Canada - World Health Organization Regional Office for Europe
Canada - World Health Organization Regional Office for Europe
Canada - World Health Organization Regional Office for Europe
Create successful ePaper yourself
Turn your PDF publications into a flip-book with our unique Google optimized e-Paper software.
46<br />
<strong>Health</strong> systems in transition <strong>Canada</strong><br />
CADTH makes a <strong>for</strong>mulary listing recommendation; and (3) health ministries<br />
make their own <strong>for</strong>mulary and benefit coverage decisions on the basis of<br />
their own drug <strong>for</strong>mulary committees, policy environments and political<br />
pressures. Provincial decisions can be influenced by the presence or absence<br />
of a significant pharmaceutical industry presence. In <strong>Canada</strong>, the majority of<br />
pharmaceutical production is concentrated in two cities – Toronto (Ontario)<br />
and Montreal (Quebec).<br />
2.8 Regulation<br />
While provincial governments have primary jurisdiction over the administration<br />
and delivery of public health care services, health ministries delegate actual<br />
delivery to physicians and individual health care organizations. <strong>Health</strong><br />
facilities and organizations – from independent hospitals and long-term care<br />
establishments to RHAs – are regulated by provincial governments. RHAs<br />
are delegated authorities rather than governments and as such have no<br />
law-making capacity. As a consequence, RHAs operate under provincial laws<br />
and regulations. The medical and financial coverage provided to employees<br />
under provincial and territorial WCBs are regulated by provincial and territorial<br />
governments.<br />
<strong>Health</strong> organizations, including RHAs and independent health facilities,<br />
are accredited on a voluntary basis through Accreditation <strong>Canada</strong>, a memberbased,<br />
non governmental organization. Most health care providers, including<br />
physicians, nurses, dentists, optometrists, chiropractors, physiotherapists,<br />
occupational therapists, are organized as self-governing professions under<br />
provincial and territorial law.<br />
2.8.1 Regulation and governance of third-party payers<br />
Provincial and territorial ministries of health are the principal third-party<br />
payers in <strong>Canada</strong>. All these governments administer their own single-payer<br />
medicare coverage systems under their own laws and regulations (see section<br />
9.3.2). As the principal payers, provincial ministries and RHAs work through,<br />
and contract with, a range of independent health care organizations including<br />
hospitals, day surgeries, diagnostic clinics, medical laboratories, emergency<br />
transportation companies, long-term care organizations and primary health<br />
clinics. Although this institutional arrangement appears similar to the internal<br />
market in the United Kingdom, it does not imply the same purchaser–provider<br />
arrangements as in the National <strong>Health</strong> Service (Boyle, 2011).