If you ask a Filipino in Canada, they would tell you that one of the reasons they opted to migrate to this country is the Canadian Healthcare System. But what makes it so excellent? We’ll look into what makes up this effective healthcare system and how it stacks up against the best in the world.
Canada is ranked tenth in Statista’s Health Care System Performance Rankings for 2021. Given that it was only ranked 12th in 2016 and 15th in 2015, this is a really impressive performance. The healthcare system is controlled by provincial governments, however they all follow the same guiding principles. Continue reading to learn more about these concepts and how they help the entire country’s people.
A Look at the Canadian Healthcare System
The Canadian healthcare system is a single-payer, publicly funded, and managed system that aims to serve all Canadian citizens and permanent residents.
The Canadian healthcare system is decentralized and funded by federal, provincial, and territorial (FPT) government taxes.
Medicare is the term given to Canada’s universal health care system, which provides free medically necessary care at the point of service but does not cover prescription medicines, dental care, or vision care.
Despite having one of the most expensive universal healthcare systems in the OECD, Canada falls behind in terms of resource availability and access. Nonetheless, when compared to other parts of the world, such as the Philippines, Canada is far more efficient and has better health outcomes.
The Evolution of Canadian Healthcare System
The Canadian Constitution defines the powers of the territorial and federal governments. In 1867, the provinces were given the authority to establish, run, and maintain hospitals, asylums, benevolent institutions, and charitable shops. The federal government also gained control of maritime hospitals and quarantine.
The federal government was given the authority to borrow and tax. This was done to ensure that the spending did not exceed the jurisdiction of the province. The Agriculture Department was also in charge of the federal government’s health commitments from 1867 to 1919.
Prior to World War II, the majority of healthcare services in Canada were privately funded and administered. Saskatchewan implemented a policy for universal hospital care in 1947. Two years later, Alberta and British Columbia followed suit. In 1957, the government enacted hospital insurance and cost-sharing legislation. This act assigned the federal government a cost-share for the percentage of hospital and diagnostic services paid for by territorial and provincial governments.
The Act required everyone to have access to certain services, including as inpatient and diagnostic facilities. After four years, all territories and provinces pledged to provide these services.
Saskatchewan created a universal health insurance scheme for its residents in 1962. The next year, the federal government passed the Medical Care Act, which compensated up to 50% of the costs associated with a doctor’s outpatient services. Within six years, all regions and provinces had the same physician insurance.
From 1957 to 1977, the proportion of federal contributions to the healthcare system provided to provinces and territories was based on the proportion of overall spending on physician and hospital services. In 1977, the cost-sharing act was replaced by a block fund comprised of tax points and cash payments.
A block fund is a type of financial structure that allows the federal government to allocate a specific amount of money to provinces and territories for a specific purpose. This system permitted the federal government to reduce taxes while allowing states and territories to raise theirs. This new financial structure allowed territories and provinces to make their own healthcare decisions.
The organization of Canada’s healthcare system is governed by the country’s Constitution, which delegated increased responsibility for the provision of social services and health care to the provinces and territories. The federal government, on the other hand, is in charge of providing specialized services to certain groups.
The majority of healthcare funding in provinces and territories comes from various taxes, including as corporate and personal income taxes, sales taxes, and payroll levies. Despite the fact that provinces have the authority to charge their residents a premium to help pay for healthcare services, this should not prevent people from receiving these treatments.
In addition to the healthcare system, provinces and territories are in charge of a variety of public health services. Cleanliness and the prevention and treatment of infectious diseases are among them. These services are often offered at the local and provincial levels.
The Health Care Act of Canada
The following are the five principles of the Canada Health Act:
A public institution accountable to the province or territory government must administer and run the provincial and territorial plans on a non-profit basis.
All medically necessary treatments provided by hospitals, physicians, and dentists working in a hospital setting must be covered by provincial and territorial plans.
All insured persons must be supplied with uniform coverage terms and conditions under provincial and territorial plans.
Accessibility: The provincial and territorial plans must ensure that all covered individuals have free and easy access to medically necessary hospital and physician services, regardless of financial or other impediments.
Transferability: All insured persons who relocate within Canada to a different province or territory or travel worldwide must be covered by the provincial or territorial plans. Non-emergency services provided outside of Canada’s provinces and territories may be subject to prior authorization and coverage limitations.
The Role of the Government
The federal government
The federal government’s involvement in the healthcare system entails developing and implementing the system’s fundamental principles, providing financial assistance to provinces, and performing a range of other duties. These include the financing and delivery of supplementary and main healthcare services to certain populations. These groups include Inuit, First Nations, veterans, military members, federal prison inmates, and refugee claimants.
The Canada Health Act establishes a number of conditions and criteria that provinces and territories must meet in order to obtain full federal financing for their healthcare systems. Among these are appropriate access to physicians and hospitals.
The Act also prohibits provinces and territories from levying user fees and other taxes. This is a common type of healthcare service offered by medical experts. It is not permitted under the provincial and territorial health insurance plans. A user charge is a fee that is not included in the usual cost of health care coverage.
The federal government sends financial and tax transfers to provinces and territories to fund their own healthcare systems through the Canada Health Transfer. It also makes equalization payments to poorer regions and provinces. These payments help provinces and territories fund their own healthcare systems.
The federal government offers primary and emergency healthcare services to First Nations and Inuit people on distant and isolated reservations. Furthermore, it provides community-based programs to improve the quality of healthcare services for these populations. It also provides a non-insured program to aid Canadian First Nations and Inuit people.
These services are typically delivered at a variety of locations, including nursing stations, health facilities, and in-patient treatment institutions. As the federal government and indigenous organizations collaborate to connect these services with territorial and provincial institutions, more individuals will be able to benefit from these efforts.
Furthermore, the federal government has the jurisdiction to supervise several aspects of the healthcare industry. Food and pharmaceutical safety, as well as disease surveillance and prevention, are examples of this.
Furthermore, the federal government supports health promotion and research. It also includes a number of tax features aimed at assisting people and families with healthcare bills. Examples include tax credits for medical expenses, tax rebates for public institutions, and deductions for private insurance premiums.
Provincial and territorial governments
The majority of health-care services in Canada are provided by territory and provincial governments. The guidelines of the Canada Health Act must be followed by all health insurance plans in the country. These plans cover the cost of medically required services provided by doctors and hospitals. These programs are funded in part by the territorial and provincial governments, with the remaining financed by the federal government.
The Canada Health Act makes no mention of medically necessary services. It is up to territorial and provincial health insurance plans to choose which services are deemed necessary, based on consultations with respective medical groups and colleges. If it is decided that the plan will cover the entire cost of the service, it must conform with the legislation.
A service is not required to be covered by a provincial or territorial health insurance plan if it is not deemed medically necessary.
Provincial and territory governments play the following roles in health care:
Doctors and other health professionals provide services such as health insurance plan administration, care planning and funding in hospitals and other health facilities, health promotion and public health initiative planning and implementation, and fee schedule negotiations with health professionals.
The majority of provincial and territory governments give and support extra benefits for specific populations not covered by the Canada Health Act (such as low-income residents and the elderly). Pharmaceuticals prescribed outside of hospitals, ambulance bills, and hearing, vision, and dental treatment are among the perks available.
Despite the fact that governments and territories provide these additional benefits to a restricted group of people, the vast majority of supplementary health services are supported privately. Individuals and families who do not qualify for publicly sponsored treatment may pay these expenses directly (out of pocket), participate in a group health plan provided by their work, or acquire private insurance. Although most provincial and territorial regulations restrict private insurers from providing the same coverage as government-sponsored plans, they are allowed to compete in the market for supplementary coverage.
Furthermore, each province and territory has its own self-funded workers’ compensation organization that assists injured workers.
Health spending varies by province and territory due to differences in population and services. This is due to a variety of factors, including people’s ages and the services given by territories and provinces. Other factors, such as a region’s population density, may also influence healthcare costs.
According to the CIHI, total healthcare costs in Canada amounted for around 7% of GDP in 1975. In 2010, total health-care expenditures in the country amounted for around 11.7% of GDP. In 2010, the government paid for around seven out of every ten dollars spent on healthcare.
Private sources provide for three-quarters of total spending. These funds were used to pay for a variety of services, including dentistry and eyesight care.
There has been a significant shift in how healthcare resources are allocated during the last three decades. While the proportion of total health expenses dedicated to physicians and hospitals has decreased, pharmaceutical spending has increased.
Despite a decrease in hospital health-care costs, hospitals continue to account for the vast majority of the nation’s healthcare spending. Medicines accounted for 16% of the total health-care spending in 2010, the second-highest amount. Physicians received the third highest allocation.
Canadian Healthcare Delivery System
The Canadian public health care system is made up of integrated health systems that provide a variety of public services. This system, known as “Medicare,” ensures that people have access to the best possible care.
What Happens First (Primary Health Care Services)
The majority of Canadians seek primary health care when they want medical attention. This service serves as the first point of contact for a variety of health-care services. It also serves as a coordinator for the various patient-accessible health care services. This ensures that patients receive the best possible continuity of care and that the health-care system is prepared to address the needs of patients with more particular needs.
Primary health care, in addition to providing comprehensive care, focuses on the prevention and treatment of a variety of common illnesses and injuries. Patients may be referred to additional services, such as hospital and specialist treatment. This type of service frequently provides various services in addition to mental health care, rehabilitation, and child development.
In private practice, physicians are usually paid on a fee-for-service basis, which specifies the services they provide.
The multiple agreements that govern the supply of primary health care services are negotiated by territorial and provincial governments, as well as the medical professions.
Doctors who work in settings other than hospitals, such as community health centers, group practices, and clinics, are more likely to be compensated under alternative payment methods. Compensation arrangements, fee-for-service payments, and incentives for specific services are examples of these.
The bulk of health professionals, including as nurses and other healthcare workers, are paid in accordance with their job contracts.
Patients who require extra evaluation or treatment are referred to other healthcare services such as diagnostic testing and allied health professionals such as nurses, doctors, and other healthcare workers.
What Happens Next? (Secondary Education)
A patient may be directed to a specialty hospital, long-term care facility, or community-based care. The majority of hospitals in Canada are managed by non-profit community boards of trustees.
The majority of hospitals are supported by global budgets that set their own expenditure limits or goals, which are frequently negotiated with territory and provincial health ministries. This method differs from fee-for-service contracts.
Several Canadian jurisdictions are testing new hospital reimbursement payment methods. Although international funding remains the most common option for funding hospitals in the country, alternative approaches are being investigated.
Secondary health care may also be provided in the community or at the patient’s home. Family members, hospitals, physicians, and other healthcare providers may recommend patients to these programs. These are usually coordinated with the help of volunteers and professional caregivers. The goal of these services is to provide the best possible therapy to the patient.
The provinces and territories cover home and continuing care services, despite the fact that the Canada Health Act does not. This means that patients in different regions can continue to receive these types of medical care. Furthermore, the federal government gives similar benefits to veterans who are unable to access them in their home state or province.
Furthermore, the federal government provides home care services to certain indigenous peoples and reserve dwellers.
Palliative care is available in a variety of settings, including hospitals, nursing homes, and hospices. It highlights the importance of emotional and physical assistance for terminally ill patients and their families.
Extra (Additional) Services
Certain people, particularly seniors and children, are denied access to the public health care system. Territories and provinces, on the other hand, may provide citizens with additional health benefits such as prescription drugs, dental treatment, vision care, and medical equipment. Wheelchairs and prosthesis are included in this category. The extent of coverage varies between provinces.
Those who do not qualify for government-sponsored insurance must pay for these services themselves or through private insurance. Canadians often have a range of coverage levels depending on the plan they choose.
Health Care Changes/Trends
The number of outpatient treatments and day procedures has increased due to technological advancements in the healthcare industry throughout the years. The number of nights spent in acute-care hospitals by Canadians per capita has decreased.
The Canadian public health care system has changed the way people acquire health care. Previously, the majority of services were provided by hospitals and physicians. They are currently available through a range of service venues, including primary health care centers, home care, and clinics.
In recent years, the Canadian health-care system has experienced numerous changes. These include rising technology costs, an aging population, and insufficient funding for mental health and substance abuse treatments.
Provinces and territories began to reduce health-care spending in the 1990s by outsourcing service delivery decision-making to local and regional bodies. These regional health authorities are in charge of overseeing the operation of a wide range of health institutions and services in their respective regions.
In recent years, certain provinces have begun to shift away from a decentralized health care delivery model. Instead, they have more health power and centralized decision-making mechanisms.
Video: How Canada’s Universal Health-Care System Works
In this video released just before the 2020 US presidential elections, the debate about the country’s healthcare system has become more prominent. On the left, progressives are praising Canada’s system as an example of improving healthcare quality. On the other hand, conservatives are using it as an example of how to prevent socialized medicine. But where exactly is the Canadian healthcare system today? And how does it compare to the US’s?
Frequently Asked Questions
#1 What exactly is Canadian Medicare?
Medicare is Canada’s publicly funded health-care system. Unlike the United States, Canada does not have a single national health insurance plan. In its place, thirteen territory and provincial insurance plans exist. All citizens have access to critical physician and hospital services without having to pay out of pocket.
#2 What is the percentage of Medicare in Canada?
Canada’s Medicare program provides coverage for about 70% of the country’s healthcare needs. The remaining 30% is paid for by the private sector. This includes services such as dentistry, vision care, and prescription drugs.
#3 What are the roles of the provincial and territorial governments in Canada?
The provision of health care services to their populations is the duty of territory and provincial governments. The Canada Health Act establishes the system’s national requirements. The federal government also provides financial aid to the provinces.
#4 What is the first point of contact for Canadians?
For many Canadians, primary health care is their initial point of contact with the Canadian health-care system.
#5 Who is responsible for providing coverage for all medically necessary services?
All medically necessary services must be covered by territorial and provincial plans. Hospitals, physicians, and dentists are among them. The Canada Health Act, on the other hand, does not specify which services are considered medically necessary.
#6 Is medical care included under public health coverage?
If a service is deemed medically necessary, the public insurance plan is required to cover the entire cost of the service.
#7 Is there a provincial and territorial plan in place in Canada?
All Canadian residents are obliged to carry coverage when traveling within the country. This includes those who live abroad.
#8 Is it necessary for provincial health insurance programs to meet health-care requirements?
In order for provinces and territories to receive full funding, their health insurance plans must meet the standards of the Canada Health Act.
If you plan to live in Canada, you should become acquainted with the country’s healthcare system. Many people are unaware that Canada has a universal healthcare system, and it is critical that they understand what this involves.
The Canadian healthcare system is intended to serve all residents and visitors, making it one of the best in the world. Although the Canadian healthcare system has evolved over time, it has always provided coverage to all Canadians.
We hope this information has helped you better understand the Canadian healthcare system and how it works. If you are planning to move to Canada, it is reassuring to know that you will be able to receive medical care at no cost.