EnactedThe Canada Health Act, which underlies the healthcare system, was enacted in 1984.Number of People CoveredAll Canadian citizens.Estimated Cost$148 billion; 10.3 percent of GDP (2006). Payment Scheme Taxes fund single-payor, government run system; small but growing private sector.
Plan in Brief
Funded from general tax revenues.
Citizens receive preventive care, medical treatment, hospitalization, and dental surgery coverage.
All insured residents receive the same level of care.
The public system does not cover all healthcare expenses (e.g., optometry, dentistry). Citizens can purchase private health care on their own or through their employers to supplement the public insurance.
The program does not cover prescription drug costs but some provinces offer some coverage.
Drug prices are regulated.
Impact on Federal Government
Health Canada leads the provincially administered system, provides funding, regulates drugs and devices, provides services to First Nations and the Inuit, and conducts research to make healthcare information available.
Organization
The federal government funds the system and determines guidelines.
Administration is conducted on a provincial or territorial basis. Provinces/territories also provide tax-based funding.
Impact on States
In a Canadian-style healthcare system, states would likely administer the program, just as provinces and territories now do in Canada.
States, like provinces/territories, would contribute some funding, sourced from various tax programs.
Impact on Insurers
Private health insurers provide supplemental insurance coverage to those who can afford it; this appears to be a growth area in Canada.
Impact on Providers
Administration of the system is conducted simply, via health cards that are presented when an individual requires services.
Compensation is considered low; many healthcare providers have left the country to work elsewhere (e.g., the United States), where their earning potential is perceived to be greater.
Impact on Employer
In a Canadian-style system, many large U.S. employers might stop providing health coverage, thereby lowering costs that would make them more competitive internationally. Additional funds could be used to increase salaries, expand, or increase returns to shareholders.
Small employers would be largely unaffected, given that most do not currently provide health insurance.
Impact on Individuals
Provinces can require healthcare premiums, but they cannot deny coverage based on an inability to pay premiums.
With few exceptions, healthcare is available to all citizens after a brief waiting period. Citizens obtain health cards that are used whenever healthcare is provided; an ID number on the card provides access to the individual’s healthcare information.
Provincially delivered coverage is portable—individuals who move to another province or leave the country retain their coverage for a time.
Proponents/Opponents
Proponents say that Canda’s health care system provides care fairly, rather than catering to the wealthy via an income-based two-tiered system. They point to key demographics as proof that the quality of care is high: Canada has one of the highest life expectancies and one of the lowest infant mortality rates among industrialized countries.
Critics question the efficiency and timeliness of treatments administered under Canada’s healthcare system and suggest that a private healthcare system like that in the United States could offer improvements on these fronts.
Key Targets for InvestmentWhile the Canadian Health Act prevents individuals from private purchase of healthcare services that are available through the public program, a 2005 Supreme Court decision overturned this policy in Quebec; privatization has increased significantly there. The decision could be the beginning of a turning point across the country.
Notable Features
Approximately three-quarters of healthcare funding comes from the public program; the remainder comes from private insurance and business contributions.
Per capita healthcare expenditures in Canada are approximately $3,326, roughly half the U.S. equivalent, but overall health outcomes have not been shown to differ consistently.
Regulation of drug prices results in lower prescription drug costs than in the United States.
Experts' Comments “So what should Canada do about patients who do not receive timely access to essential medical care? Numerous expert reports, including the 2002 Royal Commission on the Future of Health Care in Canada, have already told us we need to restore and strengthen Medicare, not decimate it.
“In May the Canadian Centre for Policy Alternatives reported that successful initiatives in team-based care and improved administration produced dramatic cuts in waiting times for surgery in B.C. Alberta, Saskatchewan and Ontario, without any need for competition.”
-- Danielle Martin,
Board Chair,
Canadian Doctors for Medicare, in the Wall Street Journal
