Canada - World Health Organization Regional Office for Europe

20
Health systems in transition Canada
services and, in 1966, the federal government introduced the Medical Care
Act to cost-share single-payer insurance for physician costs with provincial
governments. By 1971, all provinces had universal coverage for hospital and
physician services. In 1984, the federal government replaced the two previous
acts with the Canada Health Act, a law that set pan-Canadian standards for
hospital, diagnostic and medical care services.
Most health system planning is conducted at the provincial and territorial
levels, although in some jurisdictions RHAs engage in more detailed planning
of services for their defined populations. Some provincial ministries of health
and RHAs are aided in their planning by provincial quality councils and
specialized HTA agencies. In recent years, there has been a trend towards
greater centralization in terms of reducing or eliminating RHAs. Most health
professionals self-regulate under frameworks provided under provincial and
territorial law.
The federal government’s activities range from funding and facilitating
data gathering and research to regulating prescription drugs and public health
while continuing to support the national dimensions of medicare through large
funding transfers to the provinces and territories. The F/P/T governments
collaborate through conferences, councils and working groups comprised of
ministers and deputy ministers of health. In recent years, this collaboration has
been supplemented by specialized intergovernmental bodies for data collection
and dissemination, HTA, patient safety, ICT and the management of blood
products. Nongovernmental organizations at both federal and provincial levels
influence the policy direction and management of public health care in Canada.
2.1 Overview of the health system
The federal government has jurisdiction in specific aspects of health
care, including prescription drug regulation and safety; the financing and
administration of a range of health benefits and services for eligible First
Nations people and Inuit; and public health insurance coverage for members
of the Canadian armed forces, veterans, inmates in federal penitentiaries
and eligible refugee claimants. In addition, the federal government also has
important responsibilities in the domains of public health, health research and
health data collection (see section 2.3.2).