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The Canadian Health Care System
Introduction
The health care system in Canada is based on nation-wide coverage for the whole
population health care services which are provided on the basis of need. It is unlike
many other countries in which health services are available to their citizens only if they
pay the price. One example of this is in the United States where health care is purchased
as needed. In contrast, Canadians all pay into the health care system for the good of all
whether they use the system or not. "Medicare" is the name of the Canadian health
insurance plan and it is provided seamlessly across Canada. These insurance plans
include coverage in all of the ten provinces and three territories. Canadian government
ensures that any necessary health services are granted to those in need anywhere in
Canada. Health Canada's top goal is to help Canadians stay as healthy as possible.
Health Canada is required to deliver health care to specific groups as well such as the
Native People, Inuit. Furthermore, Health Canada's responsibilities include creating and
controlling numerous principles that the health care system will be guided by at all times.
Health Canada administers this through the "Canadian Health Act" (CHA). The
Canadian Health Act is the federal legislation for publicly funded health care insurance.
This insurance is covered by taxations that all citizens have to pay annually. It is a small
price to pay to gain access of coverage anywhere in Canada, for any medically necessary
health service. The Canadian Health 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."1 Canada does not
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want any barriers between tax paying citizens of Canada, and the necessary
health services they require. The main obstacle people tend to encounter is the large fees
involved in medical necessities and treatment. The Canadian Health Act is guaranteeing
reasonable access to insured health services without paying. This includes no direct
charges at the point of service.
Each Province and Territory has interlocking insurance plans, but they each have
to abide by the criteria and conditions given by the Canadian Health Act. If each
Province and Territory adheres to these conditions and criteria, it will qualify them for
their full share of the federal cash contribution which has to be used to continue
maintaining the national health criteria. Although the Federal government provides
money, each Province and Territory has to manage, organize, and ensure their residents
have the health services required. The Canadian Health Transfer (CHT) is allocated on an
equal amount of money per capita basis. This ensures the right amount of money is
distributed across the country. The (CHT) is the main financial component of the
Canadian Health Care System. 2
There are five main guiding principles of health care in Canada. These
principles ensure Canadians are provided with non-profit based public
administration, universality and portability across Canada, and excellent accessibility
to necessary health services anywhere in Canada. The Canadian Health Care System is
publically run and administered by the Federal government. The intent of the Canadian
government is to maintain a non-profit basis for their health care system. It is also to
ensure that it is run by a public authority, with all records and accounts publicly audited.
The non-profit basis is an extremely beneficial point of the health care system. Canadian
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citizens don't have to go to private doctors and pay inflated costs for their medical needs.
Public administration ensures that the citizens have the upper hand and are in control of
their own medical payments through taxation.
Every Province and Territory are required to have comprehensiveness regarding
the medical necessity of health services, and ensure that all residents of a Province or
Territory are universally entitled to insured health care services. It is generally required
to register for health insurance and acquire a Canadian "Health Card" to be entitled to
insured health services. The Health Card's in Canada are what give you access to the
health services. The Health Card also ensures that you do not have to pay any money
directly at the point of service. Universality of health care is greatly beneficial because it
eliminates any location barriers regarding insurance plans. Everywhere in Canada
citizens are entitled to health care insurance. Universality and Comprehensiveness
are two crucial principles of the Canadian Health Care System.
The insured health services are transferable all across Canada between Provinces
and Territories due to the portability principle of Canadian Health Care. Canadian
citizens are allowed to go to other Provinces and Territories temporarily and still have
insured health services. Insurance plans are organized on a Provincial and Territorial
basis. This does not make your insured health services permanent in different Provinces
and Territories where you do not reside. If a Canadian citizen is in a different Province
or Territory for a temporary visit then they still get full coverage for any medical
necessities or treatment. The portability of health insurance in Canada makes it easier
and more beneficial to Canadian citizens if they need health services when they
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are located in a different part of the country. Portability is an important principal to the
Canadian health care system.
Accessibility is an important principle of the Canadian Health Care System. It is
beneficial for the insured Canadian citizens because it guarantees that they will have
reasonable accessibility to medically necessary health services regardless of their
location. People do not have to worry about being far away from hospitals because it is
Health Canada's intent to make health services everywhere in Canada available.
Provinces and Territories must provide compensation to physicians and dentists for all
insured health services they provide people with. Also, provinces and territories must
pay hospitals to cover costs of insured health services as well. The accessibility of
Canadian health services is another principle point of the health care system and it
benefits all Canadian citizens.
"The principles of the Canada Health Act began as simple conditions attached to
federal funding for Medicare. Over time, they became much more than that.
Today, they represent both the values of underlying the health care system and
the conditions that governments attach to funding a national system of public
health care. The principles have stood the test of time and continue to reflect the
values of Canadians." (Romanow, Roy J., Q.C. November, 2002)
The goal of the Canadian Health Care System is to adhere to five principles that affect the
entire country. These principles ensure that the Health Care System is universal,
accessible to citizens, portable between provinces and territories, comprehensive of
medically necessary care, and has public administration. Each of these principles are
declared in the Canada Health Act (CHA) and are meant to make sure the Canadian
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Health Care System is as beneficial as possible, and that Canadians stay health and
improve their health.
In Canada the demand for more nurses is increasing every year by astronomical
amounts. This nursing shortage is worsening at an alarming rate and Canada will
be short a projected 60,000 nurses by 2022. If this projection is accurate, there will be
many negative outcomes for patients, nurses and for hospitals. Nurses to patient ratios
due to the fact there are not enough nurses to care for patients and to compound the issue,
Canada’s population is aging and is requiring greater amounts of health care services.
The working conditions for nurses will deteriorate and more nurses will leave the
profession which makes the nursing shortage even worse. The stress levels and harsh
work environments will lead to more nurses retiring at a younger age which in turn
will lead to more hospital beds being closed due to lack of staffing. With less hospital
beds and nurses to care for patients, wait times for surgeries and procedures will become
even longer.
Another current issue facing the Canadian Health Care System is the shortage of
Physicians and specifically family doctors. Currently in the Durham Region many new
families are searching for a family doctor they can depend on in times of medical need.
The amount of physicians in comparison to how many sick people there are, or how
many people who simply need a family doctor are extremely low. The number of
physicians is so low that in 2003, 1.2 million Canadians were unable to find a physician.3
The lack of physicians and nurses in Canada is greatly affecting the wait times for every
type of treatment at hospitals. These wait times include minor things like being
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prescribed antibiotics to treatment for oncology patients. Wait times are even increasingly
longer with surgeries and procedures. Wait times are not only frustrating for Canadians
but they are making it unsafe for some people requiring urgent medical attention. The
nursing and physician shortage is making the working conditions unbearable, and could
jeopardize the health of Canadians. As a result of these shortages the wait times for
sometimes crucial procedures is increasing and causing patients in some cases to seek
healthcare elsewhere such as in the US ( where they have to pay for the services at the
point of care).
There are many positive components of the Canadian Health Care System. They
include the highest quality health services and standards nation-wide. It is always a good
thing for patients when a country’s standards are high and the health services are even
higher, because you are getting the best help and services possible. Also, the amount of
insurance that the government provides is spectacular. The only cost to Canadian citizens
for medically necessary health services is the annual taxation that isn’t too substantial,
considering what you are receiving in return. In addition, everyone has equal
accessibility and is of equal importance to Canada’s Health Care System. One of the
most prominent principles of the Canadian Health Care System is the accessibility of
medically necessary health services all over the country. This is not only beneficial but
extremely safe for citizens who may need treatment.
There are also several negative components to the Canadian Health Care System.
Canada has a shortage of nurses and physician which causes a situation in which there are
not enough health care providers to care for the population. This lack of health care
workers results in closing down of beds, long, frustrating wait times as well as
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increasingly stressful working conditions for nurses and physicians. Wait times can also
be unsafe for any of the patients’ health. Furthermore, people may not prefer having to
pay their taxes to the government, especially if they rarely need health services. In
addition, if anyone requires any additional health options like: massages and chiropractic
services, they are not included in “Medicare” coverage. Therefore, this exclusion of
other option for health services diminishes the advantages of health insurance.
Canada’s Health Care system has stood the test of time in providing accessible
health care to all Canadians. Our health care system although expensive to administer, is
envied by other countries. Currently in the US there is a vigorous debate over the
possibility of converting to a system such as Canada’s. Other countries such as the UK,
Netherlands and Australia have a similar health care system to Canada’s and find that it is
very beneficial to their citizens. Although the Canadian health care system has been
criticized for its wait times, the country has been diligently working on a ‘wait time
strategy’ to decrease wait times in emergency rooms, for procedures and surgeries. In
addition, Canada is working towards health human resources solutions to address the
nursing and physician shortages. For instance, in some communities that do not have
enough family physicians, nurse practitioner led clinics have been implemented. These
clinics allow patients to be assessed, treated and triaged as needed. As the population
continues to age and require greater levels of health care, the Canadian government will
need to evolve the health care system and become increasingly responsive to the
challenges it faces.
