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This article refers to medicare, a name for Canada's publicly-funded health insurance system for hospital and physician services. For similarly named programs in other countries, see Medicare.

The term medicare (in lowercase) (French: assurance maladie) is the unofficial name for Canada's universal publicly funded health insurance system. French ( français,) is a Romance language spoken around the world by 118 million people as a native language and by about 180 to 260 million people Country to "Dominion of Canada" or "Canadian Federation" or anything else please read the Talk Page Universal health care is health care coverage which is extended to all eligible residents of a governmental region The formal terminology for the insurance system is provided by the Canada Health Act and the health insurance legislation of the individual provinces and territories. The Canada Health Act (CHA is a piece of Canadian federal Legislation, adopted in 1984 which specifies the conditions and criteria with which the provincial and

Under the terms of the Canada Health Act, all "insured persons" (basically, legal residents of Canada, including permanent residents) are entitled to receive "insured services" without co-pays. A Permanent Resident in Canada is someone who is not a Canadian citizen but who has been granted permission to live and work in Canada without any time Such services are defined as medically necessary services if provided in hospital, or by 'practitioners' (usually physicians). [1]. Approximately 70% of Canadian health expenditures come from public sources, with the rest paid privately (both through private insurance, and through out-of-pocket payments). The extent of public financing varies considerably across services. For example, approximately 99% of physician services, and 90% of hospital care, are paid by publicly funded sources, whereas almost all dental care is paid for privately. [2]

Contents

Funding

Funding for the insurance plans comes from the general revenues of the Canadian provinces/territories, assisted by transfer payments from the federal government through the Canada Health Transfer. The Canada Health Transfer (CHT is the Canadian government 's Transfer payment programme in support of the health systems of the provinces and territories of Some provinces charge health care premiums, but these are in effect taxes (since they are not tied to service use, nor to provincial health expenditures). The system is accordingly classified by the OECD as a tax-supported system, as opposed to the social insurance approaches used in many European countries.

Delivery

Canada uses a mix of public and private organizations to deliver health care; in turn, these organizations bill the provincial health authorities, with few exceptions. [3] Hospitals are largely non-profit organizations, historically often linked to religious or charitable organizations. In some provinces, individual hospital boards have been eliminated and combined into quasi-private regional health authorities, subject to varying degrees of provincial control. Health regions of Canada are used to administer Public health to Canadians. Laboratory services are often delivered by for-profit investor-owned corporations.

With rare exceptions, medical doctors are small for-profit independent businesses. Historically, they have practiced in small solo or group practices and billed the medicare system on a fee for service basis. Fee-for-service is a standard business model where services are unbundled and paid for separately Unlike the practice in some other countries, hospital-based physicians were rarely hospital employees, and also billed the provincial insurance plans on a fee-for-service basis. Since 2000, physicians have been allowed to incorporate for tax reasons (dates of authorization vary province to province). However, efforts to achieve primary health care reform have increasingly encouraged physicians to work in multidisciplinary teams, and be paid through blended funding models, including elements of capitation and other 'alternative funding formulas'. Similarly, some hospitals (particularly teaching hospitals and rural/remote hospitals) have also experimented with alternatives to fee-for-service. A teaching hospital is a Hospital that in addition to delivering medical care to patients also provides Clinical education and training to future and current doctors

In summary, the system is known as a "public system" due to its public financing, but is not a nationalized system such as the UK's NHS; most medicare services are provided privately. [4]

An additional complexity is that, because health care is deemed to be under provincial jurisdiction, there is not a "Canadian health care system". As noted, most providers are private, and may or may not coordinate their care. Publicly-funded insurance is organized at the level of the province/territory; each manages its own insurance system, including issuing its own healthcare identification cards (a list of the provincial medical care insurance programs is given at the end of this entry). Once care moves beyond the services required by the Canada Health Act - for which universal comprehensive coverage applies - there is inconsistency from province to province in the extent of publicly-funded coverage, particularly for such items as outpatient drug coverage and rehabilitation, as well as vision care, mental health, and long-term care, with a substantial portion of such services being paid for privately, either through private insurance, or out-of-pocket. [5][6] Eligibility for these additional programs may be based on various combinations of such factors as age (e. g. , children, seniors), income, enrollment in a home care program, or diagnosis (e. g. , HIV/AIDS, cancer, cystic fibrosis).

The Canada Health Act requires coverage for all medically necessary care provided in hospitals or by physicians; this explicitly includes diagnostic, treatment and preventive services. The Canada Health Act (CHA is a piece of Canadian federal Legislation, adopted in 1984 which specifies the conditions and criteria with which the provincial and Coverage is universal for qualifying Canadian residents, regardless of income level. Services of non-physicians working within hospitals are covered; but provinces can, but are not forced to, cover services by non-physicians if provided outside hospitals. Changing the site of treatment may thus change coverage. For example, pharmaceuticals, nursing care, and physical therapy must be covered for inpatients, but there is considerable variation from province to province in the extent to which they are covered for patients discharged to the community (e. g. , after day surgery). The need to modernize coverage was pointed out in 2002 by both the Romanow Commission and by the Kirby committee of the Canadian Senate (see External links below). The Royal Commission on the Future of Health Care in Canada, also known as the Romanow Report, is a committee study led by Roy Romanow on the future of health Michael J L Kirby (born August 5, 1941) is a Canadian politician Similarly, the extent to which non-physician providers of primary care are funded varies; Quebec offers primary health care teams through its CLSC system). Quebec (kwɨˈbɛk CLSC s ( centre local de services communautaires, local community service centre in Quebec are free clinics which are run and maintained by the provincial government

Drug coverage

Each province may also provide its own prescription drug benefit plan, although the Canada Health Act requires only coverage for pharmaceuticals delivered to hospital inpatients. [7] Provincial prescription drug benefit plans differ across provinces. Some provinces cover only those in particular age groups (usually, seniors) and/or those on social assistance. Others are more universal. Quebec achieves universal coverage through a combination of private and public plans. Co-payments also vary. [8] Provinces maintain their own provincial formularies, although efforts are underway to institute a Common Drug Review. [9] Note that there is ongoing controversy in Canada, as in other countries, about inclusion of expensive drugs and discrepancies in their availability, as well as in what if any provisions are made for allowing medications not yet approved to be administered under "exceptional drug" provisions. [10] Drug costs are contentious. Their prices are controlled by the Patented Medicine Prices Review Board, otherwise called the PMPRB. The Patented Medicine Prices Review Board is a government agency in Canada which regulates drugs that are still under patent and which yet have no generic substitutes [11] The PMPRB's pricing formula ensures that Canada pays prices based on the average of those charged to selected countries; they are neither the highest, nor the lowest.

Dental care, eye care and other services

Dental care is not required to be covered by the government insurance plans. Dentistry' is the "evaluation diagnosis prevention and/or treatment (nonsurgical surgical or related procedures of diseases disorders and/or conditions of the oral cavity Canadians rely on their employers, individual private insurance, pay cash themselves for dental treatments, or receive no care. In some jurisdictions, public health units have been involved in providing targeted programs to address the need of the young, the elderly or those who are on welfare. The Canadian Association of Public Health Dentistry tracks programs, and has been advocating for extending coverage to those currently unable to receive dental care. [12]

The range of services for vision care coverage also varies widely among the provinces. Generally, "medically required" vision care is covered if provided by physicians (cataract surgery, diabetic vision care, some laser eye surgeries required as a result of disease, but not if the purpose is to replace the need for eyeglasses). Similarly, the standard vision test may or may not be covered. Some provinces allow a limited number of tests (e. g. , no more than once within a two-year period). Others, including Ontario, Alberta and Saskatchewan, do not, although different provisions may apply to particular sub-groups (e. g. , diabetics, children).

Naturopathic services are covered in some cases, but homeopathic services are generally not covered. Chiropractic is partially covered in some provinces. Cosmetic procedures are not typically covered. Psychiatric services (provided by physicians) are covered, fee-for-service psychology services outside of hospitals or community based mental health clinics are usually not. Physical therapy, occupational therapy, speech therapy, nursing, and chiropractic services are often not covered unless within hospitals. Some provinces, including Ontario include some rehabilitation services for those in the home care program, those recently discharged from hospitals (e. g. , after a hip replacement), or those in particular age categories. Again, considerable variation exists, and provinces can (and do) alter their coverage decisions.

Opinions on Medicare

Polling data in the last few years have consistently cited medicare as among the most important political issues in the minds of Canadian voters. Along with peacekeeping, the CBC ran a poll that found medicare to be one of the most defining characteristics of Canada. Peacekeeping, as defined by the United Nations, is "a way to help countries torn by conflict create conditions for sustainable peace

It has increasingly become a source of controversy in Canadian politics. As a recent report from the Health Council of Canada has noted "Herein lies one of the puzzles of Canadian health care: Canadians increasingly view the health care system as unsustainable and under threat, even as their own experiences with the system are mostly positive. " [13]

As analysts have noted, the root of the concern may be traced to successful cost control efforts in the mid 1990s, where public health expenditure per capita, in inflation-adjusted dollars, actually fell. [14] These efforts arose from efforts by the federal government to deal with its deficit, which led to cuts in their transfers to the provinces, and in turn to squeezing hospital budgets and physician reimbursements. The number of physicians being trained was reduced. The result was seen in increased wait times, particularly for elective procedures. More recently, government has been reinvesting in health care, but public confidence has been slow to recover.

A number of studies have compared Canada with other countries, and concluded that each system has its own strengths and weaknesses. [15] [16] One widely-cited statistic which has been used to argue that Canada was under-performing came from the World Health Organization, which ranked Canada as 30th in 2000. However, the basis for these rankings has been highly contentious. As Deber noted, "The measure of "overall healthsystem performance" derives from adjusting "goal attainment" for educational attainment. Although goal attainment is in theory based on five measures (level and distribution of health, level and distribution of "responsiveness" and "fairness of financial contribution"), the actual values assigned to most countries, including Canada, were never directly measured. The scores do not incorporate any information about the actual workings of the system, other than as reflected in life expectancy. The primary reason for Canada's relatively low standing rests on the relatively high educational level of its population, particularly as compared to France, rather than on any features of its health system. "[17] Other countries had similar complaints, and the WHO has not repeated this ranking.

The 2003 Accord

In 2003, the prime minister and the provincial premiers agreed upon priority areas for reinvestment. The 2003 First Ministers’ Accord on Health Care Renewal [18] reaffirmed their commitment to the principles of the Canada Health Act. They indicated the following principles:

"Drawing from this foundation, First Ministers view this Accord as a covenant which will help to ensure that:

The accord set the following priority areas: primary health care, home care, catastrophic drug coverage, access to diagnostic/medical equipment and information technology and an electronic health record. The extent of progress in meeting reform goals has varied across these areas.

Evaluating Claims about the System

Evaluating the accuracy of claims about the system is hampered by several factors. The highly decentralized nature of health care delivery means that good data is not always available. It is often difficult to distinguish compelling but atypical anecdotes from systemic problems. Considerable effort is being made to develop and implement comparable indicators to allow better assessment of progress. However, the Health Council of Canada - with a mandate to monitor and report on health reform - complained in 2007 that progress has stalled [19]

The debate about health care has also become heavily ideological. The Fraser Institute, a think tank supporting "competitive market solutions for public policy problems" is a frequent critic of medicare. The Fraser Institute is Conservative and Libertarian Think tank based in Canada that espouses Free market principles It publishes yearly reports about wait times which are then used to argue that the system is both failing and unsustainable. [20] Others criticize their methodology, which is based on physician perceptions rather than actual waits. [21] Other complaints come from the political left, who object to 'privatization' (by which they usually mean a heavier involvement of for-profit providers). (See, for example, the Canadian Health Coalition web page. [22] There are frequent debates in the media and on line between advocates and opponents of Canadian healthcare.

Wait Times and Access

Common complaints relate to access, usually to elective surgery (especially hip and knee replacement and cataract surgery) and diagnostic imaging. These have been the primary targets of health care reinvestment, and it appears that considerable progress has been made for certain services, although the implications for procedures not on the target list are unclear. [23] [24] [25] Canadian physicians have been heavily involved, particularly in developing appropriateness criteria to ensure timely access for necessary care. [26] It cost Canada's economy $14. Canada is the home to the ninth largest economy in the world (measured in US dollars at market exchange rates is one of the world's wealthiest nations and a member of the Organization 8 billion in 2007 to have patients waiting longer than needed for medical procedures. Year 2007 ( MMVII) was a Common year starting on Monday of the Gregorian calendar in the 21st century. [27]

Health Human Resources

A related issue is the volume, and distribution, of health human resources. [28] There are ongoing issues about the distribution of physicians, with the pendulum swinging from arguing that there were too many, to arguing that there were too few. As Ben Chan found, the major factor driving the drop in physician numbers was changes in training programs. [29] Combined with such factors as changes in the hours worked by each physician , and a decrease in the proportion of doctors choosing to go into family practice, there were shortages in some areas, particularly for general practitioners (GP) / family doctors. One response has been to encourage 'primary care reform', including greater use of multidisciplinary health care teams. [30] There are also ongoing issues regarding nurses. (See Nursing Health Services Research Unit, which links to some reports. [31] CIHI also gives data about nursing. )

The Parallel Private Debate

Some politicians and think tanks have proposed removing barriers to the existence of a parallel private healthcare system. A think tank (also called a policy institute) is an organization institute corporation or group that conducts Research and engages in advocacy in areas such Others note that such systems act to erode cost control and impede equity. [32] Though polling suggests support for such reforms has been increasing, it has yet to be adopted as official policy by any of the main federal political parties.

There are no barriers under the Canada Health Act to private clinics, although provincial governments may or may not permit them. Individual physicians can and do operate private clinics, but there are disputes as to whether surgical procedures can be performed. Two related issues have obstructed the growth of such clinics. One is regulatory - hospital-based quality assurance often failed to encompass them. This gap has been filled in most provinces, but sometimes only after celebrated incidents in which patients died in unregulated clinics, including one physician who performed cosmetic surgery in an Ontario hotel room. The second is economic - there may be no way for physicians to recoup the additional costs of running a surgical facility from their fees. Here, provinces can choose to offer 'facility fees' to these clinics, but doing so has often been contentious, particularly if hospitals felt that these costs would be better devoted to allowing them to increase their operating room time.

Note that uninsured persons can pay for care (including medical tourism), and that insured persons can still pay for uninsured services. These are both niche markets.

American opinion on Canadian medicare tends to be non-neutral, either supportive as in the preceding paragraph and therefore desirable within the USA, or negative and not desirable. Opinions not supportive of medicare put forth issues such as wait times and budget cuts having severely impaired the Canadian healthcare system, to the point where Canadian mothers have to go to the U. S. to deliver because of lack of room and nurses in Canadian hospitals. [33]

Governments in Canada spend a smaller amount per capita on healthcare than governments in the United States, while almost every Canadian citizen is fully covered. In the United States a high percentage of the population is uncovered or only marginally covered, despite higher proportional spending along with large private investment. Even more people are just a job loss away from not having coverage (although in most cases the employer must maintain health care with copayment of the patient for a period of time after employment in the United States has gone down not up). A copayment, or copay, is a capped contribution defined in the policy and paid by an insured person each time a medical service is accessed

The lack of competition has given healthcare unions a monopoly on essential services, thus ensuring a very strong bargaining position. Nova Scotia is currently debating healthcare legislation aimed at removing the threat of striking healthcare workers and replacing it with binding arbitration. [34]

Proposed reforms

One proposed solution for improving the Canadian healthcare system is to increase funding. Proponents of this approach point to the rise of neo-conservative economic policies in Canada and the associated reduction in welfare state expenditure (particularly in the provinces) from the 1980s onwards as the cause of degradation in the system. Neoconservatism (or Neocon is a Right-wing political philosophy that emerged in the United States from the rejection of the Social liberalism, Moral relativism This article refers specifically to the Welfare state of the United Kingdom. In fact, there is evidence that the percentage of total government expenditures spent on healthcare has been increasing, in part due to a higher percentage of older Canadians. Population ageing (Aging Population also or population aging (see English spelling differences) occurs when the median age of a country or region

Other critics of healthcare state that increased funding will not solve systematic problems in the healthcare system including a rising cost of medical technology, infrastructure, and wages. These critics say that Canada's proximity to the United States causes a "brain drain" or migration of Canadian-trained doctors and nurses (as well as other professionals) to the United States, where private hospitals can pay much higher wages and income tax rates are lower. A brain drain or human capital flight is a large emigration of individuals with technical skills or knowledge, normally due to conflict, lack of opportunity Some of these critics argue that increased privatization of healthcare would improve Canada's health infrastructure.

Critics of the systematic reform approach state that healthcare should be kept public, (public in funding only, as most services are provided by the private sector including doctors who in most cases are private corporations) in part because it separates Canadians from Americans by mandating equality and fairness in health care. Truth is that the system is not a true public system, as in Italy, where doctors are on a per capita salary. The Canadian Health care system is merely publicly funded, which most Canadians appreciate and desire. Making the system a true public system is an alternative to the current half public, half private system.

Ontario's reform experiments

Since the early 1990s, Ontario has implemented several systematic reforms to reduce health care costs. Similar reforms have been implemented in other provinces.

User premiums

Currently in Ontario, people who earn salaries above $20,000 must pay an annual health care premium ranging from $300-$900. Funding for medicare in Ontario also comes in part from a dedicated Employer Health Tax (EHT) that ranges from 0. 98%-1. 95% of employer payroll. Eligible employers are exempted from EHT on the first $400,000 of payroll. British Columbia, Quebec, and Alberta charge similar premiums. Alberta charges $44 a month or $88 per family, though as Alberta approaches debt-free status, there has been talk of removing them.

Medical clinics

Ontario has increased the number of 24-hour drop-in medical clinic networks to reduce costs associated with treating off-hours emergencies in hospital emergency rooms.

Many family doctor practices have created their own clinics, offering 24-hour service for their patients if needed. Each doctor in the practice takes a turn at being "on call" on a rotating basis. Patients who have family doctors belonging to these practices are able to have a doctor come to their home in extreme situations. There is no additional charge for these services as they are billed to the Province, the same as an office visit.

Hospitals in some major Canadian cities, such as London, Ontario, have restructured their emergency services to share emergency treatment among several hospitals. One hospital may provide full emergency room care, while another sees patients who have broken limbs, minor injuries and yet another sees patients suffering cold, flu, etc.

Recently, the first nurse practitioner-led office to relieve waiting times caused by a shortage of primary practitioners was opened in Sudbury, Ontario. Greater Sudbury (2006 Census population 157857 is a city in Northern Ontario, Canada. [35][36]

Alternatives to fee-for-service

Ontario has also attempted to move the system away from bill for service and toward preventive and community-based approaches to healthcare. The Ontario government in the early 1990's helped develop many community health care centres, often in low-income areas, which provide both medical and social support which combines health care with programs such as collective kitchens, Internet access, anti-poverty groups and groups to help people quit smoking.

While funding has decreased for these centres, and they have had to cut back, they have had a lower cost than the traditional fee-for-service approach. Many of these centres are filled to capacity in terms of general doctors, and there are often fairly long waiting lists and the centres also utilize nurse practitioners, who reduce the workload on the doctors and increase efficiency. A Nurse Practitioner (NP is a Registered nurse who has completed specific advanced Nursing education (generally a Master's degree) and training in the

Midwives and hospital birthing reforms

Ontario and Quebec have recently licensed midwives, providing another option for childbirth which can reduce costs for uncomplicated births. Midwifery is a Health care profession where providers give Prenatal care to expecting Mothers attend the birth of the Infant Midwives remain close to hospital facilities in case the need for emergency care emerges. These births often cost much less than the traditional hospital delivery. Hospitals have also reformed their approach to birthing by adding private birthing areas, often with a hot tub (which is good for relieving pain without medication).

Privatization

Currently, privately owned and operated hospitals that allow patients to pay out-of-pocket for services cannot obtain public funding in Canada, as they contravene the "equal accessibility" tenets of the Canada Health Act. Out-of-pocket expenses are direct outlays of cash which are not reimbursed The Canada Health Act (CHA is a piece of Canadian federal Legislation, adopted in 1984 which specifies the conditions and criteria with which the provincial and Some politicians and medical professionals have proposed allowing public funding for these hospitals. Workers' Compensation Boards, the Canadian Military, the RCMP, federally incarcerated prisoners, and medical care for which an insurance company has liability (e. g. , motor vehicle accidents) all pay for health care outside of the public systems in all provinces. [37][38]

In Quebec, a recent legal change has allowed this reform to occur. In June 2005, the Supreme Court of Canada overturned a Quebec law preventing people from buying private health insurance to pay for medical services available through the publicly funded system and this ruling does not apply outside the province. See: Chaoulli v. Quebec (Attorney General)[1]. Chaoulli v Quebec (Attorney General 1 SCR 791 was a decision by the Supreme Court of Canada where the Court ruled that the Quebec Health Insurance Act

In November 2005, the Quebec government announced that it would allow residents to purchase private medical insurance to comply with this ruling.

Private insurance from companies such as Blue Cross, Green Shield and Manulife have been available for many years to cover services not covered by Medicare, such as dental care and eye care. Blue Cross redirects here For other uses see Blue Cross (disambiguation The Blue Cross Blue Shield Manulife Financial Corporation (,,) also known as The Manufacturers Life Insurance Company, is a major Canadian insurance company and Financial Private insurance is provided by many employers as a benefit.

The Canadian Medical Association (CMA) released a report[39] in July 2007 endorsing private healthcare as a means to improve an ailing healthcare system. The current president of the CMA, Dr. Brian Day, is the owner of the largest private healthcare hospital in Canada and a proponent of mixed public and private healthcare in Canada. Dr Brian Day, MRCP (UK FRCS (Eng FRCS (C (born c 1947 is a Physician in Canada and the 2007-2008 president of the Canadian

Canadian Health Practitioner standards

It is generally accepted that physicians arriving in Canada from other countries must meet Canadian Health Practitioner standards. So there is concern that doctors from other countries are not trained or educated to meet Canadian standards. Consequently, doctors who want to practice in Canada must meet the same educational and medical qualifications as Canadian-trained practitioners, others suggest that the current regulatory bodies, the Canadian Medical Association, the Doctors Union, and the College of Physicians and Surgeons has created too much red tape to allow qualified doctors to practise in Canada. The Canadian Medical Association (CMA with more than 65000 members is the largest association of doctors in Canada and works to represent their interests nationally The Ontario Medical Association is a Professional organization for Physicians in Ontario Canada founded in 1880. [40] It should be noted that Canada's Health system is ranked 30th in the world, suggesting the logic of the doctor shortage defies the statistics. [41] In fact according to a report by Keith Leslie of the Canadian Press in the Chronicle Journal, Nov 21, 2005, over 10,000 trained doctors are working in the United States, a country ranked 37th in the world. It would suggest money or the perception of better working conditions, or both, are resulting in an exodus of Canadian doctors (and nurses) to the USA. [42]

It is important to recognize that many consider the doctor shortage in Canada to be a very severe problem affecting all sectors of health care. It may relate in part to the details of how doctors are paid; a detail often misunderstood. In Canada, almost all doctors receive a fee per-visit, not per-service. It has been suggested that this type of "fee-for-visit" payment system can encourage complexity, volume visits, repeat visits, referrals, and testing. [43][44]

One consequence of the shortage in Canada is that a great many patients are left without family doctors, and trained specialists, making early intervention very difficult. As the article in the Toronto Star specially isolates, it is not so much a problem of a doctor shortage but of a shortage of 'licensed doctors'. Michael Urbanski states that Canada already has a hidden reserve of foreign-trained MDs eager to begin medical practice. "However, what's crucial to understanding the issue of doctor shortage in Ontario is that while the Liberal government is planning to go "poaching" for other countries' doctors, there are an estimated 4,000 internationally trained doctors right here in Ontario working at low-wage jobs. " [45]

A CBC report [6](August 21, 2006) on the health care system reports the following:

Dr. Albert Schumacher,[46] former president of the Canadian Medical Association estimates that 75 per cent of health-care services are delivered privately, but funded publicly. "Frontline practitioners whether they're GPs or specialists by and large are not salaried. They're small hardware stores. Same thing with labs and radiology clinics …The situation we are seeing now are more services around not being funded publicly but people having to pay for them, or their insurance companies. We have sort of a passive privatization.

In a report by Keith Leslie of the Canadian Press in the Chronicle Journal, Nov 21, 2005, commenting on an Ontario Medical Association Report, prepared by the human resources committee states "The year 2005 finds the province in the midst of a deepening physician resources crisis". The report continues to report, "the government should make it easier for doctors from other provinces to work in Ontario and . . . . ". Here we have signs of inter-provincial competition affecting the doctor shortage in one province over another. [47]. Essentially, privatized healthcare is not a choice of interest for lower income Canadians, it is most likely to be unaffordable and unfair to those who suffer on a social standard.

Provincial insurance plans

Though the Canada Health Act provides national guidelines for healthcare, the provinces have exclusive jurisdiction over health under the constitution and are free to ignore these guidelines, although if they ignore the guidelines, the federal government may deny federal funding for healthcare. The Canada Health Act (CHA is a piece of Canadian federal Legislation, adopted in 1984 which specifies the conditions and criteria with which the provincial and The Constitution of Canada is the supreme law in Canada; the country's Constitution is an amalgamation of codified acts and uncodified traditions The Canadian Government, formally Her Majesty's Government in Canada, is the Federal government of Canada. All provinces currently abide by the Canada Health Act in order to receive this funding; however the Alberta legislature has considered proposals to ignore the Act to allow them to implement reforms not allowed under the Act. Alberta (ælˈbɝtə is one of Canada's prairie provinces. It became a province on September 1 1905

The federal government has no direct role in the delivery of medicine in the provinces and territories so each province and territory has its own independent public health insurance program. Under the Canada Health Act, each province and territory must provide services to members of plans in other provinces and territories.

List of provincial programs

Province Name of plan
Alberta Alberta Health Care Insurance Plan
British Columbia Medical Services Plan
Manitoba Manitoba Health
New Brunswick Medicare
Newfoundland and Labrador Newfoundland and Labrador Medical Care Plan
Northwest Territories NWT Health Care Insurance Plan
Nova Scotia Medical Service Insurance
Nunavut Nunavut Health Care Plan
Ontario Ontario Health Insurance Plan
Prince Edward Island Medicare
Quebec Assurance maladie (RAMQ Medicare)
Saskatchewan Saskatchewan Medical Care Insurance Plan
Yukon Yukon Health Care Insurance Plan

See also

References

  1. ^ Canada Health Act Overview
  2. ^ Canadian Institute for Health Information (September 27, 2005), CIHI exploring the 70-30 split, <http://www.cihi.ca/cihiweb/dispPage.jsp?cw_page=AR_1282_E>. Alberta (ælˈbɝtə is one of Canada's prairie provinces. It became a province on September 1 1905 British Columbia (ˌbrɪtɨʃ kəˈlʌmbiə ( BC) ( (la Colombie-Britannique C The Medical Services Plan of British Columbia (MSP is the government-administered single-payer Health insurance scheme in the Canadian province of Manitoba (English ˌmænɨˈtoʊbə French /manitoba/ is a province of Canada, spanning 647797 square kilometres (250116  sq mi of North America Manitoba Health is an agency of the Government of Manitoba. It is overseen by the Minister of Health, and provides information on various aspects of health care in New Brunswick ( French: Nouveau-Brunswick /nuvobʁɔnzwik/ is one of Canada 's three Maritime provinces and is the only constitutionally Newfoundland and Labrador (ˈnuːfɨn(dlənd ən(d ˈlæbrəˌdɔr (Terre-Neuve-et-Labrador is a province of Canada, the tenth and latest to join the Confederation The Northwest Territories (ˌnɔrθˌwɛstˈtɛrɨtɔriz ( NWT or NT; French, les Territoires du Nord-Ouest) is a territory Nova Scotia (ˌnəʊvəˈskəʊʃə ( Latin for New Scotland; Alba Nuadh Nouvelle-Écosse is a Canadian province located on Canada 's Nunavut (ˈnuːnəvʊt ( Inuktitut syllabics: ᓄᓇᕗᑦ is the largest and newest territory of Canada; it was separated officially from the Ontario (ɒnˈtɛrioʊ is a province located in the central part of Canada, the largest by population and second largest after Quebec The Ontario Health Insurance Plan ( OHIP) is the government -run health plan for the Canadian province of Ontario. Prince Edward Island (ˌprɪns ˌɛdwɚd ˈaɪlɨnd ( PEI or P Quebec (kwɨˈbɛk Saskatchewan (səˈskætʃəwən) is a prairie province in Canada, which has an area of 588276 Yukon (ˈjuːkɒn is the westernmost and smallest of Canada's three territories. The Canada Health Act (CHA is a piece of Canadian federal Legislation, adopted in 1984 which specifies the conditions and criteria with which the provincial and Several individuals may be recognized as " father of " the Canadian system of universal public medicare: Tommy Douglas forwarded The Ontario Health Insurance Plan ( OHIP) is the government -run health plan for the Canadian province of Ontario. The " Matthew effect " denotes the phenomenon that "the rich get richer and the poor get poorer" and can be observed in various different contexts where "rich" This article describes the Australian universal health scheme Medicare This article refers to Medicare, a United States health insurance program The National Health Service is the name commonly used to refer to the four Publicly-funded healthcare systems of the United Kingdom collectively or individually (although Health care in Canada is funded and delivered through a Publicly-funded health care system with most services provided by private entities The Royal Commission on the Future of Health Care in Canada, also known as the Romanow Report, is a committee study led by Roy Romanow on the future of health The 1962 Saskatchewan Doctors' Strike was a 23-day labour action exercised by Medical doctors in the Canadian province of Saskatchewan in an attempt to force The Canadian Institute for Health Information (CIHI is an independent not-for-profit organization in Canada, primarily funded by the provincial and federal governments Events 489 - Odoacer attacks Theodoric at the Battle of Verona and is defeated again Year 2005 ( MMV) was a Common year starting on Saturday (link displays full calendar of the Gregorian calendar. Retrieved on 21 December 2007 .
  3. ^ Raisa Deber (August 2002), Delivering Health Care Services: Public, Not-For-Profit or Private, <http://www.hc-sc.gc.ca/english/pdf/romanow/pdfs/17_Deber_E.pdf>. Other names In Arabic, the month is called أغسطسص ʾUġusṭuṣ or آب ʾĀb; usage varies from place to place and See also 2002 (disambiguation Year 2002 ( MMII) was a Common year starting on Tuesday of the Gregorian calendar. Retrieved on 24 December 2007 .
  4. ^ CBC Health Care Private versus Public
  5. ^ Neil MacKinnon. Commentary: Provincial drug plans. 2004
  6. ^ Mark Kaplan. Myths and Realities of Canadian Medicare. Fall 2004
  7. ^ Prescription Drug Coverage in Canada drugcoverage.ca
  8. ^ Valérie Paris and Elizabeth Docteur. Pharmaceutical Pricing and Reimbursement Policies in Canada. OECD Health Working Papers 24, 2006.
  9. ^ McMahon M, Morgan S and Mitton C. The Common Drug Review: A NICE start for Canada? Health Policy. 2006 August;77(3):339-351. Summary
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  11. ^ PMPRB Home page. Accessed Dec 26, 2007.
  12. ^ Canadian Association of Public Health Dentistry home page
  13. ^ [http://www.healthcouncilcanada.ca/docs/rpts/2007/ Public%20Perceptions%20-%20English%20Final_Feb-07. pdf Stuart N. Soroka. Canadian Perceptions of the Health Care System. 2007. ISBN 0-9739726-8-8]
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  16. ^ OECD Health Data 2007. How Does Canada Compare?
  17. ^ R. Deber. Why Did the World Health Organization Rate Canada's Health System as 30th? Some Thoughts on League Tables. Longwoods Review 2(1) 2004.
  18. ^ Home page on the accord
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  20. ^ Fraser Institute press release, October 2007
  21. ^ CHSRF Mythbusters: A parallel private system would relieve waiting times in the public system. 2005
  22. ^ Canadian Health Coalition. Home Page. Accessed Dec 26, 2007.
  23. ^ Health Council of Canada. Wading through wait times. 2007
  24. ^ Health Canada home page on wait times, with links to major studies. 2007
  25. ^ CIHI Waiting for Health Care in Canada: What We Know and What we Don't Know. 2006.
  26. ^ Home page of Wait Time Alliance accessed December 26, 2007
  27. ^ CTV.ca | Patient wait times costing economy $14.8B
  28. ^ CIHI Canada's Health Care Providers accessed Dec 26, 2007
  29. ^ CIHI report, From Perceived Surplus to Perceived Shortage: What Happened to Canada’s Physician Workforce in the 1990s? 2002
  30. ^ Health Canada Primary Health Care home page, accessed Dec 26, 2007
  31. ^ NHRSU home page. Accessed Dec 26, 2007.
  32. ^ I. Dhalla. Private Health Insurance: An International Overview and Considerations for Canada. Longwoods Review vol 5(3) 2007.
  33. ^ FOXNews.com - Canada's Expectant Moms Heading to U.S. to Deliver - Local News | News Articles | National News | US News
  34. ^ Nova Scotia News - TheChronicleHerald.ca
  35. ^ "First Nurse Practitioner-Led Clinic Opens Doors in Sudbury", REGISTERED NURSES' ASSOCIATION OF ONTARIO, CNW Group, 2007-08-31. Year 2007 ( MMVII) was a Common year starting on Monday of the Gregorian calendar in the 21st century. Events 1056 - Byzantine Empress Theodora becomes ill dying suddenly a few days later without children to succeed the Throne Retrieved on 2007-09-02. Year 2007 ( MMVII) was a Common year starting on Monday of the Gregorian calendar in the 21st century. Events 44 BC - Pharaoh Cleopatra VII of Egypt declares her son co-ruler as Ptolemy XV Caesarion.  
  36. ^ "1st nurse practitioner-governed clinic opens in Sudbury", CBC News, CBC, 2007-08-31. Year 2007 ( MMVII) was a Common year starting on Monday of the Gregorian calendar in the 21st century. Events 1056 - Byzantine Empress Theodora becomes ill dying suddenly a few days later without children to succeed the Throne Retrieved on 2007-09-02. Year 2007 ( MMVII) was a Common year starting on Monday of the Gregorian calendar in the 21st century. Events 44 BC - Pharaoh Cleopatra VII of Egypt declares her son co-ruler as Ptolemy XV Caesarion.  
  37. ^ B.C. Canadian Taxpayers Federation
  38. ^ Canada Health Act Overview
  39. ^ Doctors’ group prescribes private health care
  40. ^ Red tape is strangling foreign-trained physicians CANADIAN MEDICAL ASSOCIATION JOURNAL
  41. ^ Universal Health Care - Canada ranks 30th
  42. ^ Ont. Medi Scare - Chronicle Journal, Thunder Bay, November 21, 2005 - Physician shortage puts stability of health-care system at risk. OMA
  43. ^ Improving health care for Canadians.
  44. ^ Health Care Costs Nobody Talks About
  45. ^ What doctor shortage? - Toronto Star, August 19, 2004
  46. ^ Private verses Public - Dr. Albert Schumacher
  47. ^ Ont. Medi Scare - Chronicle Journal, Thunder Bay, November 21, 2005 - Physician shortage puts stability of health-care system at risk. OMA

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