Applying Canada Health Act Principles – References

[1] The CHA has no funding provisions. Funding is provided under the Canada Health Transfer provisions of the Federal-Provincial Fiscal Arrangements Act.

[2] Includes a number of therapeutic services, such as nursing and physiotherapy.

[3] Deber, R.B. (2009). Public funded, not-for-profit health care: Clarifying Canada’s complex reality.

[4] Health Canada Health Care System.

[5] Section 2 of the Canada Health Act; Monique Lanoix (2016).

[6] All provinces and territories have publicly funded home care programmes, although service delivery models vary substantially across Canada. Services may be delivered by public agencies or by private establishments (either not-for-profit or for-profit) or a mix (Statistics Canada, 2017).

[7] These additional benefits are often directed to specific groups, such as seniors, children, and social assistance recipients, and they may be partially or fully covered. Examples include prescription drugs, general dental care, and optometric, chiropractic, and ambulance services.

[8] Wellesley Institute. Nazeefah Laher, Lauren Bates & Seong-gee Um. The Changing Face of Home and Community Care (2019).

 [9] The legislative review process for Bill 175 has been fast-tracked, but public review opportunities are currently unknown.

[10] Under Bill 175, “home and community care” is the umbrella term for home care and community support services.

[11] Although the legislation was passed in 2006, LHINs officially came into effect in 2007 as crown agencies accountable to both the Minister of Health and the public.

[12] Auditor General of Ontario, 2015. Annual Report Value-For-Money Audits – Community Care Access Centres. Subsequently, CCACs were disbanded and their functions were folded into the associated LHIN.

[13] Accountability rested primarily with the Ministry of Health and Long-Term Care. This previous ministry’s functions are now divided among three ministries: Health; Long-Term Care; and Mental Health and Addictions.

[14] Ontario Health, a new crown agency, amalgamates 20 provincial health agencies, including Local Health Integration Networks (LHINs) and assumes the LHINs’ system planning and integration functions.

[15] Canadian health services are provided primarily by private businesses, accountable only to their owners/operators or boards of directors. Public accountability for use of public funds and alignment with publicly-established goals are limited. David Naylor terms this “public payment for private practice”. Ontario has the largest proportion of private sector home care delivery agents (Statistics Canada, 2017).

[16] For example, Ontario’s College of Physicians and Surgeons, the Ontario Medical Association, and several associations representing medical specialists.

[17] First Nations members also receive some federal health benefits, but comprehensiveness and availability still depend on location.

[18] For example, Ontario’s secondary and tertiary care (i.e., highly specialized) hospitals tend to be located in major urban centres, such as Toronto, Ottawa, Hamilton, and London.

[19] Manitoba’s programme also takes into account the availability of other resources, such as family care and local community services, in determining service provision.

[20] Also, private insurance plans are generally prohibited from covering medically necessary services provided by the public plan, although they can top up services (e.g., semi-private or private hospital rooms) beyond the basic public service.

[21] Note that Universality does not mean no-charge coverage for all possible health interventions, regardless of the cost, since no government can provide all services without charge on a sustainable basis. In Canada, everyone who pays taxes contributes to Medicare costs, which are pooled and distributed across the insured population.

[22] It is acknowledged that while OHIP is essentially “status blind”, some individual medical decisions may be influenced by non-medical considerations (such as ageism). LGBTQ communities also face structural discrimination as well as biased practitioners and care practices.

[23] Except for a few, highly specialized services (for example, tertiary hospitals) where availability is limited.

[24] The federal government and, more recently, the Canadian Snowbird Association have challenged this decision as a breach of the CHA, but the matter is still unresolved.

[25] In addition to the basic eligibility, each service includes specific “qualifiers”, which recipients must also meet to receive service.

[26] Most often used for primary care, childbirth, or general emergency (non-trauma) services.

[27] For example, for hip/knee replacements and cancer care.

[28] Accessibility for Ontarians with Disabilities Act.