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The Canada Health Act
The Canada Health Act is Canada's federal health insurance legislation. It defines the principles that govern the country's health care system and is a symbol of Canadian values.
The provinces are responsible for the administration and delivery of health care services.
The Act establishes the criteria and conditions provinces and territories must meet in order to receive their full cash contribution from the federal government in support of their health care programs. The aim of the Act is to ensure that all residents of Canada have reasonable access to insured health services without direct charges.
The Principles of the Canada Health Act
- Public Administration: Provincial and territorial health insurance plans are to be administered and operated on a non-profit basis by a public authority, responsible to the provincial/territorial governments and subject to audits of their accounts and financial transactions.
- Comprehensiveness: The health care insurance plans of the provinces and territories must cover all medically-necessary hospital and physician services and, when the province/territory permits, services rendered by other health care practitioners.
- Universality: All insured residents of a province or territory must be entitled to the insured health services on uniform terms and conditions. Provinces and territories generally require that residents register with the plans to establish entitlement.
- Portability: Residents moving from one province or territory to another must remain covered for insured health care services by the "home" province during any waiting period imposed by the new province of residence. Residents temporarily absent from their home provinces or territories, or from the country, must also continue to be covered for insured health care services. This allows individuals to travel or be absent, within prescribed limits, from their home provinces or territories but still retain their health insurance coverage.
- Accessibility: The health insurance plans of the provinces and territories must provide reasonable access to insured health care services on uniform terms and conditions.
What are "insured health care services" under the Act?
- Insured health services are medically necessary hospital, physician and surgical-dental services provided to eligible residents.
- For example, insured hospital services include all medically necessary in-patient and out-patient services provided in a hospital, namely: standard or public ward accommodation; nursing services; laboratory, radiological and diagnostic procedures such as blood tests and X-rays; drugs administered in hospital; and the use of operating rooms, case rooms and anaesthetic facilities.
Who is insured under the Act?
- Insured persons are eligible residents of a province or territory, but do not include members of the Canadian Forces, officers of the Royal Canadian Mounted Police, inmates of federal penitentiaries. The Government of Canada provides coverage for these groups through separate federal programs.
- Some categories of resident, such as landed immigrants and Canadians returning to live in Canada from other countries, may be subject to a waiting period by a province or territory, not to exceed three months, before they are entitled to receive insured health care services.
Enforcing the Canada Health Act
- Under the Act, the Minister of Health must report annually to Parliament on the administration and operation of the Act. The Canada Health Act Annual Report provides information on the extent to which provincial and territorial health care insurance plans have satisfied the criteria and conditions for payment under the Canada Health Act.
- The most recent report - the Canada Health Act Annual Report 2002-2003 - was presented to Parliament in February 2004.
- In April 2002, provincial and territorial governments (except Quebec) agreed to a Canada Health Act dispute avoidance and resolution process that would apply to the interpretation of the Act.
- While the federal Minister of Health has the final authority to interpret and enforce the Canada Health Act , the Government of Canada's approach to administering the Act emphasizes transparency, consultation and dialogue with the provinces and territories.
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