Canada - World Health Organization Regional Office for Europe

Health systems in transition Canada 69
3.3 Overview of the statutory financing system
There are two levels of statutory or compulsory funding and coverage for
health services. At the federal level, the Canada Health Act stipulates universal
coverage for universally insured services administered at the provincial and
territorial levels of government as a condition of providing fiscal transfers to
support public insurance plans. At the provincial and territorial level, there are
separate laws stipulating the right of access by residents, on the same terms and
conditions, to medicare services (Fig. 3.7) (see section 9.3.2).
Fig. 3.7
Composition of financial flows in the Canadian health system
Premiums
Taxes
Taxpayers,
policy holders
and employers
Patients
Taxes
Taxes
Levies
OOP
OOP
OOP
Transfers
Private insurers
Federal government
Provincial and territorial government
Municipal government
Community health services
Other health institutions
Dental and vision care, other professionals
Hospitals
Physicians (fee for service 74%)
Drugs (prescribed and non-prescribed)
Public health
Reimbursements
While the provinces and territories are most directly responsible for raising
the majority of financing for publicly funded health care, the federal government
contributes funding through transfers to these governments. The transfers to
the Canada Health Transfer are conditional on the provinces and territories
meeting the five conditions under the Canada Health Act (see section 2.3.2).
Transfers
Armed forces, veterans,
federal penal facilities, First Nations and Inuit, etc.
Regional health authorities
Workers’ compensation schemes
Primary financier
Secondary financier
Service flows