Modernizing the Canadian Health Act

Canada’s public health care system, known as “Medicare”, is unique and has continued to offer coverage for medically necessary hospital and physician services to all citizens since it was first established in 1984 under the Canada Health Act (Flood & Thomas, 2016). The federal government allocates health transfers fund to provincial and territorial governments, who are tasked with administering and financing their respective programs.

The Canada health Act (CHA) establishes the main five overarching national principles for the health insurance system: public administration, comprehensiveness, universality, portability, and accessibility. Meanwhile, the Canadian healthcare system is currently challenged based on the values of its very basic guiding principles (Chowdhury & Chowdhury, 2018).

The provincial and territorial healthcare plans differ in what is covered based on their interpretation of “medically necessary,” a term that was left without clear definition by the CHA (Chowdhury & Chowdhury, 2018). One common thread between the different health care plans is a lack of coverage for prescription medications outside of hospitals which is one of several signs of the aging system established based on concepts developed in the 1960s (Flood & Thomas, 2016).

To modernize the Canada Health Act, the government must consider the current and future health needs of the growing population of Canada. Which will increase the demand for health services. Innovations in efficiency and sustainability are a great way to start. However, policymakers should consider factors on supply side. More doctors, nurses and allied healthcare workers are needed, while red tape and bureaucracy limit the expansion and retention of the healthcare workforce.

From my experience, wait times for imaging procedures such as MRI and CT scans are a major issue that requires innovative solutions. In Alberta, data from May to July of 2023 shows that 90% of pediatric patients wait 29.8 weeks for an MRI scan (Government of Alberta, 2023). In 2020, the Canadian healthcare system operated with 549 CT scanners and 378 MRI machines. When compared to all OECD (Organisation for Economic Co-operation and Development) countries, Canada's ranking falls in the lower fourth for the number of CT machines and in the lower third for MRI machines (Canadian Agency for Drugs and Technologies in Health (CADTH), 2023).

Although expanding the funding and increasing the number of MRI and CT units available per capita is needed, which requires substantial investments, other solutions could be explored that are more sustainable. These include increasing the utilization rate of current equipment by scheduling non-emergency exams outside the normal working hours, which would also require training, hiring and retaining more technologists.

References

Canadian Agency for Drugs and Technologies in Health (CADTH). (2023). The Canadian Medical Imaging Inventory 2019—2020. https://www.cadth.ca/canadian-medical-imaging-inventory-2019-2020

Chowdhury, M. Z. I., & Chowdhury, M. A. (2018). Canadian Health Care System: Who Should Pay for All Medically Beneficial Treatments? A Burning Issue. International Journal of Health Services, 48(2), 289–301. https://doi.org/10.1177/0020731417738976

Flood, C. M., & Thomas, B. (2016). Modernizing the Canada Health Act. Dalhousie Law Journal, 39(2), 397–411.

Government of Alberta. (2023). Alberta MRI Wait Times Reporting. http://waittimes.alberta.ca/CategorySummary.jsp?rcatID=18&levelOfCare=All.