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Structure and History of Canadian Healthcare

Canada’s healthcare system is held up as a model for the world. Lately it’s played a role in the heated debate over healthcare reform in the United States. Tommy Douglas is known as its father; his reforms in 1947 in Saskatchewan began the march toward a national publicly funded health care system.

Medicare’s Origins Lie In Saskatchewan

The origins of Medicare date back to 1947 in Saskatchewan. Premier Tommy Douglas passed the Saskatchewan Hospitalization Act, making healthcare free for much of the population. A decade later, Prime Minister Louis St. Laurent introduced a national hospital insurance program despite an outcry from the medical community, and insurance companies.

In 1962, the NDP (New Democratic Party) government of saskatchewan introduces the first public Medicare program. Doctors react by going on strike over a fee-for billing principle. The strike only lasts 3 weeks, and ends with the doctors keeping the principle meaning they can now influence healthcare spending. Four years later, the federal government follows suit creating a national Medicare program. They also agree to pay for half the costs. A few years later, the Trudeau government gave the provinces more control over health spending, by shifting to block funding. This meant the federal government would set a fixed amount per year

Between 1980 and 84, the Canadian Health Coalition (CHC) issued demands for the healthcare system to reflect five principles. The group wanted it to: be public, and Not-for-profit, comprehensive, universal, portable, and accessible.

The result was, the Canada Health Act, passed unanimously by Parliament in 1984.

Healthcare System Governed By The Canada Health Act

The Canada Health Act (CHA) provides the system’s overall structure. The act’s primary goal is to: “protect, promote, and restore the physical and mental well-being of residents of Canada, and to facilitate reasonable access to health services without financial or other barriers.”

The legislation defines the five principles stated above, who is insured, and spells out the penalties for provinces who break it. The penalties that could be incurred by the provinces are financial, and include mandatory deductions from transfer payments- cuts in healthcare funding. Since its implementation in 1984, this portion hasn’t been used.

The five governing principles are defined as follows:

1. Public Administration: This is principle is to make sure all provincially run insurance programs- for example OHIP (Ontario Hospital Insurance Plan) are administrated by a public authority, responsible to the Provincial or Territorial government for decision- making and service levels. Basically, this means they’re responsible to the health minister.

2. Comprehensiveness: This requires all services provided by physicians, hospitals, and dentists (provided the surgery is done in a hospital setting) are covered by provincial health insurance. For example if a dental patient needs anesthetic to have wisdom teeth out, and that procedure is done in a hospital, it’s covered under the province’s health insurance. This principle also allows for additional services to be insured.

3. Unversality: When people move domestically (from province-province), the “home jurisdiction” is required to continue covering their residents during any waiting period. For example: If someone moves from Ontario to Saskatchewan, OHIP is required to cover that person throughout the three-month waiting period. After the time is up, Saskatchewan assumes responsibility.

The principle of universality is also designed to guarantee residents have access to insured hospital, medical, and surgical-dental services, which are provided by the provincial or territorial insurance plan. Additionally each province must provide reasonable compensation to doctors and dentists for insured health services, and payment to the hospitals.

4. Portability: When moving domestically (from province-province), the “home jurisdiction” is required to continue covering their residents during any waiting period. For example: If someone moves from Ontario to Saskatchewan, OHIP is required to cover that person throughout the three-month waiting period. After the time is up, Saskatchewan assumes responsibility

5. Accessibility: This principle is designed to guarantee all residents have access to insured hospital, medical, and surgical-dental services, which are provided by the provincial or territorial insurance plan. Additionally each province must provide reasonable compensation to doctors and dentists for insured health services, and payment to the hospitals.

Want to learn more? Check out the Overview of the Canada Health Act

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Site Disclaimer: This site is designed for educational purposes only and is not engaged in rendering medical advice or professional services.
If you feel that you have a health problem, you should seek the advice of your Physician or health care Practitioner.

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