Canada - World Health Organization Regional Office for Europe

Health systems in transition Canada 131
addressing by providing more information on waiting lists, patient navigation,
benefits and quality, as well as the reform and performance objectives of
provincial ministries of health, RHAs and other health care organizations.
7.2 Financial protection and equity in financing
7.2.1 Financial protection
Financial protection measures the extent to which individuals are protected
from the financial consequences of illness. Three factors underpin the need
for financial protection: uncertainty about the need for health care due to the
unpredictability of the timing and severity of illness; the high cost of most
interventions and treatments; and the potential loss of earnings due to ill health.
Historically, financial protection was the key motivation behind the
introduction of universal medicare in Canada. Although coverage is deep (no
user fees), the scope of medicare is narrow, limited as it is to hospital and
physician services. As a result, there continues to be a debate as to whether
financial protection is adequate for pharmaceuticals, dental care and other
sectors and services not included in medicare.
Table 7.1 focuses on the mix of OOP and PHI coverage in non-medicare
sectors and services. When it comes to prescription drugs, PHI constitutes as
important a source of coverage as public coverage plans. In the 1990s, many
argued in favour of a national, universal pharmacare programme that would
Table 7.1
OOP spending relative to private health insurance coverage for non-medicare services,
amount (C$ billions) and % of total health care spending in Canada, 2008
OOP spending
($C billions)
% of health
spending
in category
PHI spending
($C billions)
% of health
spending
in category
Prescription drugs 4.2 17.8 8.5 36.1
Over-the-counter drugs and personal
health supplies
4.5 100.0 0.0 0.0
Dental care 5.2 44.4 6.0 51.0
Professionals other than physicians
providing medicare
4.3 64.3 1.6 24.1
Institutions other than hospitals 4.9 28.5 0.0 0.0
Sources: CIHI (2010b); Hurley & Guindon (2011).