Canada’s primary healthcare system provides services to individuals, families and communities. It also involves a proactive approach to preventing health problems and ensuring better management and follow-up once a health problem has occurred.
These services are publicly funded from general tax revenues without direct charges to the patient.
A patient may be referred for specialised care at a hospital or long-term care facility or in the community. The majority of Canadian hospitals are operated by community boards of trustees, voluntary organisations or municipalities.
Healthcare services are mainly provided in long-term institutions, paid for by the provincial and territorial governments, while room and board are paid for by the individual; in some cases these payments are subsidised by the provincial and territorial governments.
Healthcare services can also be provided in the home and/or community. Referrals to home care can be made by doctors, hospitals, community agencies, families and potential residents.
These services, such as specialised nursing care, homemaker services and adult day care, are provided to people who are partially or totally incapacitated. Needs are assessed and services are coordinated to provide continuity of care and comprehensive care.
The provinces and territories also provide coverage to certain groups of people – seniors, children and social assistance recipients, for example – for health services that are not generally covered under the publicly funded health care system.
These supplementary health benefits often include prescription drugs, dental care, vision care, medical equipment and appliances (prostheses, wheelchairs, etc.), independent living and the services of allied health professionals, such as podiatrists and chiropractors.
Funding the system
Like the NHS in Britain, Canada provides a good but not perfect system of healthcare. The level of coverage varies across the country and many Canadians have supplemental private insurance coverage through group plans, which covers the cost of these supplementary services.
The Canadian Medical Association believes an estimated four million of Canada’s 33 million population don’t have a family doctor and more than one million are waiting for treatment.
Canada has 2.1 physicians per 1,000 people, while Belgium has 3.9, according to the Organisation for Economic Cooperation and Development.
Much of the resentment towards the healthcare system is caused by the fact that so much of Canada’s already high tax goes towards it. The average Canadian family pays about 48 per cent of its income in taxes each year and, while rates vary from province to province, Ontario, the most populous, spends around 40 per cent of its tax revenue on health, according to the Canadian Taxpayers Federation.
The federation, which campaigns for tax reform and private enterprise in healthcare, believes the system is suffering serious financial challenges. It calculates that by 2035, Ontario will be spending 85 per cent of its budget on healthcare.
The federal government and most provinces acknowledge there’s a crisis: a lack of physicians and nurses, state-of-the-art equipment and funding. In Ontario, more than 10,000 nurses and hospital workers are facing layoffs over the next two years unless the provincial government boosts funding, says the Ontario Hospital Association, which represents healthcare providers in the province.
In 1984 Parliament passed the Canada Health Act, which affirmed the federal government’s commitment to provide mostly free healthcare to all, including the 200,000 immigrants arriving each year. The system is called Medicare (no relation to Medicare in the United States).
Despite the financial burden, Canadians value their Medicare as a marker of egalitarianism and independent identity that sets their country apart from the United States, where some 45 million Americans lack health insurance.
In 2000 The World Health Organisation ranked Canada 30th in the provision of public healthcare and the United States 37th. France’s system was ranked the best, followed by Italy, Spain, Oman and Australia.