Canadian Health System Overview
Health System Rankings
Health System Outcomes
Health System Coverage
Costs for Consumers
Health System Expenditures
Canada’s COVID-19 Policy
Population Insurance Coverage For A Core Set Of Healthcare Services* (%) (2019):
Public Coverage: 100%; Primary Private Health Coverage: 0%; Total: 100%
*“Population coverage for health care is defined here as the share of the population eligible for a core set of health care services – whether through public programmes or primary private health insurance. The set of services is country-specific but usually includes consultations with doctors, tests and examinations, and hospital care. Public coverage includes both national health systems and social health insurance. On national health systems, most of the financing comes from general taxation, whereas in social health insurance systems, financing typically comes from a combination of payroll contributions and taxation. Financing is linked to ability-to-pay. Primary private health insurance refers to insurance coverage for a core set of services, and can be voluntary or mandatory by law (for some or all of the population.”
Source: OECD (2021), Health at a Glance 2021: OECD Indicators, OECD Publishing, Paris, https://doi.org/10.1787/ae3016b9-en.
Annual household out-of-pocket payment, current USD per capita (2019): $753
Source: Global Health Expenditure Database. Health expenditure series. Geneva: World Health Organization. Last accessed July 21, 2022.
Out-of-Pocket Spending as Share of Final Household Consumption (%) (2019): 2.9%
Source: OECD (2021), Health at a Glance 2021: OECD Indicators, OECD Publishing, Paris, https://doi.org/10.1787/ae3016b9-en.
“The breadth, depth and scope of coverage for broadly defined insured services under the CHA [Canada Health Act], although not identical, are remarkably similar from province to province. FPT [Federal, Provincial, and Territorial] governments have designed their UHC [Universal Health Coverage] programmes to ensure that all eligible residents of Canadian PTs [Provinces and Territories] have free access to medically necessary hospital, diagnostics and medical services, commonly summarized as “medicare” (Marchildon, 2009).
“Temporary health coverage is provided for refugee claimants, resettled refugees, asylum seekers and victims of human trafficking by the federal government through an Interim Federal Health Program until that person becomes resident and receives health coverage through the PT health insurance programme. In 2012, the Conservative federal government under Prime Minister Stephen Harper reformed this programme to reduce coverage provided for some categories of refugees and refugee claimants; though this change was overturned by the federal court in 2014 (Stevenson, 2018).
“Undocumented migrants or those who enter the country illegally are not covered by any programme but generally receive emergency services from hospitals. A 2011 decision by the federal appeals court upheld this exclusion of health coverage to residents who are in Canada illegally and ruled against the argument that this practice contravened the Charter of Human Rights and Freedoms (Nell Toussaint v Attorney General of Canada).
“Insured services are not specifically defined in either the CHA or PT medicare laws. However, the principle of comprehensiveness in the CHA requires that PT health systems cover medically necessary health services provided by hospitals and physicians, and as such PT governments err on the side of inclusion in their respective determinations of what services are included in medicare.
“Similarly, at the provincial level, there is neither a positive list of inclusions nor a negative list of exclusions in the pertinent medicare legislation and regulations. Instead, provincial governments have, from the time that medicare was first introduced, tended to include all services provided in a hospital with the exception of some medically unnecessary (e.g. cosmetic surgery) procedures. As to which physician services are included, this has largely been a matter of negotiation between the provincial governments and the provincially based medical associations, but in practice almost all physician services are included. Ontario has one of the more formal mechanisms, involving three administrative bodies, for determining which physicians services are universally covered: 1) the Physicians Services Committee, a joint committee of officials drawn from the provincial health ministry and the Ontario Medical Association; 2) Medical Directors – physicians employed by the provincial health ministry who determine claims for public funding; and 3) the provincial Health Services Appeal and Review Board (Flood, Stabile & Tuohy, 2006). Also the Ontario Health Technology Advisory Committee reviews submissions for new services or medical technologies to receive public funding and makes recommendations to the provincial health ministry.”
Source: Marchildon G.P., Allin S., Merkur S. Canada: Health system review. Health Systems in Transition, 2020; 22(3): i–194.
“Historically, individual patient rights in Canada have largely been defined in terms of a perceived “right” of access to universally insured services under the Canada Health Act. Since the introduction of the Charter of Rights and Freedoms in 1982, there have been a small number of cases in which patients have challenged provincial governments’ interpretation of what the basket of universal health services includes. In addition, there have been a range of health care cases where patients have used section 7, the “right to life, liberty and security of the person” in the Charter of Rights and Freedoms to strike down laws perceived as restricting an individual’s ability to access health care. There have been successful challenges that have struck laws which criminalized medical aid in dying and the use of cannabis for medical purposes. Section 7 has also been used in an effort to strike down laws limiting the opportunity for a parallel private tier to medicare’s single public tier. A more recent challenge in British Columbia sought to expunge the provincial laws protecting single-tier medicare. Although unsuccessful at trial, it may take years for the appeal courts to make a final decision on the matter. (Flood & Thomas, 2018; Flood et al., 2005; 2007).
“All FPT [Federal, Provincial, and Territorial] governments have general legislation to ensure that disabled residents have access to public facilities or to facilities that serve the general public. Since virtually all health care facilities come within this definition, disabled persons are ensured physical access to health services.”
Source: Marchildon G.P., Allin S., Merkur S. Canada: Health system review. Health Systems in Transition, 2020; 22(3): i–194.
Health Systems Facts is a project of the Real Reporting Foundation. We provide reliable statistics and other data from authoritative sources regarding health systems in the US and sixteen other nations.
Page last updated Oct. 19, 2022 by Doug McVay, Editor.
