the structure and organization of health care in Canada
This section of the website will explore the concept of the universal Canadian health care system
so that you have a better understanding of the overall system, how it is organized and the
Canadian social values
on which it is built and maintained.
The
Canadian government believes in its responsibility to protect the health and well being of the Canadian population.
This was the basic underlying value for the passing of the Canada Health Act.
It was federal legislation, first the Hospital Insurance and
Diagnostic Services Act (1957) and then the Medical Care Act (1966), that along with federal
money, established a national approach to health care in Canada. And when extra-billing and
user fees threatened the accessibility of medicare, the federal government responded with the
Canada Health Act. These actions reflect Canadians' belief that access to health care services
was not only a personal, community or provincial issue, but also a national issue that demanded
active participation by the federal government. (p46)
The delivery of care is primarily a provincial jurisdiction but the provinces rely on the transfer of money from the federal government
in order to do this.
Doctors Go On Strike
In response to a proposal made in 1962 that the provincial health care insurance plan be extended to
include physician services
the doctors went on strike.
As a result physician services were left out of the plan and a third-party billing system was implemented.
This system remains in place today.
Nurses, social workers, hospital pharmacists and other health
care workers are salaried but physicians remain self-employed.
Structure of The Canadian Health Care System
Most provinces in Canada are organized into regional health authorities (or boards).
Money flows to the regional health authority through their annual budget process and they are required govern,
plan, and coordinate the delivery of health care services in a specified geographic region.
They are also accountable for the quality and quantity of service provided to the public they serve.
Within this basic structure, here are some other points about how health care in Canada is structured.
doctors work in the community in their own offices.
They are not employed by hospitals but rather are given permission
to admit their patients to the hospital when they need hospital services
when physicians provide care to a patient they send a bill to the government and are paid according to an agreed upon fee schedule.
the physicians belong to a provincial organization that acts as a labor union to negotiate
with the government for how they are paid and what benefits they receive. As health care professionals
working in Canadian health care they are subject to the terms and conditions of labor laws which regulate union strikes
in the health care sector.
nurses who work in a hospital would be employees of that hospital or health region.
hospitals are run by registered societies or foundations and are administered through governing boards.
They must be non-profit (see the Canada Health Act).
hospitals and other agencies that deliver health care services receive money from the
provincial government annually for their operating budgets.
Capital expenses are also negotiated with the provincial government as it is the provincial level of authority
who holds the purse strings.
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