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Canada Health Act Canada Health Act CANADA HEALTH ACT CANADA HEALTH CANADA HEALTH ACT Public Administration Public Administration Accessibility Accessibility Universality Universality ANNUAL REPORT Comprehensiveness Comprehensiveness 2014–2015 Portability Portability ANNUAL 2014 REPORT 2015 Health Canada is the federal department responsible for helping the people of Canada maintain and improve their health. Health Canada is committed to improving the lives of all of Canada’s people and to making this country’s population among the healthiest in the world as measured by longevity, lifestyle and effective use of the public health care system. Published by authority of the Minister of Health. Canada Health Act – Annual Report 2014–2015 is available on Internet at the following address: http://www.hc-sc.gc.ca/hcs-sss/pubs/cha-lcs/index-eng.php Également disponible en français sous le titre: Loi canadienne sur la santé – Rapport Annuel 2014-2015 This publication can be made available on request on diskette, large print, audio-cassette and braille. For further information or to obtain additional copies, please contact: Health Canada Address Locator 0900C2 Ottawa, Ontario K1A 0K9 Telephone: (613) 957-2991 Toll free: 1-866-225-0709 Fax: (613) 941-5366 © Her Majesty the Queen in Right of Canada, represented by the Minister of Health of Canada, 2015 All rights reserved. No part of this information (publication or product) may be reproduced or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, or stored in a retrieval system, without prior written permission of the Minister of Public Works and Government Services Canada, Ottawa, Ontario K1A 0S5 or [email protected] HC Pub: 150140 Cat.: H1-4E-PDF ISBN:1497-9144 ACKNOWLEDGEMENTS Health Canada would like to acknowledge the work and effort that went into producing this Annual Report. It is through the dedication and timely commitment of the following departments of health and their staff that we are able to bring you this report on the administration and operation of the Canada Health Act: Newfoundland and Labrador Department of Health and Community Services Prince Edward Island Department of Health and Wellness Nova Scotia Department of Health and Wellness New Brunswick Department of Health Quebec Ministry of Health and Social Services Ontario Ministry of Health and Long-Term Care Manitoba Health, Healthy Living and Seniors Saskatchewan Health Alberta Health British Columbia Ministry of Health Yukon Health and Social Services Northwest Territories Department of Health and Social Services Nunavut Department of Health We also greatly appreciate the extensive work effort that was put into this report by our production team: the desktop publishing company, the translators, editors and concordance experts, printers and staff of Health Canada at headquarters and in the regional offices. CANADA HEALTH ACT ANNUAL REPORT 2014–2015 i ii CANADA HEALTH ACT ANNUAL REPORT 2014–2015 TABLE OF CONTENTS Acknowledgements __________________________________________________________________________________________ i Introduction ________________________________________________________________________________________________1 Chapter 1 — Canada Health Act Overview ________________________________________________________________________3 Chapter 2 — Administration and Compliance _____________________________________________________________________11 Chapter 3 — Provincial and Territorial Health Care Insurance Plans in 2013–2014 _______________________________________19 Newfoundland and Labrador _______________________________________________________________________21 Prince Edward Island _____________________________________________________________________________31 Nova Scotia _____________________________________________________________________________________39 New Brunswick __________________________________________________________________________________49 Quebec ________________________________________________________________________________________ 59 Ontario ________________________________________________________________________________________63 Manitoba _______________________________________________________________________________________75 Saskatchewan ____________________________________________________________________________________85 Alberta _________________________________________________________________________________________95 British Columbia ________________________________________________________________________________103 Yukon _________________________________________________________________________________________115 Northwest Territories ___________________________________________________________________________ 125 Nunavut _______________________________________________________________________________________133 Annex A — Canada Health Act and Extra-Billing and User Charges Information Regulations ___________________________141 Annex B — Policy Interpretation Letters _______________________________________________________________________163 Annex C — Dispute Avoidance and Resolution Process under the Canada Health Act __________________________________171 Contact Information for Provincial and Territorial Departments of Health _________________________________inside back cover CANADA HEALTH ACT ANNUAL REPORT 2014–2015 iii iv CANADA HEALTH ACT ANNUAL REPORT 2014–2015 INTRODUCTION Canada has a predominantly publicly financed and adminis- primary jurisdiction in the administration and delivery of tered health care system. The Canadian health insurance system health care services. This includes setting their own priorities, is achieved through 13 interlocking provincial and territorial administering their health care budgets and managing their health insurance plans, and is designed to ensure that all own resources. The federal government, under the Canada eligible residents of Canadian provinces and territories have Health Act, sets out the criteria and conditions that must be reasonable access to medically necessary hospital and physician satisfied by the provincial and territorial health insurance plans services on a prepaid basis, without charges related to the for provinces and territories to qualify for their full share of the provision of insured health services. cash contribution available to them under the federal Canada Health Transfer. The Canadian health insurance system evolved into its present form over more than six decades. Saskatchewan was the first On an annual basis, the federal Minister of Health is required province to establish universal, public hospital insurance in to report to Parliament on the administration and operation of 1947 and, ten years later, the Government of Canada passed the Canada Health Act, as set out in section 23 of the Act. The the Hospital Insurance and Diagnostic Services Act (1957), to vehicle for so doing is the Canada Health Act Annual Report. share in the cost of these services with the provinces and While the principal and intended audience for the annual territories. By 1961, all the provinces and territories had public report is Parliamentarians, it is a public document that offers insurance plans that provided universal access to hospital a comprehensive description of insured health services in each services. Saskatchewan again pioneered by providing insurance of the provinces and territories. The annual report is structured for physician services, beginning in 1962. The Government of to address the mandated reporting requirements of the Act; as Canada enacted the Medical Care Act in 1966 to cost-share the such, its scope does not extend to commenting on the status of provision of insured physician services with the provinces and the Canadian health care system as a whole. territories. By 1972, all provincial and territorial plans had been extended to include physician services. Provincial and territorial health care insurance plans generally respect the criteria and conditions of the Canada Health Act In 1979, at the request of the federal government, Justice and many exceed the requirements of the Act. However, Emmett Hall undertook a review of the state of health services when instances of possible non-compliance with the Act in Canada. In his report, he affirmed that health care services arise, Health Canada’s approach to the administration of the in Canada ranked among the best in the world, but warned that Act emphasizes transparency, consultation and dialogue with extra-billing by doctors and user charges levied by hospitals provincial and territorial health care ministries. The application were creating a two-tiered system that threatened the universal of financial penalties through deductions under the Canada accessibility of care. This report, and the national debate it gen- Health Transfer is considered only as a last resort when all erated, led to the enactment of the Canada Health Act in 1984. other options to resolve an issue collaboratively have been exhausted. Pursuant to the commitment made by premiers The Canada Health Act is Canada’s federal health insurance under the 1999 Social Union Framework Agreement, federal, legislation and defines the national principles that govern provincial and territorial governments (except Quebec) agreed the Canadian health insurance system, namely, public admin- through an exchange of letters, in April 2002, to a Canada istration, comprehensiveness, universality, portability and Health Act Dispute Avoidance and Resolution (DAR) process. accessibility. These
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