ca/en/health-canada/services/health-
care-system/canada-health-care-system-medicare/canada-
health-act.html
●Government of Canada. (2019). Canada's Health Care
System. Retrieved September 8, 2022 from
https://www.canada.ca/en/health-canada/services/health-care-
system/reports-publications/health-care-system/canada.html
What’s Next?
Module 2 Content
