Care Watch has long supported the principles underlying the Canada Health Act (CHA). We also believe these principles are fundamental to any system for in-home and community support services. We posted a detailed assessment on Applying CHA Principles to Home and Community Care Suppport Services and will share snippets each day.

Constitutionally, our provincial/territorial governments are responsible for health services and programming. The federal government is responsible for leadership, coordination, funding, and maintaining nationwide equity. National frameworks such as the Canada Health Act provide a foundation and guidance for consistent and coordinated provincial/territorial action. This action creates public goods that benefit us all. Such frameworks can guide not only health care, but also other national initiatives and programmes.

As of this writing, Ontario is restructuring the delivery and funding of health services, including home care and community support services. The CHA’s five legislated principles (public administration, comprehensiveness, universality, portability, and accessibility), as well as the implicit principles of equity and solidarity, provide a lens for viewing and assessing current and pending changes.

The Canada Health Act

The Canada Health Act establishes a national policy framework for publicly funded health insurance plans (generally called Medicare), which cover (or insure) necessary medical, surgical dentistry, and hospital services by authorized providers. Medicare is not, however, a single unified programme; each province and territory establishes its own insurance plan, with its own terms and conditions. To qualify for federal funding (transfer payments), these plans must conform to the CHA’s legislated principles. Although most providers operate as private, for-profit businesses, their medically necessary services are publicly funded, so users don’t pay directly for them and don’t pay at the point of service. Some people, in Canada and elsewhere, think of Canada’s Medicare system as free. It is not, however, any more “free” than any other insurance system. Insured people pay (through their taxes) into a common pooled fund, from which they withdraw as needed.

Sect. 3 of the CHA states that Canadian health care policy’s primary objective “… 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.”

Health Canada also affirms that ‘‘framed by the Canada Health Act, the principles governing our health care system are symbols of the underlying Canadian values of equity and solidarity” based on the shared goals and interests of maintaining and improving individual health, population health, and the public health system.

Check back tomorrow, or read through the full backgrounder.