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"
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 - RCMP, 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.
The Canada Health Act is in place to ensure that the Canadian health care system is accessible to all Canadians,
and that they have
affordable coverage for health insurance for all medically necessary care services.
Go back to The Canadian Health Care System - Organization of Health Care in Canada
