Canada - World Health Organization Regional Office for Europe

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Health systems in transition Canada
As for prescription drugs, every provincial and territorial government has a
prescription drug plan that covers outpatient prescription drugs for designated
populations (e.g. seniors and social assistance recipients), with the federal
government providing drug coverage for eligible First Nations and Inuit. These
public insurers depend heavily on HTA, including the CDR conducted by the
CADTH, to determine which drugs should be included in their respective
formularies. Despite the creation of a National Pharmaceuticals Strategy
following the 10-Year Plan agreed by first ministers in 2004, there has been
little progress on a pan-Canadian catastrophic drug coverage programme.
Rehabilitation and long-term care policies and services, including home
and community care, palliative care and support for informal carers, vary
considerably among provinces and territories. Until the 1960s, the locus of
most mental health care was in large, provincially run psychiatric hospitals.
Since deinstitutionalization, individuals with mental illnesses are diagnosed
and treated by psychiatrists on an outpatient basis even though they may spend
periods of time in the psychiatric wards of hospitals. Family physicians provide
the majority of primary mental health care.
Unlike mental health care, almost all dental care is privately funded in
Canada. As a consequence of access being largely based on income, outcomes
are highly inequitable. CAM is also privately funded and delivered.
Due to the disparities in health outcomes for Aboriginal peoples – as well
as the historical challenge of servicing some of the most remote communities
in Canada – F/P/T governments have established a number of targeted
programmes and services. While Aboriginal health status has improved in the
postwar period, a large gap in health status continues to separate the Aboriginal
population from most other Canadians.
5.1 Public health
Public health aims to improve health, prolong life and improve the quality of
life through health promotion, disease prevention and other forms of health
intervention. Unlike the other services covered in this chapter, the majority
of public health policies and programmes target populations rather than
individuals. Provincial governments have had a long history of public health
interventions dating back to 1882 when Ontario’s Public Health Act established
a broad range of public health measures, a permanent board of health and the
country’s first medical officer of health.