The Canada Health Act
Legislation for
the Canadian Health Care System

The Canada Health Act sets out the requirements for the structure of the thirteen individual health insurance plans in each of the provinces and territories. The Canadian health care system requires each province to provide individual health insurance to residents.

The act was passed in order to create national unity in the structure of provincial health insurance plans across the country and was adopted in 1984.

The Canadian health care system requires that the provinces and territories take the responsibility for the administration of the publicly funded health care system. The provinces do not fund the health care system on their own. They rely on transfer payments from the federal government for about 70% of the cost of health care in the province.

Each provincial and territorial government must conform to the conditions of the Canada Health Act to receive federal funding for the delivery of primary health care services.

What is a Tenet?

"An opinion, belief, or principle held to be true by someone or especially an organization"

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The Canada Health Act

The primary objective of the Canada Health Act 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." (Section 3).

There are five main conditions or criteria specified in the Canada Health Act.

These five criteria are often referred to as the "tenets" of the CHA.

• Public administration - this tenet stipulates that each of the individual health insurance plans in the 13 provinces and territories must be administered on a non-profit basis by a public authority. This makes illegal for anyone to sell private health insurance (for profit) for medically necessary procedures.


• Comprehensiveness - this tenet makes sure that all medically necessary procedures are covered by each individual health insurance plan. It stipulates that this coverage must include "all insured health services provided by hospitals, medical practitioners or dentists" (Section 9), but does not give a definition of the term "medically necessary", so each province or territory is allowed to determine that.


• Universality - this provision ensures that everyone is covered and lays out certain exceptions for coverage such as those covered under a federal insurance plan, like the Royal Canadian Mounted Police, landed immigrants, and those who have lived outside of Canada and are now returning to a permanent residency. It also lays the foundation for insurance coverage for those people who are unable to pay and stipulates that insurance cannot be withheld because of inability to pay.


• Portability - the CHA stipulates that health insurance must be portable from one province to another if a Canadian should move within the country. When an insured person moves to another province or territory in Canada the health care insurance plan of the province they moved from must remain in force for any medically necessary procedures in the new province for three months. This "waiting period" allows sufficient time for transfer of insurance from one province to another.


• Accessibility - this tenet requires that medically necessary insured services are available to everyone. The federal government believes that "extra billing" or private charges to an individual for insured services restricts access if people do not have the ability to pay the extra charge. Therefore under this tenet the federal government can withold transfer payments on a "dollar-for-dollar" basis for any province that allows private or extra billing to residents for insured services.