Understanding Medicare in Canada

• By the end of the class, students will understand Medicare, its administration across Canada, and the Canada Health Act.
• Students will also identify and examine pressing health system issues through readings, reports, and notes.

Medicare in Canada

• Medicare is Canada's publicly funded healthcare system, consisting of 13 provincial and territorial health insurance plans.
• Canadian residents have reasonable access to medically necessary hospital and physician services without direct payments.
• The roles in health services are shared between provincial/territorial and federal governments.

Provincial and Territorial Responsibilities

• Provinces and territories manage, organize, and deliver healthcare services to their residents.
• Physician services are generally covered across Canada. Things like pharmaceuticals, home care, optometrists, and physiotherapists vary by province.

Federal Government Responsibilities

• Setting and administering national standards via the Canada Health Act.
• Providing funding support for provincial and territorial health services.
• Supporting healthcare delivery to specific groups like First Nations on reserves, Inuit, Canadian Forces members, veterans, and federal inmates.
• Health-related functions by regulating products, including food, consumer goods, pharmaceuticals, cosmetics, and medical devices.
• Also supports health research, promotion, protection, and disease prevention plus provides tax support for health-related costs, including disability and medical expenses.

Impact of WWI

• Medical exams revealed health problems when men enlisted, including tuberculosis and childhood illnesses.
• For many, it was their first time being seen by a doctor.
• The war resulted in gruesome conditions, amputations, and severe burns.
• The inability of returning troops to afford care became a political issue, with the federal government providing veterans free medical care.

The Canada Health Act

• It is a federal law that provides financing principles for healthcare delivery, which falls under provincial/territorial jurisdiction.
• Ensures reasonable access for eligible residents to insured health services on a prepaid basis, with no direct charges at the point of service.
• Provincial and territorial health insurance plans must meet Canada Health Act standards or risk losing full payment under the Canada Health Transfer.

Emmett Hall and Medicare's Origins

• Justice Emmett Hall, known as the father of Canadian Medicare, led efforts to establish a national-scale health plan.
• The Hall Commission interviewed Canadians, highlighting health concerns and the importance of universal accessibility.
• The National Medical Care Insurance Act was passed on December 8, 1966.

Key Facts About Emmett Hall

• Hall's early experience with economic hardships likely influenced his passion for helping fellow citizens.
• Hall was Chief Justice of Saskatchewan before being appointed to the Supreme Court of Canada in 1962.
• The National Medical Care Insurance Act passed with a vote of 177 to 2.
• Hall remained an advocate for the rights of Indigenous peoples and persons with disabilities.

Impact on Lives Today

• Healthcare costs could cripple Canadian families without the National Medical Care Insurance Act
• Canadians experience a level of health accessibility ensuring the well-being of millions, thanks to Hall's passionate support for national health insurance.
• Hall understood that investing in Canadians' health would better Canadian society.

Canada Health Act's Objective

• To protect, promote, and restore the physical and mental well-being of residents of Canada.
• This facilitates reasonable access to health services without financial barriers.

The Canada Health Act Standards

• Includes the principles of comprehensive coverage, universality, public administration, portability, and accessibility.

Comprehensive Coverage

• Provincial and territorial plans must ensure all medically necessary services provided by hospitals, physicians, and dentists (when hospitalization is required).
• Full costs for medically necessary services must be covered by public health insurance.

Universality and Public Administration

• Provincial and territorial plans must cover all residents.
• Plans must be administered and operated on a non-profit basis by a public authority.

Portability

• Provincial and territorial plans must cover all residents when they travel within Canada.
• Limited coverage for travel outside the country is also required. When residents move provinces, they can use their original health card for three months.

Accessibility

• Provincial and territorial plans must provide all residents reasonable access to medically necessary services.
• Access must be based on medical needs, not the ability to pay.

Present Day Challenges

• Limited resources, inefficiencies in scheduling, and resource allocation contribute to long wait times and specialist consultations.
• Shortage of healthcare professionals, geographic disparities, and reliance on employer-sponsored insurance to cover gaps in services.
• Aging population strains the system and hospitals operate near capacity.
• Access to mental health services is also inconsistent, with healthcare managed provincially leading to variability in service quality and access.