Contents:
Healthcare Provincial Systems
Healthcare System:Provincial Systems and the Federal Government
Introduction to Healthcare Provincial Systems
The Constitution Act of 1867 made the provinces responsible for matters of health policy (see Constitution of Canada). As a result, instead of national health insurance, Canada has ten provincial and three territorial health insurance systems. Although the federal government has a strong presence in the health sector, the provinces are primarily responsible for health care. Each province and territory has its own statute that regulates its health-care system. The provincial governments administer health insurance programs and make decisions about funding hospitals and reimbursing physicians. Most provinces fund their health insurance out of general revenues and do not impose a specific health tax on individuals or businesses. Only Alberta and British Columbia levy health-care insurance premiums for their public insurance. Health insurance is an expensive operation, and provinces spend from 30 to 35 percent of their total budget on health care.
The federal government contributes to the provincial systems as part of the Canada Health and Social Transfer (CHST), a block grant that includes the federal contributions to health care, higher education, social assistance, and other social services. The federal government also links the provincial health-care systems together with a set of principles, commonly referred to as national standards. These standards were articulated in the Canada Health Act, which the Canadian Parliament passed in 1984.
Under that law, provinces must ensure that their health-care systems respect five criteria: (1) public administration-the health insurance plans must be administered by a public authority accountable to the provincial government; (2) comprehensive benefits-the plan must cover all medically necessary services prescribed by physicians and provided by hospitals; (3) universality-all legal residents of the province must be covered; (4) portability-residents continue to be covered if they move or travel from one province to another; and (5) accessibility-services must be made available to all residents on equal terms, regardless of income, age, or ability to pay. In the 1980s and 1990s the federal government began to contribute a lower percentage of provincial health insurance funding. In response some critics questioned the extent to which the federal government could continue to expect the provinces to uphold the national standards of the Canada Health Act with less funding.
In addition to setting standards and providing funds for the provincial health systems, the federal government is required by the constitution of Canada to provide health care to military personnel and veterans, members of the Royal Canadian Mounted Police, and inmates of federal prisons. The federal government is also directly responsible for the health needs of aboriginal Canadians living on reserves. The federal government promotes public health through activities such as prenatal nutrition programs and youth antismoking campaigns. It also maintains laboratories for disease control and product safety.” (1)