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The Canada Health Act (CHA or the Act) is Canada's federal legislation for publicly funded health care insurance. The Act sets out the primary objective of Canadian health care policy, which 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."
for Indigenous rights, equal access to health care, and the rights of the disabled. His words, in defense of universal access to care, still hold true: We, as a society, are aware that the pain of illness, the trauma of surgery, the slow decline to death,
- Executive Summary
- 1 Introduction
- 2 Context and Key Provisions
- 3 Selected Issues of Concern
- 4 Court Challenges: Chaoulli v. Quebec
- 5 Criticism of The Canada Health Act
- 6 Parliamentary Action
- Notes
The Canada Health Act (CHA) sets out criteria and conditions that provincial and territorial health insurance plans have to meet in order to receive the full cash contribution for which they are eligible under the Canada Health Transfer. The CHA requires that “medically necessary” or “medically required” hospital, physician or surgical-dental servi...
The Canada Health Act (CHA) states that This legislation, along with the Canada Health Transfer (CHT)2 that supports it, is the vehicle that allows the federal government to influence health care, which is primarily within provincial/territorial jurisdiction. The CHA requires that health care insurance plans meet certain criteria and conditions in ...
2.1 Division of Powers and Health
Sections 91 and 92 of the Constitution Act, 1867 5assign exclusive legislative authority over certain matters to either Parliament or to provincial legislatures. While some health-related subjects are listed in these sections (hospitals, other than marine hospitals, for example, are a provincial matter), there is no specific reference to “health.” As a result, health-related subjects and measures can be characterized as being within the jurisdiction of either Parliament or provincial legislat...
2.2 Definitions, Criteria and Conditions, Extra-billing, and User Charges
There are a number of key terms in the CHAwhose definitions are required to understand the scope of the Act. These are set out in Table 1 below. The qualification that services be either “medically necessary” or “medically required” has been the subject of debate for many years. These terms are not defined in the CHA, which has left it open to the provinces and territories to interpret and determine what services are medically necessary or medically required.7As a result, the list of insured...
2.3 Compliance and Enforcement
If the federal minister is of the opinion that a province or territory's health care insurance plan does not meet one of the criteria, or that the province or territory is not meeting the conditions necessary for receiving the CHT, the minister may refer the matter to the Governor in Council (section 14 of the CHA). The Governor in Council's possible actions are outlined in section 15: As mentioned above, section 20 of the CHA provides that an amount, as determined by the federal Minister, eq...
3.1 Abortion
In New Brunswick, abortions performed outside hospitals (i.e., in a private clinic) are excluded from the list of insured health services. This situation was first raised as an issue of concern in the Canada Health Act Annual Report 2014–2015 16in relation to the comprehensiveness and accessibility criteria. Paying for travel costs and having to take time off work to travel to a hospital for abortion services disproportionately affects women with low incomes. Up until a few years ago, CHA ann...
3.2 Private Clinics
The term “private clinic” can refer to facilities that provide health services to patients outside the provincial and territorial health insurance systems, meaning that patients pay physicians directly for services instead of physicians billing the province or territory. Some provinces reimburse patients of these physicians, referred to as non‑participating physicians, for amounts equivalent to what the physicians could bill their province. The term “private clinic” can also refer to faciliti...
3.3 Portability
As mentioned in Table 2 of this paper, the CHA contains a portability requirement that relates to health care services obtained outside the province or territory of residence or outside the country. The portability criterion outlined in section 11(1)(b) of the CHArequires, among other matters, that the health insurance plan of a province On 1 January 2020, most of Ontario's provisions relating to coverage for out‑of‑country health care services will be revoked.20As a result, out-of-country co...
In the early 2000s, a Quebec doctor (Jacques Chaoulli) and patient (George Zeliotis) challenged Quebec's provisions that prohibited residents of the province from obtaining private health insurance for services that were covered by the provincial health insurance plan.23Such insurance would be used to pay for a service obtained from a physician who...
The CHA has faced criticism over the years on a number of fronts. Some observers have highlighted the lack of a patient focus within the CHA.34 It is also alleged by some critics that enforcement of the CHA's provisions is lacking,35 although policies introduced in 2018 by the then-federal minister suggest that the federal government may place a gr...
6.1 Parliamentary Committees
In 2018, as part of its study on a national pharmacare program, the House of Commons Standing Committee on Health recommended that the CHA be amended to include prescription drugs dispensed outside hospitals in the definition of “insured health service.” 43
6.2 Private Members' Bills
In May 2019, K. Kellie Leitch, MP, introduced Bill C-450, An Act to amend the Canada Health Act.44 That private member's bill would have added an “accountability” criterion to the CHA. Among other things, the bill would have required provincial and territorial laws to include measures ensuring the delivery of insured health services in a timely manner and, where there was no “reasonable access to care under the plan,” allowed a person to receive insured services outside the plan. The bill die...
6.3 Federal Minister of Health's Mandate Letter
The mandate letter sent to the federal minister at the beginning of the 43rd Parliament asks the minister to consider making amendments to the CHAto address the following priorities: 1. ensuring access to a family doctor or primary health care team; 2. setting national standards for access to mental health services; 3. improving access to home care and palliative care; and 4. implementing national universal pharmacare.48 If these amendments are introduced, it may also be an opportunity for th...
† Library of Parliament Background Papers provide in-depth studies of policy issues. They feature historical background, current information and references, and many anticipate the emergence of the issues they examine. They are prepared by the Parliamentary Information and Research Service, which carries out research for and provides information an...
Dec 14, 2021 · The term “health equity” is broad, as this title has taken on vastly different definitions over the past decade. Public Health Ontario describes health equity as a healthcare system that reduces unjust and unfair differences which are avoidable. Differences that impact health equity include socio-economic factors such as education, income ...
Jul 2, 1999 · c. Patients Bill of Rights. 1) Private Member s Bill. Federal health care initiatives tend to focus on collective, system-wide principles and objectives rather than on the rights and expectations of individual users of the health care system. The absence of a federal focus on individual rights stems largely from the constitutional division of ...
Purpose of this Act. 4 The purpose of this Act is to establish criteria and conditions in respect of insured health services and extended health care services provided under provincial law that must be met before a full cash contribution may be made. R.S., 1985, c. C-6, s. 4. 1995, c. 17, s. 35.
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Adopted unanimously by Parliament in 1984, the Canada Health Act, Canada's federal health care insurance legislation, codified the national principles which underpin federal funding for hospital and physician services and added prohibitions on patient charges which threatened to undermine universal access to care.
