Canada - World Health Organization Regional Office for Europe

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116 Health systems in transition Canada level of anxiety disorders in the Canadian population (4.6%) relative to the Australian population (2.7%), although the rate of alcohol and drug dependence was somewhat lower. Despite similarities in the levels and availability of mental health providers, mental health consultations were lower in Canada (51.3%) relative to Australia (64.6%). 5.12 Dental care Almost all dental health services are delivered by independent practitioners operating their own practices. Payment for these services is through PHI or direct OOP payment. If a provincial or territorial resident is receiving social assistance, then a portion or all of the costs for personal dental services may be covered by the provincial or territorial government. Similarly, if an individual is an eligible First Nation or Inuit, then a portion or all of the costs will be covered by the federal government through the “non-insured health benefits” programme. Almost 54% of all private-funded dental care is funded through PHI, the majority of which is through employment-based benefit plans (Hurley & Guindon, 2008). The remaining amount is funded directly by OOP payments. Unlike most high-income countries, Canada provides a very low level of public subsidies to access dental care. Currently, 95% of all dental services are funded privately, a level that is similar to the United States, Spain and Portugal, the only other wealthy countries with such high levels of private finance for dental services (Grignon et al., 2010). This degree of dependence on private funding, in the absence of other barriers to access, has produced high levels of inequalities in terms of dental care (Leake & Birch, 2008; Wallace & MacEntee, 2012). These inequalities are directly linked to the fact that lower income Canadians visit dentists less often due to cost (Health Canada, 2010). In order to address these inequities, a few targeted oral health and dental service programmes have been initiated by governments. The first provincial programme of this type, launched by the Government of Saskatchewan in the 1970s, targeted school children. Utilizing dental nurses and dental para-professionals, the Saskatchewan Health Dental Program proved to be highly effective but was disbanded within a decade (Wolfson, 1997). This was followed by a similar programme in Manitoba targeting rural children but it too was eventually discontinued by a subsequent administration (Marchildon, 2011). Ontario has the CINOT (Children in Need of Treatment Program) as well as Health Smiles Ontario, a low-income programme launched in 2010
Health systems in transition Canada 117 (Ito, 2011). As mentioned above, the federal government funds the largest targeted programme in Canada by providing dental care coverage under the “non-insured health benefits” programme. 5.13 Complementary and alternative medicine CAM embraces entire non-Western systems of medicine, such as traditional Chinese medicine and Aboriginal healing, as well as specific medicines and therapies such as herbalism, relaxation therapy and reflexology. Jonas & Levin (1999) have catalogued some 4000 different CAM practices including homeopathy, chiropractic and therapeutic massage. Although these practices vary considerably, most CAM therapies share at least four common characteristics (Smith & Simpson, 2003): • they are presumed to work in conjunction with the body’s own self-healing mechanisms; • they are “holistic” in the sense that they treat the whole person; • they try to involve the individual as an active participant in the healing process; and • they focus on disease prevention and well-being as much as treatment. As is the case in most OECD countries, Canadians have shown increasing interest in CAM. The rate of growth of at least some classes of alternative practitioner has outstripped the rate of growth in mainstream health care providers (Clarke, 2004). At the same time, the response of the established health care professions to emerging CAM practitioners ranges from acceptance to scepticism and even hostility (Kelner et al., 2004; Nahas & Balla, 2011). Some CAM groups, including naturopaths, traditional Chinese medicine acupuncturists and homeopaths have responded to these challenges by pursuing further professionalization including self-regulation (Welsh et al., 2004; Gilmour et al., 2002). Since 2004, natural health products have been regulated by Health Canada’s Natural Health Product Directorate. Health Canada defines health products as products containing only those ingredients listed on Schedule 1 of the Food and Drugs Act’s Natural Health Products Regulations (e.g. plant or plant material, alga, bacterium, fungus, mineral, amino acid and vitamin), homeopathic medicines or traditional medicines, and it excludes those products containing ingredients listed on Schedule 2 (e.g. tobacco, controlled drugs or substances,
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Health Systems in Transition Gregor
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Contents Preface . . . . . . . . .
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Preface The Health Systems in Trans
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Acknowledgements The HiT on Canada
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List of abbreviations Abbreviations
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Abstract Canada is a high-income co
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The European Observatory on Health
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Canada - World Health Organization Regional Office for Europe

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