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Navid Karimi: What most Canadians don’t know about the Canada Health Act, but should


Universality is a foundational concept of our national health plan.


Ted Rhodes / Calgary Herald

When the Canada Health Act was passed in 1984 by the Liberal government of Pierre Elliot Trudeau and Health Minister Monique Begin, it contained ambiguities that to this day many Canadians are not aware of and believe the principles it held were the perfect alternative to their costly healthcare.

Canadians don’t know that medical clinics — as well as doctor’s practices — are private businesses, which means doctors can choose when and where they want to work and can simply bill their provincial government for their services they have provided.

According to the Sec. 8 of the act: “The health care insurance plan must be administered by a public authority,” but this puts the province at full control and prevents competition. Although Sec. 8 states this plan ought to be on a non-profit basis, the provinces set their own standards.

Further, Sec. 9 of the act does not oversee which services the provinces will insure and which ones they will not. This eventually makes health care providers charge people for the services that are not covered by their provinces.

Additionally, Sec. 10 of the act states universality and 100 per cent coverage by “the plan,” but again “the plan” is set up by the provinces at their own discretion. The question here is: Was “the plan” supposed to protect the people or merely the health care providers?

Also, this section indicates “the insurance plan of a province must entitle 100 per cent of the insured persons,” but what about those who are not insured or those who can’t get insured? This perhaps leaves hundreds of thousands without any coverage.

Moreover, Sec. 11.a indicates a waiting period of three months for “minimum period of residence in the province,” which disables new immigrants and returning Canadians from universal health care, and sadly enough, to this day, Ontario, B.C and Quebec implement it.

In addition, Canadians planning on travelling abroad should take a look at Sec. 11.c. It indicates if “the health services are provided out of Canada, payment is made on the basis of the amount that would have been paid by the province for similar services.”

This means if any Canadian who gets injured in the U.S., for example, where hospital and doctor fees are outrageous compared to Canada, they are literally on their own. This clearly undermines the “portability” claim of the act and requires immediate action by the federal government.

Lastly, under the “accessibility” section of the act, reasonable access is not clearly defined, which is exactly why those living in the north or far from cities have less access to health clinics or hospitals.

According to the Health Canada statistics released in 2015, nearly five million Canadians, with a national average of 16.8 per cent (20.8 per cent of Aboriginals and 16.1 per cent of non-Aboriginals), did not have a primary care provider. Again, this is conceivably due to inaccessibility to health care providers.

Health Canada statistics released in 2016 showed an estimate of 90 per cent of Canadians with major chronic conditions report taking prescription drugs that are not covered (other than those provided in hospitals) by a universal insurance plan.

According to the Canadian Institute for Health Information, in 2010, out-of-pocket spending made up 34 per cent of private expenditures on prescription drugs, and in 2011, Canadian households spent an average of $476 out-of-pocket on prescription drugs.

This is exactly why Dr. Daniel Martin, a physician in Toronto, advocates for bringing prescription drugs under medicare. If our health act is universal, then why has it failed to acknowledge this concept?

Navid Karimi is a Master’s student and soon to be a PhD student in experimental medicine at the University of British Columbia.


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