Health Practices of Canada

7/29/2019 Health Practices of Canada

1/17

BEST HEALTH CARE

PRACTICES OFCANADA

CIA 3

Name- Samatha A. S.

Registrat ion Number-1114389

Class- 3 PSEco


2/17

INTRODUCTION

Health care in Canada

Health care in Canada is delivered through apublicly funded health caresystem, which is mostly free at

the point of use and has most services provided by private entities .[2]It is guided by the provisions of

theCanada Health Actof 1984.[3]

The government assures the quality of care through federal standards.

The government does not participate in day-to-day care or collect any information about an individual's

health, which remains confidential between a person and his or her physician. [citation needed] Canada's

provincially based Medicare systems are cost-effective partly because of their administrative simplicity. In

each province each doctor handles the insurance claim against the provincial insurer. There is no need

for the person who accesses health care to be involved in billing and reclaim. Private health expenditure

accounts for 30% of health care financing.

[4]

Competitive practices such as advertising are kept to a minimum, thus maximizing the percentage of

revenues that go directly towards care. In general, costs are paid through funding from income taxes. In

British Columbia, taxation-based funding is supplemented by a fixed monthly premium which is waived or

reduced for those on low incomes.[5]There are no deductibles on basic health care and co-pays are

extremely low or non-existent (supplemental insurance such as Fair Pharmacare may have deductibles,

depending on income).

A health card is issued by the Provincial Ministry of Health to each individual who enrolls for the program

and everyone receives the same level of care.[6]There is no need for a variety of plans because virtually

all essential basic care is covered, including maternity and infertility problems. Depending on the

province, dental and vision care may not be covered but are often insured by employers through privatecompanies. In some provinces, private supplemental plans are available for those who desire private

rooms if they are hospitalized. Cosmetic surgery and some forms of elective surgery are not considered

essential care and are generally not covered. These can be paid out-of-pocket or through private

insurers. Health coverage is not affected by loss or change of jobs, health care cannot be denied due to

unpaid premiums (in BC), and there are no lifetime limits or exclusions for pre-existing conditions.

Pharmaceutical medications are covered by public funds for the elderly or indigent,[7]or through

employment-based private insurance. Drug prices are negotiated with suppliers by the federal

government to control costs.Family physicians(often known as general practitioners or GPs in Canada)

are chosen by individuals. If a patient wishes to see a specialist or is counseled to see a specialist, a

referral can be made by a GP. Preventive care and early detection are considered important and yearlycheckups are encouraged. Early detection extends life expectancy and quality of life, and also reduces

overall costs.

Canada has a publicly fundedmedicaresystem, with most services provided by the private sector. Each

province may opt out, though none currently do. Canada's system is known as a single payer system,

where basic services are provided by private doctors (since 2002 they have been allowed to incorporate),
http://en.wikipedia.org/wiki/Publicly_funded_health_carehttp://en.wikipedia.org/wiki/Publicly_funded_health_carehttp://en.wikipedia.org/wiki/Publicly_funded_health_carehttp://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-CBC-2http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-CBC-2http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-CBC-2http://en.wikipedia.org/wiki/Canada_Health_Acthttp://en.wikipedia.org/wiki/Canada_Health_Acthttp://en.wikipedia.org/wiki/Canada_Health_Acthttp://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-Canada_Health_Act-3http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-Canada_Health_Act-3http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-Canada_Health_Act-3http://en.wikipedia.org/wiki/Wikipedia:Citation_neededhttp://en.wikipedia.org/wiki/Wikipedia:Citation_neededhttp://en.wikipedia.org/wiki/Wikipedia:Citation_neededhttp://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-4http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-4http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-4http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-5http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-5http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-5http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-6http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-6http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-6http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-7http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-7http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-7http://en.wikipedia.org/wiki/Family_physicianhttp://en.wikipedia.org/wiki/Family_physicianhttp://en.wikipedia.org/wiki/Family_physicianhttp://en.wikipedia.org/wiki/Medicare_(Canada)http://en.wikipedia.org/wiki/Medicare_(Canada)http://en.wikipedia.org/wiki/Medicare_(Canada)http://en.wikipedia.org/wiki/Single_payer_systemhttp://en.wikipedia.org/wiki/Single_payer_systemhttp://en.wikipedia.org/wiki/Single_payer_systemhttp://en.wikipedia.org/wiki/Single_payer_systemhttp://en.wikipedia.org/wiki/Medicare_(Canada)http://en.wikipedia.org/wiki/Family_physicianhttp://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-7http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-6http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-5http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-4http://en.wikipedia.org/wiki/Wikipedia:Citation_neededhttp://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-Canada_Health_Act-3http://en.wikipedia.org/wiki/Canada_Health_Acthttp://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-CBC-2http://en.wikipedia.org/wiki/Publicly_funded_health_care


3/17

with the entire fee paid for by the government at the same rate. Most government funding (94%) comes

from the provincial level.[14]Most family doctors receive a fee per visit. These rates are negotiated

between the provincial governments and the province's medical associations, usually on an annual basis.

Pharmaceutical costs are set at a global median by government price controls.

Canadian per capita health care spending by age group in 2007.[14]

Total Canadian health care expenditures in 1997 dollars from 1975 to 2009.[15]

Hospital care is delivered by publicly funded hospitals in Canada. Most of the public hospitals, each of

which are independent institutions incorporated under provincial Corporations Acts, are required by law to

operate within their budget.[16]Amalgamation of hospitals in the 1990s has reduced competition between

hospitals. As the cost of patient care has increased, hospitals have been forced to cut costs or reduce

services. Applyingperspective (pharmacoeconomic)to analyze cost reduction, it has been shown that

savings made by individual hospitals result in actual cost increases to the Provinces .[17]

In 2009, the government funded about 70% of Canadians' health care costs. This is slightly below the

OECD average of public health spending.[18]

This covered most hospital and physician cost while the

dental and pharmaceutical costs were primarily paid for by individuals.[18]Half of private health

expenditure comes from private insurance and the remaining half is supplied by out-of-pocket payments.

Under the terms of theCanada Health Act, public funding is required to pay for medically necessary care,

but only if it is delivered in hospitals or by physicians. There is considerable variation across the

provinces/territories as to the extent to which such costs as out of hospital prescription medications,

physical therapy, long-term care, dental care andambulance servicesare covered.[19]

Health care spending in Canada (in 1997 dollars) has increased each year between 1975 and 2009, from

$39.7 billion to $137.3 billion, or per capita spending from $1,715 to $4089 .[20]In 2012, total health care

spending in Canada is expected to reach $207 billion, averaging $5,948 per person. Figures in National
http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-CIHI_p.xiv-14http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-CIHI_p.xiv-14http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-CIHI_p.xiv-14http://en.wikipedia.org/wiki/Price_controlhttp://en.wikipedia.org/wiki/Price_controlhttp://en.wikipedia.org/wiki/Price_controlhttp://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-CIHI_p.xiv-14http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-CIHI_p.xiv-14http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-CIHI_p.xiv-14http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-15http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-15http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-15http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-16http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-16http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-16http://en.wikipedia.org/wiki/Perspective_(pharmacoeconomic)http://en.wikipedia.org/wiki/Perspective_(pharmacoeconomic)http://en.wikipedia.org/wiki/Perspective_(pharmacoeconomic)http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-17http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-17http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-17http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-CIHI_p.xiii-18http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-CIHI_p.xiii-18http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-CIHI_p.xiii-18http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-CIHI_p.xiii-18http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-CIHI_p.xiii-18http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-CIHI_p.xiii-18http://en.wikipedia.org/wiki/Canada_Health_Acthttp://en.wikipedia.org/wiki/Canada_Health_Acthttp://en.wikipedia.org/wiki/Canada_Health_Acthttp://en.wikipedia.org/wiki/Emergency_Medical_Services_in_Canadahttp://en.wikipedia.org/wiki/Emergency_Medical_Services_in_Canadahttp://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-19http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-19http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-19http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-20http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-20http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-20http://en.wikipedia.org/wiki/File:Total_health_expenditure_in_constant_1997_dollars.pnghttp://en.wikipedia.org/wiki/File:Total_health_expenditure_in_constant_1997_dollars.pnghttp://en.wikipedia.org/wiki/File:Spending_on_health_care_per_capita_by_age_group.pnghttp://en.wikipedia.org/wiki/File:Spending_on_health_care_per_capita_by_age_group.pnghttp://en.wikipedia.org/wiki/File:Total_health_expenditure_in_constant_1997_dollars.pnghttp://en.wikipedia.org/wiki/File:Total_health_expenditure_in_constant_1997_dollars.pnghttp://en.wikipedia.org/wiki/File:Spending_on_health_care_per_capita_by_age_group.pnghttp://en.wikipedia.org/wiki/File:Spending_on_health_care_per_capita_by_age_group.pnghttp://en.wikipedia.org/wiki/File:Total_health_expenditure_in_constant_1997_dollars.pnghttp://en.wikipedia.org/wiki/File:Total_health_expenditure_in_constant_1997_dollars.pnghttp://en.wikipedia.org/wiki/File:Spending_on_health_care_per_capita_by_age_group.pnghttp://en.wikipedia.org/wiki/File:Spending_on_health_care_per_capita_by_age_group.pnghttp://en.wikipedia.org/wiki/File:Total_health_expenditure_in_constant_1997_dollars.pnghttp://en.wikipedia.org/wiki/File:Total_health_expenditure_in_constant_1997_dollars.pnghttp://en.wikipedia.org/wiki/File:Spending_on_health_care_per_capita_by_age_group.pnghttp://en.wikipedia.org/wiki/File:Spending_on_health_care_per_capita_by_age_group.pnghttp://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-20http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-19http://en.wikipedia.org/wiki/Emergency_Medical_Services_in_Canadahttp://en.wikipedia.org/wiki/Canada_Health_Acthttp://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-CIHI_p.xiii-18http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-CIHI_p.xiii-18http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-17http://en.wikipedia.org/wiki/Perspective_(pharmacoeconomic)http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-16http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-15http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-CIHI_p.xiv-14http://en.wikipedia.org/wiki/Price_controlhttp://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-CIHI_p.xiv-14


4/17

Health Expenditure Trends, 1975 to 2012, show that the pace of growth is slowing. Modest economic

growth and budgetary deficits are having a moderating effect. For the third straight year, growth in health

care spending will be less than that in the overall economy. The proportion of Canadas gross domestic

product (GDP) spent on health care will reach 11.6% this yeardown from 11.7% in 2011 and the all-

time high of 11.9% in 2010.[21]Total spending in 2007 was equivalent to 10.1% of the gross domestic

product which was slightly above the average forOECD countries, and below the 16.0% of GDP spent onhealth care in the United States.[22]

In 2009, the greatest proportion of this money went tohospitals($51B), followed

bypharmaceuticals($30B), andphysicians($26B).[23]The proportion spent on hospitals and physicians

has declined between 1975 and 2009 while the amount spent on pharmaceuticals has increased .[24]Of

the three biggest health care expenses, the amount spent on pharmaceuticals has increased the most. In

1997 the total price of drugs surpassed that of doctors. In 1975 the three biggest health costs were

hospitals ($5.5B/44.7%), physicians ($1.8B/15.1% ), and medications ($1.1B/8.8% ) while in 2007 the

three biggest costs were hospitals ($45.4B/28.2% ), medications ($26.5B/16.5% ), and physicians

($21.5B/13.4% ).[25]

Health care costs per capita vary across Canada with Quebec ($4,891) and British Columbia ($5,254) at

the lowest level and Alberta ($6,072) and Newfoundland ($5,970) at the highest.[14]It is also the greatest

at the extremes of age at a cost of $17,469 per capita in those older than 80 and $8,239 for those less

than 1 year old in comparison to $3,809 for those between 1 and 64 years old in 2007 .[14]

Medical Care Act [ ed i t source | ed i t b e t a ]

The programs in Saskatchewan and Alberta proved a success and the federal government ofLester B.

Pearsonintroduced theMedical Care Actin 1966 that extended the HIDS Act cost-sharing to allow each

province to establish a universal health care plan -an initiative that was drafted and initiated by theLiberal

partyand supported by theNew Democratic Party(NDP). It also set up theMedicaresystem. In 1984,

theCanada Health Actwas passed under a majority Liberal government, which prohibiteduser feesand

extra billing by doctors. In 1999,Prime MinisterJean Chrtienand most premiers reaffirmed in theSocial

Union Framework Agreementthat they are committed to health care that has "comprehensiveness,

universality, portability, public administration and accessibility."[33]

Government involvement [ ed i t source | ed i t b e t a ]

The various levels of government pay for about 70% of Canadians' health care, although this number has

decreased somewhat in recent years.[34]TheConstitution Act, 1867(formerly called the British North

America Act, 1867, and still known informally as the BNA Act) did not give either the federal or provincial

governments responsibility for health care, as it was then a minor concern. The Act did give the provincesresponsibility for regulating hospitals, and the provinces claimed that their general responsibility for local

and private matters encompassed health care. The federal government felt that the health of the

population fell under thePeace, Order, and Good Governmentpart of its responsibilities. This led to

several decades of debate over jurisdiction that were not resolved until the 1930s. Eventually the Judicial

Committee of the Privy CouncilJCPCdecided that the administration and delivery of health care was a

provincial concern, but that the federal government also had the responsibility of protecting the health and

well-being of the population.
http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-21http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-21http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-21http://en.wikipedia.org/wiki/OECDhttp://en.wikipedia.org/wiki/OECDhttp://en.wikipedia.org/wiki/OECDhttp://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-22http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-22http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-22http://en.wikipedia.org/wiki/Hospitalshttp://en.wikipedia.org/wiki/Hospitalshttp://en.wikipedia.org/wiki/Hospitalshttp://en.wikipedia.org/wiki/Pharmaceuticalshttp://en.wikipedia.org/wiki/Pharmaceuticalshttp://en.wikipedia.org/wiki/Pharmaceuticalshttp://en.wikipedia.org/wiki/Physicianshttp://en.wikipedia.org/wiki/Physicianshttp://en.wikipedia.org/wiki/Physicianshttp://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-CBC2009-23http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-CBC2009-23http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-CBC2009-23http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-24http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-24http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-24http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-25http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-25http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-25http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-CIHI_p.xiv-14http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-CIHI_p.xiv-14http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-CIHI_p.xiv-14http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-CIHI_p.xiv-14http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-CIHI_p.xiv-14http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-CIHI_p.xiv-14http://en.wikipedia.org/w/index.php?title=Health_care_in_Canada&action=edit&section=8http://en.wikipedia.org/w/index.php?title=Health_care_in_Canada&action=edit&section=8http://en.wikipedia.org/w/index.php?title=Health_care_in_Canada&veaction=edit&section=8http://en.wikipedia.org/w/index.php?title=Health_care_in_Canada&veaction=edit&section=8http://en.wikipedia.org/w/index.php?title=Health_care_in_Canada&veaction=edit&section=8http://en.wikipedia.org/wiki/Lester_B._Pearsonhttp://en.wikipedia.org/wiki/Lester_B._Pearsonhttp://en.wikipedia.org/wiki/Lester_B._Pearsonhttp://en.wikipedia.org/wiki/Lester_B._Pearsonhttp://en.wikipedia.org/w/index.php?title=Medical_Care_Act&action=edit&redlink=1http://en.wikipedia.org/w/index.php?title=Medical_Care_Act&action=edit&redlink=1http://en.wikipedia.org/w/index.php?title=Medical_Care_Act&action=edit&redlink=1http://en.wikipedia.org/wiki/Liberal_party_of_Canadahttp://en.wikipedia.org/wiki/Liberal_party_of_Canadahttp://en.wikipedia.org/wiki/Liberal_party_of_Canadahttp://en.wikipedia.org/wiki/Liberal_party_of_Canadahttp://en.wikipedia.org/wiki/New_Democratic_Party_of_Canadahttp://en.wikipedia.org/wiki/New_Democratic_Party_of_Canadahttp://en.wikipedia.org/wiki/New_Democratic_Party_of_Canadahttp://en.wikipedia.org/wiki/Medicare_(Canada)http://en.wikipedia.org/wiki/Medicare_(Canada)http://en.wikipedia.org/wiki/Medicare_(Canada)http://en.wikipedia.org/wiki/Canada_Health_Acthttp://en.wikipedia.org/wiki/Canada_Health_Acthttp://en.wikipedia.org/wiki/Canada_Health_Acthttp://en.wikipedia.org/wiki/User_feehttp://en.wikipedia.org/wiki/User_feehttp://en.wikipedia.org/wiki/User_feehttp://en.wikipedia.org/wiki/Prime_Minister_of_Canadahttp://en.wikipedia.org/wiki/Prime_Minister_of_Canadahttp://en.wikipedia.org/wiki/Jean_Chr%C3%A9tienhttp://en.wikipedia.org/wiki/Jean_Chr%C3%A9tienhttp://en.wikipedia.org/wiki/Jean_Chr%C3%A9tienhttp://en.wikipedia.org/wiki/Social_Union_Framework_Agreementhttp://en.wikipedia.org/wiki/Social_Union_Framework_Agreementhttp://en.wikipedia.org/wiki/Social_Union_Framework_Agreementhttp://en.wikipedia.org/wiki/Social_Union_Framework_Agreementhttp://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-33http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-33http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-33http://en.wikipedia.org/w/index.php?title=Health_care_in_Canada&action=edit&section=9http://en.wikipedia.org/w/index.php?title=Health_care_in_Canada&action=edit&section=9http://en.wikipedia.org/w/index.php?title=Health_care_in_Canada&veaction=edit&section=9http://en.wikipedia.org/w/index.php?title=Health_care_in_Canada&veaction=edit&section=9http://en.wikipedia.org/w/index.php?title=Health_care_in_Canada&veaction=edit&section=9http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-34http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-34http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-34http://en.wikipedia.org/wiki/Constitution_Act,_1867http://en.wikipedia.org/wiki/Constitution_Act,_1867http://en.wikipedia.org/wiki/Constitution_Act,_1867http://en.wikipedia.org/wiki/Peace,_Order,_and_Good_Governmenthttp://en.wikipedia.org/wiki/Peace,_Order,_and_Good_Governmenthttp://en.wikipedia.org/wiki/Peace,_Order,_and_Good_Governmenthttp://en.wikipedia.org/wiki/JCPChttp://en.wikipedia.org/wiki/JCPChttp://en.wikipedia.org/wiki/JCPChttp://en.wikipedia.org/wiki/JCPChttp://en.wikipedia.org/wiki/Peace,_Order,_and_Good_Governmenthttp://en.wikipedia.org/wiki/Constitution_Act,_1867http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-34http://en.wikipedia.org/w/index.php?title=Health_care_in_Canada&veaction=edit&section=9http://en.wikipedia.org/w/index.php?title=Health_care_in_Canada&action=edit&section=9http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-33http://en.wikipedia.org/wiki/Social_Union_Framework_Agreementhttp://en.wikipedia.org/wiki/Social_Union_Framework_Agreementhttp://en.wikipedia.org/wiki/Jean_Chr%C3%A9tienhttp://en.wikipedia.org/wiki/Prime_Minister_of_Canadahttp://en.wikipedia.org/wiki/User_feehttp://en.wikipedia.org/wiki/Canada_Health_Acthttp://en.wikipedia.org/wiki/Medicare_(Canada)http://en.wikipedia.org/wiki/New_Democratic_Party_of_Canadahttp://en.wikipedia.org/wiki/Liberal_party_of_Canadahttp://en.wikipedia.org/wiki/Liberal_party_of_Canadahttp://en.wikipedia.org/w/index.php?title=Medical_Care_Act&action=edit&redlink=1http://en.wikipedia.org/wiki/Lester_B._Pearsonhttp://en.wikipedia.org/wiki/Lester_B._Pearsonhttp://en.wikipedia.org/w/index.php?title=Health_care_in_Canada&veaction=edit&section=8http://en.wikipedia.org/w/index.php?title=Health_care_in_Canada&action=edit&section=8http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-CIHI_p.xiv-14http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-CIHI_p.xiv-14http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-25http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-24http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-CBC2009-23http://en.wikipedia.org/wiki/Physicianshttp://en.wikipedia.org/wiki/Pharmaceuticalshttp://en.wikipedia.org/wiki/Hospitalshttp://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-22http://en.wikipedia.org/wiki/OECDhttp://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-21


5/17

By far the largest government health program isMedicare, which is actually ten provincial programs, such

asOHIPinOntario, that are required to meet the general guidelines laid out in the federalCanada Health

Act. Almost all government health spending goes throughMedicare, but there are several smaller

programs. The federal government directly administers health to groups such as the military, and inmates

of federal prisons. They also provide some care to theRoyal Canadian Mounted Policeand veterans, but

these groups mostly use the public system. Prior to 1966, Veterans Affairs Canadahad a large healthcare network, but this was merged into the general system with the creation ofMedicare. The largest

group the federal government is directly responsible for isFirst Nations. Native peoples are a federal

responsibility and the federal government guarantees complete coverage of their health needs. For the

last 20 years and despite health care being a guaranteed right for First Nations due to the many treaties

the government of Canada signed for access to First Nations lands and resources, the amount of

coverage provided by the Federal government has diminished drastically for optometry, dentistry, and

medicines. Status First Nations individuals qualify for a set amount of visits to the optometrist and dentist,

with a limited amount of coverage for glasses, eye exams, fillings, root canals, etc. For the most part First

Nations people use the normal hospitals and the federal government then fully compensates the

provincial government for the expense. The federal government also covers any user fees the province

charges. The federal government maintains a network of clinics and health centres onNative Reserves.

At the provincial level, there are also several much smaller health programs alongsideMedicare. The

largest of these is the health care costs paid by the worker's compensationsystem. Regardless of federal

efforts, healthcare forFirst Nationshas generally not been considered effective.[35][36][37]

Despite being a provincial responsibility, the large health costs have long been partially funded by the

federal government. The cost sharing agreement created by the HIDS Act and extended by the Medical

Care Act was discontinued in 1977 and replaced byEstablished Programs Financing. This gave a bloc

transfer to the provinces, giving them more flexibility but also reducing federal influence on the health

system. In 1996, when faced with a large budget shortfall, the Liberal federal government merged the

health transfers with the transfers for other social programs into theCanada Health and Social Transfer,

and overall funding levels were cut. This placed considerable pressure on the provinces, and combined

withpopulation agingand the generally high rate ofinflationin health costs, has caused problems with

the system.

Private sector [ ed i t source | ed i t b e t a ]

About 27.6% of Canadians' health care is paid for through the private sector. This mostly goes towards

services not covered or partially covered by Medicare, such as prescription

drugs,dentistryandoptometry. Some 75% of Canadians have some form of supplementary private

health insurance; many of them receive it through their employers.[38]There are also large private entities

that can buy priority access to medical services in Canada, such as WCB in BC.

The Canadian system is for the most part publicly funded, yet most of the services are provided by private

enterprises. Most doctors do not receive an annual salary, but receive a fee per visit or

service.[2]According to Dr. Albert Schumacher, former president of theCanadian Medical Association, an

estimated 75 percent of Canadian health care services are delivered privately, but funded publicly.

"Frontline practitioners whether they're GPs or specialists by and large are not salaried. They're small

hardware stores. Same thing with labs and radiology clinics ...The situation we are seeing now are more
http://en.wikipedia.org/wiki/Medicare_(Canada)http://en.wikipedia.org/wiki/Medicare_(Canada)http://en.wikipedia.org/wiki/Medicare_(Canada)http://en.wikipedia.org/wiki/OHIPhttp://en.wikipedia.org/wiki/OHIPhttp://en.wikipedia.org/wiki/OHIPhttp://en.wikipedia.org/wiki/Ontariohttp://en.wikipedia.org/wiki/Ontariohttp://en.wikipedia.org/wiki/Ontariohttp://en.wikipedia.org/wiki/Canada_Health_Acthttp://en.wikipedia.org/wiki/Canada_Health_Acthttp://en.wikipedia.org/wiki/Canada_Health_Acthttp://en.wikipedia.org/wiki/Canada_Health_Acthttp://en.wikipedia.org/wiki/Medicare_(Canada)http://en.wikipedia.org/wiki/Medicare_(Canada)http://en.wikipedia.org/wiki/Medicare_(Canada)http://en.wikipedia.org/wiki/Royal_Canadian_Mounted_Policehttp://en.wikipedia.org/wiki/Royal_Canadian_Mounted_Policehttp://en.wikipedia.org/wiki/Royal_Canadian_Mounted_Policehttp://en.wikipedia.org/wiki/Veterans_Affairs_Canadahttp://en.wikipedia.org/wiki/Veterans_Affairs_Canadahttp://en.wikipedia.org/wiki/Veterans_Affairs_Canadahttp://en.wikipedia.org/wiki/Medicare_(Canada)http://en.wikipedia.org/wiki/Medicare_(Canada)http://en.wikipedia.org/wiki/Medicare_(Canada)http://en.wikipedia.org/wiki/First_Nationshttp://en.wikipedia.org/wiki/First_Nationshttp://en.wikipedia.org/wiki/First_Nationshttp://en.wikipedia.org/wiki/Indian_reservehttp://en.wikipedia.org/wiki/Indian_reservehttp://en.wikipedia.org/wiki/Indian_reservehttp://en.wikipedia.org/wiki/Medicare_(Canada)http://en.wikipedia.org/wiki/Medicare_(Canada)http://en.wikipedia.org/wiki/Medicare_(Canada)http://en.wikipedia.org/wiki/Worker%27s_compensationhttp://en.wikipedia.org/wiki/Worker%27s_compensationhttp://en.wikipedia.org/wiki/Worker%27s_compensationhttp://en.wikipedia.org/wiki/First_Nationshttp://en.wikipedia.org/wiki/First_Nationshttp://en.wikipedia.org/wiki/First_Nationshttp://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-35http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-35http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-37http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-37http://en.wikipedia.org/wiki/Established_Programs_Financinghttp://en.wikipedia.org/wiki/Established_Programs_Financinghttp://en.wikipedia.org/wiki/Established_Programs_Financinghttp://en.wikipedia.org/wiki/Canada_Health_and_Social_Transferhttp://en.wikipedia.org/wiki/Canada_Health_and_Social_Transferhttp://en.wikipedia.org/wiki/Canada_Health_and_Social_Transferhttp://en.wikipedia.org/wiki/Population_aginghttp://en.wikipedia.org/wiki/Population_aginghttp://en.wikipedia.org/wiki/Population_aginghttp://en.wikipedia.org/wiki/Inflationhttp://en.wikipedia.org/wiki/Inflationhttp://en.wikipedia.org/wiki/Inflationhttp://en.wikipedia.org/w/index.php?title=Health_care_in_Canada&action=edit&section=10http://en.wikipedia.org/w/index.php?title=Health_care_in_Canada&action=edit&section=10http://en.wikipedia.org/w/index.php?title=Health_care_in_Canada&veaction=edit&section=10http://en.wikipedia.org/w/index.php?title=Health_care_in_Canada&veaction=edit&section=10http://en.wikipedia.org/w/index.php?title=Health_care_in_Canada&veaction=edit&section=10http://en.wikipedia.org/wiki/Prescription_drughttp://en.wikipedia.org/wiki/Prescription_drughttp://en.wikipedia.org/wiki/Prescription_drughttp://en.wikipedia.org/wiki/Prescription_drughttp://en.wikipedia.org/wiki/Dentistryhttp://en.wikipedia.org/wiki/Dentistryhttp://en.wikipedia.org/wiki/Dentistryhttp://en.wikipedia.org/wiki/Optometryhttp://en.wikipedia.org/wiki/Optometryhttp://en.wikipedia.org/wiki/Optometryhttp://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-38http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-38http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-38http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-CBC-2http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-CBC-2http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-CBC-2http://en.wikipedia.org/wiki/Canadian_Medical_Associationhttp://en.wikipedia.org/wiki/Canadian_Medical_Associationhttp://en.wikipedia.org/wiki/Canadian_Medical_Associationhttp://en.wikipedia.org/wiki/Canadian_Medical_Associationhttp://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-CBC-2http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-38http://en.wikipedia.org/wiki/Optometryhttp://en.wikipedia.org/wiki/Dentistryhttp://en.wikipedia.org/wiki/Prescription_drughttp://en.wikipedia.org/wiki/Prescription_drughttp://en.wikipedia.org/w/index.php?title=Health_care_in_Canada&veaction=edit&section=10http://en.wikipedia.org/w/index.php?title=Health_care_in_Canada&action=edit&section=10http://en.wikipedia.org/wiki/Inflationhttp://en.wikipedia.org/wiki/Population_aginghttp://en.wikipedia.org/wiki/Canada_Health_and_Social_Transferhttp://en.wikipedia.org/wiki/Established_Programs_Financinghttp://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-37http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-35http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-35http://en.wikipedia.org/wiki/First_Nationshttp://en.wikipedia.org/wiki/Worker%27s_compensationhttp://en.wikipedia.org/wiki/Medicare_(Canada)http://en.wikipedia.org/wiki/Indian_reservehttp://en.wikipedia.org/wiki/First_Nationshttp://en.wikipedia.org/wiki/Medicare_(Canada)http://en.wikipedia.org/wiki/Veterans_Affairs_Canadahttp://en.wikipedia.org/wiki/Royal_Canadian_Mounted_Policehttp://en.wikipedia.org/wiki/Medicare_(Canada)http://en.wikipedia.org/wiki/Canada_Health_Acthttp://en.wikipedia.org/wiki/Canada_Health_Acthttp://en.wikipedia.org/wiki/Ontariohttp://en.wikipedia.org/wiki/OHIPhttp://en.wikipedia.org/wiki/Medicare_(Canada)


6/17

services around not being funded publicly but people having to pay for them, or their insurance

companies. We have sort of a passive privatization."[2]

"Although there are laws prohibiting or curtailing private health care in some provinces, they can be

changed", according to a report in the New England Journal of Medicine.[39][40]In June 2005, theSupreme

Court of Canadaruled inChaoulli v. Quebec (Attorney General)that Quebec's prohibition against privatehealth insurance for medically necessary services laws violated the Quebec Charter of Human Rights and

Freedoms, potentially opening the door to much more private sector participation in the health system.

JusticesBeverley McLachlin, Jack Major,Michel BastaracheandMarie Deschampsfound for the

majority. "Access to a waiting list is not access to health care", wrote Chief Justice Beverly McLachlin.

The Quebec and federal governments asked the high court to suspend its ruling for 18 months. Less than

two months after its initial ruling, the court agreed to suspend its decision for 12 months, retroactive to

June 9, 2005.[41]

Physicians and medical organizat ion [ed i t source | ed i t b e t a ]

Canada, like its North American neighbour the United States, has a ratio of practicing physicians topopulation that is below the OECD average[42]but a level of practicing nurses that is higher than either

the U.S. or the OECD average.[43]

Family physicians in Canada make an average of $202,000 a year (2006, before

expenses).[44]

Albertahas the highest average salary of around $230,000, while Quebechas the lowest

average annual salary at $165,000, arguably creating interprovincial competition for doctors and

contributing to local shortages.[44]In fact, the cost of living in Alberta is considerably higher than the cost

of living in Quebec, so absolute income differentials can be massively misleading.

In 1991, the Ontario Medical Association agreed to become a province-wideclosed shop, making the

OMA union a monopoly. Critics argue that this measure has restricted the supply of doctors to guarantee

its members' incomes.[45]

In September 2008, theOntario Medical Associationand theOntarian governmentagreed to a new four-

year contract that will see doctors receive a 12.25% pay raise. The new agreement is expected to cost

Ontarians an extra$1 billion. Referring to the agreement, OntariopremierDalton McGuintysaid, "One of

the things that we've got to do, of course, is ensure that we're competitive ... to attract and keep doctors

here in Ontario...".[46]

In December 2008, theSociety of Obstetricians and Gynaecologists of Canadareported a critical

shortage ofobstetriciansandgynaecologists. The report stated that 1,370 obstetricians were practicing in

Canada and that number is expected to fall by at least one-third within five years. The society is asking

the government to increase the number ofmedical schoolspots for obstetrics and gynecologists by 30

per cent a year for three years and also recommended rotating placements of doctors into smaller

communities to encourage them to take up residence there.[47]

Each province regulates its medical profession through a self-governing College of Physicians and

Surgeons, which is responsible for licensing physicians, setting practice standards, and investigating and

disciplining its members.
http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-CBC-2http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-CBC-2http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-CBC-2http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-39http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-39http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-39http://en.wikipedia.org/wiki/Supreme_Court_of_Canadahttp://en.wikipedia.org/wiki/Supreme_Court_of_Canadahttp://en.wikipedia.org/wiki/Supreme_Court_of_Canadahttp://en.wikipedia.org/wiki/Supreme_Court_of_Canadahttp://en.wikipedia.org/wiki/Chaoulli_v._Quebec_(Attorney_General)http://en.wikipedia.org/wiki/Chaoulli_v._Quebec_(Attorney_General)http://en.wikipedia.org/wiki/Chaoulli_v._Quebec_(Attorney_General)http://en.wikipedia.org/wiki/Quebec_Charter_of_Human_Rights_and_Freedomshttp://en.wikipedia.org/wiki/Quebec_Charter_of_Human_Rights_and_Freedomshttp://en.wikipedia.org/wiki/Quebec_Charter_of_Human_Rights_and_Freedomshttp://en.wikipedia.org/wiki/Quebec_Charter_of_Human_Rights_and_Freedomshttp://en.wikipedia.org/wiki/Beverley_McLachlinhttp://en.wikipedia.org/wiki/Beverley_McLachlinhttp://en.wikipedia.org/wiki/Beverley_McLachlinhttp://en.wikipedia.org/wiki/Michel_Bastarachehttp://en.wikipedia.org/wiki/Michel_Bastarachehttp://en.wikipedia.org/wiki/Michel_Bastarachehttp://en.wikipedia.org/wiki/Marie_Deschampshttp://en.wikipedia.org/wiki/Marie_Deschampshttp://en.wikipedia.org/wiki/Marie_Deschampshttp://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-41http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-41http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-41http://en.wikipedia.org/w/index.php?title=Health_care_in_Canada&action=edit&section=11http://en.wikipedia.org/w/index.php?title=Health_care_in_Canada&action=edit&section=11http://en.wikipedia.org/w/index.php?title=Health_care_in_Canada&veaction=edit&section=11http://en.wikipedia.org/w/index.php?title=Health_care_in_Canada&veaction=edit&section=11http://en.wikipedia.org/w/index.php?title=Health_care_in_Canada&veaction=edit&section=11http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-42http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-42http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-42http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-43http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-43http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-43http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-CTV.ca-44http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-CTV.ca-44http://en.wikipedia.org/wiki/Albertahttp://en.wikipedia.org/wiki/Albertahttp://en.wikipedia.org/wiki/Albertahttp://en.wikipedia.org/wiki/Quebechttp://en.wikipedia.org/wiki/Quebechttp://en.wikipedia.org/wiki/Quebechttp://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-CTV.ca-44http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-CTV.ca-44http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-CTV.ca-44http://en.wikipedia.org/wiki/Closed_shophttp://en.wikipedia.org/wiki/Closed_shophttp://en.wikipedia.org/wiki/Closed_shophttp://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-45http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-45http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-45http://en.wikipedia.org/wiki/Ontario_Medical_Associationhttp://en.wikipedia.org/wiki/Ontario_Medical_Associationhttp://en.wikipedia.org/wiki/Ontario_Medical_Associationhttp://en.wikipedia.org/wiki/Ontarian_governmenthttp://en.wikipedia.org/wiki/Ontarian_governmenthttp://en.wikipedia.org/wiki/Ontarian_governmenthttp://en.wikipedia.org/wiki/Canadian_dollarhttp://en.wikipedia.org/wiki/Canadian_dollarhttp://en.wikipedia.org/wiki/Premier_of_Ontariohttp://en.wikipedia.org/wiki/Premier_of_Ontariohttp://en.wikipedia.org/wiki/Dalton_McGuintyhttp://en.wikipedia.org/wiki/Dalton_McGuintyhttp://en.wikipedia.org/wiki/Dalton_McGuintyhttp://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-46http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-46http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-46http://en.wikipedia.org/wiki/Society_of_Obstetricians_and_Gynaecologists_of_Canadahttp://en.wikipedia.org/wiki/Society_of_Obstetricians_and_Gynaecologists_of_Canadahttp://en.wikipedia.org/wiki/Society_of_Obstetricians_and_Gynaecologists_of_Canadahttp://en.wikipedia.org/wiki/Obstetricianshttp://en.wikipedia.org/wiki/Obstetricianshttp://en.wikipedia.org/wiki/Obstetricianshttp://en.wikipedia.org/wiki/Gynaecologistshttp://en.wikipedia.org/wiki/Gynaecologistshttp://en.wikipedia.org/wiki/Gynaecologistshttp://en.wikipedia.org/wiki/Medical_schoolhttp://en.wikipedia.org/wiki/Medical_schoolhttp://en.wikipedia.org/wiki/Medical_schoolhttp://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-47http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-47http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-47http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-47http://en.wikipedia.org/wiki/Medical_schoolhttp://en.wikipedia.org/wiki/Gynaecologistshttp://en.wikipedia.org/wiki/Obstetricianshttp://en.wikipedia.org/wiki/Society_of_Obstetricians_and_Gynaecologists_of_Canadahttp://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-46http://en.wikipedia.org/wiki/Dalton_McGuintyhttp://en.wikipedia.org/wiki/Premier_of_Ontariohttp://en.wikipedia.org/wiki/Canadian_dollarhttp://en.wikipedia.org/wiki/Ontarian_governmenthttp://en.wikipedia.org/wiki/Ontario_Medical_Associationhttp://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-45http://en.wikipedia.org/wiki/Closed_shophttp://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-CTV.ca-44http://en.wikipedia.org/wiki/Quebechttp://en.wikipedia.org/wiki/Albertahttp://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-CTV.ca-44http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-43http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-42http://en.wikipedia.org/w/index.php?title=Health_care_in_Canada&veaction=edit&section=11http://en.wikipedia.org/w/index.php?title=Health_care_in_Canada&action=edit&section=11http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-41http://en.wikipedia.org/wiki/Marie_Deschampshttp://en.wikipedia.org/wiki/Michel_Bastarachehttp://en.wikipedia.org/wiki/Beverley_McLachlinhttp://en.wikipedia.org/wiki/Quebec_Charter_of_Human_Rights_and_Freedomshttp://en.wikipedia.org/wiki/Quebec_Charter_of_Human_Rights_and_Freedomshttp://en.wikipedia.org/wiki/Chaoulli_v._Quebec_(Attorney_General)http://en.wikipedia.org/wiki/Supreme_Court_of_Canadahttp://en.wikipedia.org/wiki/Supreme_Court_of_Canadahttp://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-39http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-39http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-CBC-2


7/17

The national doctors association is called theCanadian Medical Association;[48]it describes its mission as

"To serve and unite the physicians of Canada and be the national advocate, in partnership with the

people of Canada, for the highest standards of health and health care. "[49]Because health care is

deemed to be under provincial/territorial jurisdiction, negotiations on behalf of physicians are conducted

by provincial associations such as theOntario Medical Association. The views of Canadian doctors have

been mixed, particularly in their support for allowing parallel private financing. The history of Canadianphysicians in the development of Medicare has been described by C. David Naylor.[50]Since the passage

of the 1984Canada Health Act, the CMA itself has been a strong advocate of maintaining a strong

publicly funded system, including lobbying the federal government to increase funding, and being a

founding member of (and active participant in) the Health Action Lobby (HEAL).[51]

However, there are internal disputes. In particular, some provincial medical associations have argued for

permitting a larger private role. To some extent, this has been a reaction to strong cost control; CIHI

estimates that 99% of physician expenditures in Canada come from public sector sources, and

physiciansparticularly those providing elective procedures who have been squeezed for operating room

timehave accordingly looked for alternative revenue sources.

One indication of this internal dispute came when Dr.Brian Dayof B.C. was elected CMA president in

August 2007. Day is the owner of the largest private hospital in Canada and a vocal supporter of

increasing private health care in Canada. The CMA presidency rotates among the provinces, with the

provincial association electing a candidate who is customarily ratified by the CMA general meeting. Day's

selection was sufficiently controversial that he was challengedalbeit unsuccessfullyby another

physician. The newspaper story went on to note that "Day said he has never supported the privatization

of health care in Canada, and accused his detractors of deliberately distorting his position."[52]

Restr ict ions on pr ivately funded heal th care [ed i t

source | ed i t b e t a ] M a i n a r t i c l e : C a n a d a H e a l t h A c t

TheCanada Health Act, which sets the conditions with which provincial/territorial health insurance plans

must comply if they wish to receive their full transfer payments from the federal government, does not

allow charges to insured persons for insured services (defined as medically necessary care provided in

hospitals or by physicians). Most provinces have responded through various prohibitions on such

payments. This does not constitute a ban on privately funded care; indeed, about 30% of Canadian health

expenditures come from private sources, both insurance and out-of-pocket payments.[66]The Canada

Health Act does not address delivery. Private clinics are therefore permitted, albeit subject to

provincial/territorial regulations, but they cannot charge above the agreed-upon fee schedule unless they

are treating non-insured persons (which may include those eligible under automobile insurance or

worker's compensation, in addition to those who are not Canadian residents), or providing non-insured

services. This provision has been controversial among those seeking a greater role for private funding.

In 2006, the Government of British Columbia threatened to shut down one private clinic because it was

planning to start accepting private payments from patients.[67]
http://en.wikipedia.org/wiki/Canadian_Medical_Associationhttp://en.wikipedia.org/wiki/Canadian_Medical_Associationhttp://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-48http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-48http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-48http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-49http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-49http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-49http://en.wikipedia.org/wiki/Ontario_Medical_Associationhttp://en.wikipedia.org/wiki/Ontario_Medical_Associationhttp://en.wikipedia.org/wiki/Ontario_Medical_Associationhttp://en.wikipedia.org/wiki/David_Naylorhttp://en.wikipedia.org/wiki/David_Naylorhttp://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-50http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-50http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-50http://en.wikipedia.org/wiki/Canada_Health_Acthttp://en.wikipedia.org/wiki/Canada_Health_Acthttp://en.wikipedia.org/wiki/Canada_Health_Acthttp://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-51http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-51http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-51http://en.wikipedia.org/wiki/Brian_Dayhttp://en.wikipedia.org/wiki/Brian_Dayhttp://en.wikipedia.org/wiki/Brian_Dayhttp://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-52http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-52http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-52http://en.wikipedia.org/w/index.php?title=Health_care_in_Canada&action=edit&section=15http://en.wikipedia.org/w/index.php?title=Health_care_in_Canada&action=edit&section=15http://en.wikipedia.org/w/index.php?title=Health_care_in_Canada&action=edit&section=15http://en.wikipedia.org/w/index.php?title=Health_care_in_Canada&veaction=edit&section=15http://en.wikipedia.org/w/index.php?title=Health_care_in_Canada&veaction=edit&section=15http://en.wikipedia.org/w/index.php?title=Health_care_in_Canada&veaction=edit&section=15http://en.wikipedia.org/wiki/Canada_Health_Acthttp://en.wikipedia.org/wiki/Canada_Health_Acthttp://en.wikipedia.org/wiki/Canada_Health_Acthttp://en.wikipedia.org/wiki/Canada_Health_Acthttp://en.wikipedia.org/wiki/Canada_Health_Acthttp://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-66http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-66http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-66http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-67http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-67http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-67http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-67http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-66http://en.wikipedia.org/wiki/Canada_Health_Acthttp://en.wikipedia.org/wiki/Canada_Health_Acthttp://en.wikipedia.org/w/index.php?title=Health_care_in_Canada&veaction=edit&section=15http://en.wikipedia.org/w/index.php?title=Health_care_in_Canada&action=edit&section=15http://en.wikipedia.org/w/index.php?title=Health_care_in_Canada&action=edit&section=15http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-52http://en.wikipedia.org/wiki/Brian_Dayhttp://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-51http://en.wikipedia.org/wiki/Canada_Health_Acthttp://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-50http://en.wikipedia.org/wiki/David_Naylorhttp://en.wikipedia.org/wiki/Ontario_Medical_Associationhttp://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-49http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-48http://en.wikipedia.org/wiki/Canadian_Medical_Association


8/17

Governments have responded through wait time strategies, discussed above, which attempt to ensure

that patients will receive high-quality, necessary services in a timely manner. Nonetheless, the debate

continues.

U S c i t i z e n s v i s i t i n g C a n a d a t o r e c e i v e h e a l t h c a r e [ed i t

source | ed i t b e t a]

Some US citizens travel to Canada for health-care related reasons:

Many US c i t i zens pu r chas e p r es c r i p t i on d r ugs f r om Canada , e i t he r ove r

t he I n t e r ne t o r by t r ave l i ng t he r e t o bu y t hem i n pe r s on , becaus e

p r es c r ip t i on dr u g p r i c es i n C an ad a a r e subs t an t i a l l y l o wer

t han p r es c r i p t i on dr u g p r i c es in t h e Un i t ed S t a t e s ; t h i s c r os s - bor de r

pu r ch as in g h as be en e s t im at ed a t $ 1 b i l l i on annu al l y. [ 8 2 ]

Becaus e med i ca l mar i j uana i s l ega l i n Canada bu t i l l ega l i n mos t o f t he

US, many US c i t i zens s u f f e r i ng f r om cance r , AIDS , mul t i p l e s c l e r os i s ,

an d g l aucoma have t r ave l ed t o Canada f o r med i ca l t r ea t men t . One o f

t hos e i s S t eve Kubby, t h e L i be r t a r i an Pa r t y ' s 1998 cand i da t e f o r

gove r nor o f Ca l i f o r n i a , who i s s u f f e r i ng f r om adr ena l

cance r . [ 8 3 ] Recen t l ega l changes s uch a s Pr opos i t i on 215 may dec r eas e

t h i s t ype o f med i ca l t ou r i s m f r om Ca l i f o r n i a on l y .

Comparison to other countries [ e d i t s o u r c e | e d i t b e t a ]

Ma in a r t i c l e : Compar i s on o f Canad i an and Amer i can hea l t h c ar e s ys t ems

The Canadian health care system is oftencomparedto the US system. The US system spends the

most in the worldper capita, and was ranked 37th in the world by theWorld Health

Organizationin 2000, while Canada's health system was ranked 30th. The relatively low

Canadian WHO ranking has been criticized by some[who?] for its choice of ranking criteria and

statistical methods, and the WHO is currently revising its methodology and withholding new

rankings until the issues are addressed.[84][85]

Canada spent approximately 10.0% of GDP on health care in 2006, more than one percentage

point higher than the average of 8.9% inOECDcountries.[86]

According to theCanadian Institutefor Health Information, spending is expected to reach $160 billion, or 10.6% of GDP, in

2007.[87]This translates to $4,867 per person.

Most health statistics in Canada are at or above the G8 average.[88]Direct comparisons of health

statistics across nations is complex. TheOECDcollects comparative statistics, and has published

brief country profiles.[89][90][91]
http://en.wikipedia.org/w/index.php?title=Health_care_in_Canada&action=edit&section=18http://en.wikipedia.org/w/index.php?title=Health_care_in_Canada&action=edit&section=18http://en.wikipedia.org/w/index.php?title=Health_care_in_Canada&action=edit&section=18http://en.wikipedia.org/w/index.php?title=Health_care_in_Canada&veaction=edit&section=18http://en.wikipedia.org/w/index.php?title=Health_care_in_Canada&veaction=edit&section=18http://en.wikipedia.org/w/index.php?title=Health_care_in_Canada&veaction=edit&section=18http://en.wikipedia.org/w/index.php?title=Health_care_in_Canada&veaction=edit&section=18http://en.wikipedia.org/wiki/Prescription_drug_prices_in_the_United_Stateshttp://en.wikipedia.org/wiki/Prescription_drug_prices_in_the_United_Stateshttp://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-82http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-82http://en.wikipedia.org/wiki/Medical_marijuanahttp://en.wikipedia.org/wiki/Medical_marijuanahttp://en.wikipedia.org/wiki/Medical_marijuanahttp://en.wikipedia.org/wiki/Cancerhttp://en.wikipedia.org/wiki/Cancerhttp://en.wikipedia.org/wiki/AIDShttp://en.wikipedia.org/wiki/AIDShttp://en.wikipedia.org/wiki/AIDShttp://en.wikipedia.org/wiki/Multiple_sclerosishttp://en.wikipedia.org/wiki/Multiple_sclerosishttp://en.wikipedia.org/wiki/Multiple_sclerosishttp://en.wikipedia.org/wiki/Glaucomahttp://en.wikipedia.org/wiki/Glaucomahttp://en.wikipedia.org/wiki/Steve_Kubbyhttp://en.wikipedia.org/wiki/Steve_Kubbyhttp://en.wikipedia.org/wiki/Steve_Kubbyhttp://en.wikipedia.org/wiki/Libertarian_Party_(United_States)http://en.wikipedia.org/wiki/Libertarian_Party_(United_States)http://en.wikipedia.org/wiki/Californiahttp://en.wikipedia.org/wiki/Californiahttp://en.wikipedia.org/wiki/Adrenal_cancerhttp://en.wikipedia.org/wiki/Adrenal_cancerhttp://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-83http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-83http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-83http://en.wikipedia.org/wiki/Proposition_215http://en.wikipedia.org/wiki/Proposition_215http://en.wikipedia.org/w/index.php?title=Health_care_in_Canada&action=edit&section=19http://en.wikipedia.org/w/index.php?title=Health_care_in_Canada&action=edit&section=19http://en.wikipedia.org/w/index.php?title=Health_care_in_Canada&veaction=edit&section=19http://en.wikipedia.org/w/index.php?title=Health_care_in_Canada&veaction=edit&section=19http://en.wikipedia.org/w/index.php?title=Health_care_in_Canada&veaction=edit&section=19http://en.wikipedia.org/wiki/Comparison_of_Canadian_and_American_health_care_systemshttp://en.wikipedia.org/wiki/Comparison_of_Canadian_and_American_health_care_systemshttp://en.wikipedia.org/wiki/Canadian_and_American_health_care_systems_comparedhttp://en.wikipedia.org/wiki/Canadian_and_American_health_care_systems_comparedhttp://en.wikipedia.org/wiki/Canadian_and_American_health_care_systems_comparedhttp://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_(PPP)_per_capitahttp://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_(PPP)_per_capitahttp://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_(PPP)_per_capitahttp://en.wikipedia.org/wiki/World_Health_Organizationhttp://en.wikipedia.org/wiki/World_Health_Organizationhttp://en.wikipedia.org/wiki/World_Health_Organizationhttp://en.wikipedia.org/wiki/World_Health_Organizationhttp://en.wikipedia.org/wiki/Wikipedia:Avoid_weasel_wordshttp://en.wikipedia.org/wiki/Wikipedia:Avoid_weasel_wordshttp://en.wikipedia.org/wiki/Wikipedia:Avoid_weasel_wordshttp://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-84http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-84http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-84http://en.wikipedia.org/wiki/OECDhttp://en.wikipedia.org/wiki/OECDhttp://en.wikipedia.org/wiki/OECDhttp://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-OECD_2008-86http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-OECD_2008-86http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-OECD_2008-86http://en.wikipedia.org/wiki/Canadian_Institute_for_Health_Informationhttp://en.wikipedia.org/wiki/Canadian_Institute_for_Health_Informationhttp://en.wikipedia.org/wiki/Canadian_Institute_for_Health_Informationhttp://en.wikipedia.org/wiki/Canadian_Institute_for_Health_Informationhttp://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-87http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-87http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-87http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-88http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-88http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-88http://en.wikipedia.org/wiki/OECDhttp://en.wikipedia.org/wiki/OECDhttp://en.wikipedia.org/wiki/OECDhttp://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-89http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-89http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-91http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-91http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-91http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-89http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-89http://en.wikipedia.org/wiki/OECDhttp://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-88http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-87http://en.wikipedia.org/wiki/Canadian_Institute_for_Health_Informationhttp://en.wikipedia.org/wiki/Canadian_Institute_for_Health_Informationhttp://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-OECD_2008-86http://en.wikipedia.org/wiki/OECDhttp://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-84http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-84http://en.wikipedia.org/wiki/Wikipedia:Avoid_weasel_wordshttp://en.wikipedia.org/wiki/World_Health_Organizationhttp://en.wikipedia.org/wiki/World_Health_Organizationhttp://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_(PPP)_per_capitahttp://en.wikipedia.org/wiki/Canadian_and_American_health_care_systems_comparedhttp://en.wikipedia.org/wiki/Comparison_of_Canadian_and_American_health_care_systemshttp://en.wikipedia.org/w/index.php?title=Health_care_in_Canada&veaction=edit&section=19http://en.wikipedia.org/w/index.php?title=Health_care_in_Canada&action=edit&section=19http://en.wikipedia.org/wiki/Proposition_215http://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-83http://en.wikipedia.org/wiki/Adrenal_cancerhttp://en.wikipedia.org/wiki/Adrenal_cancerhttp://en.wikipedia.org/wiki/Californiahttp://en.wikipedia.org/wiki/Libertarian_Party_(United_States)http://en.wikipedia.org/wiki/Steve_Kubbyhttp://en.wikipedia.org/wiki/Glaucomahttp://en.wikipedia.org/wiki/Multiple_sclerosishttp://en.wikipedia.org/wiki/AIDShttp://en.wikipedia.org/wiki/Cancerhttp://en.wikipedia.org/wiki/Medical_marijuanahttp://en.wikipedia.org/wiki/Health_care_in_Canada#cite_note-82http://en.wikipedia.org/wiki/Prescription_drug_prices_in_the_United_Stateshttp://en.wikipedia.org/w/index.php?title=Health_care_in_Canada&veaction=edit&section=18http://en.wikipedia.org/w/index.php?title=Health_care_in_Canada&action=edit&section=18http://en.wikipedia.org/w/index.php?title=Health_care_in_Canada&action=edit&section=18


9/17

C o u n

t r y

L i f e

e x p e c t

a n c y

I n f a n t

m o r t a l i t

y r a t e

P h y s i c i a n

s p e r

1 0 0 0

p e o p l e

N u r s e s

p e r

1 0 0 0

p e o p l e

P e r

c a p i t a

e x p e n d i

t u r e o n

h e a l t h

( U S D )

H e a l t h

c a r e

c o s t s

a s a

p e r c e n

t

o f G D P

% o f

g o v e r n

m e n t

r e v e n u

e s p e n t

o n

h e a l t h

% o f

h e a l t h

c o s t s

p a i d b y

g o v e r n

m e n t

A u s t r a l

i a 8 1 . 4 4 . 2 2 . 8 9 . 7 3 , 1 3 7 8 . 7 1 7 . 7 6 7 . 7

C a n a d a 8 1 . 3 4 . 5 2 . 2 9 . 0 3 , 8 9 5 1 0 . 1 1 6 . 7 6 9 . 8

F r a n c e 8 1 . 0 4 . 0 3 . 4 7 . 7 3 , 6 0 1 1 1 . 0 1 4 . 2 7 9 . 0

G e r m a n

y 7 9 . 8 3 . 8 3 . 5 9 . 9 3 , 5 8 8 1 0 . 4 1 7 . 6 7 6 . 9

J a p a n 8 2 . 6 2 . 6 2 . 1 9 . 4 2 , 5 8 1 8 . 1 1 6 . 8 8 1 . 3

S w e d e n 8 1 . 0 2 . 5 3 . 6 1 0 . 8 3 , 3 2 3 9 . 1 1 3 . 6 8 1 . 7

U K 8 1 4 . 8 2 . 5 1 0 . 0 2 , 9 9 2 8 . 4 1 5 . 8 8 1 . 7

U S 7 8 . 1 6 . 9 2 . 4 1 0 . 6 7 , 2 9 0 1 6 . 01 8 . 5

Public Health ~Community Health Nurs ing Practice in

Canada-Roles and Activit ies

I n t r oduc t i on
http://en.wikipedia.org/wiki/Life_expectancyhttp://en.wikipedia.org/wiki/Life_expectancyhttp://en.wikipedia.org/wiki/Life_expectancyhttp://en.wikipedia.org/wiki/Life_expectancyhttp://en.wikipedia.org/wiki/Infant_mortalityhttp://en.wikipedia.org/wiki/Infant_mortalityhttp://en.wikipedia.org/wiki/Infant_mortalityhttp://en.wikipedia.org/wiki/Infant_mortalityhttp://en.wikipedia.org/wiki/Physicianhttp://en.wikipedia.org/wiki/Physicianhttp://en.wikipedia.org/wiki/Physicianhttp://en.wikipedia.org/wiki/Nurseshttp://en.wikipedia.org/wiki/Gross_domestic_producthttp://en.wikipedia.org/wiki/Gross_domestic_producthttp://en.wikipedia.org/wiki/Gross_domestic_producthttp://en.wikipedia.org/wiki/Health_care_in_Australiahttp://en.wikipedia.org/wiki/Health_care_in_Australiahttp://en.wikipedia.org/wiki/Health_care_in_Australiahttp://en.wikipedia.org/wiki/Health_care_in_Francehttp://en.wikipedia.org/wiki/Health_care_in_Francehttp://en.wikipedia.org/wiki/Health_care_in_Germanyhttp://en.wikipedia.org/wiki/Health_care_in_Germanyhttp://en.wikipedia.org/wiki/Health_care_in_Germanyhttp://en.wikipedia.org/wiki/Health_care_in_Japanhttp://en.wikipedia.org/wiki/Health_care_in_Japanhttp://en.wikipedia.org/wiki/Health_care_in_Swedenhttp://en.wikipedia.org/wiki/Health_care_in_Swedenhttp://en.wikipedia.org/wiki/Health_care_in_the_United_Kingdomhttp://en.wikipedia.org/wiki/Health_care_in_the_United_Kingdomhttp://en.wikipedia.org/wiki/Health_care_in_the_United_Stateshttp://en.wikipedia.org/wiki/Health_care_in_the_United_Stateshttp://en.wikipedia.org/wiki/Health_care_in_the_United_Stateshttp://en.wikipedia.org/wiki/Health_care_in_the_United_Kingdomhttp://en.wikipedia.org/wiki/Health_care_in_Swedenhttp://en.wikipedia.org/wiki/Health_care_in_Japanhttp://en.wikipedia.org/wiki/Health_care_in_Germanyhttp://en.wikipedia.org/wiki/Health_care_in_Germanyhttp://en.wikipedia.org/wiki/Health_care_in_Francehttp://en.wikipedia.org/wiki/Health_care_in_Australiahttp://en.wikipedia.org/wiki/Health_care_in_Australiahttp://en.wikipedia.org/wiki/Gross_domestic_producthttp://en.wikipedia.org/wiki/Nurseshttp://en.wikipedia.org/wiki/Physicianhttp://en.wikipedia.org/wiki/Physicianhttp://en.wikipedia.org/wiki/Infant_mortalityhttp://en.wikipedia.org/wiki/Infant_mortalityhttp://en.wikipedia.org/wiki/Infant_mortalityhttp://en.wikipedia.org/wiki/Life_expectancyhttp://en.wikipedia.org/wiki/Life_expectancyhttp://en.wikipedia.org/wiki/Life_expectancy


10/17

The Canad i an Pub l i c Hea l t h As s oc i a t i on ( CPHA) has i n t he pas t

r e s ponded t o r e s o l u t i ons f r om i t s pub l i c hea l t h / communi t y hea l t h nu r s i ng

member s r eques t i ng a r t i cu l a t i on and c l a r i f i ca t i on o f t he r o l e and

f unc t i ons o f nu r s es wor k i ng i n t he communi t y i n Canada . Thes e

r es o l u t i ons r e s u l t ed i n t he p r epa r a t i on o f t he document : A S ta t eme nt o f

F unc t i ons an d Qu a l i f i ca t i on s f or t he Pr ac t i c e o f Pub l i c He al th Nu rs ing i n

Canada i n 1966 and an upda t e o f t h i s document i n 1976 en t i t l ed The

N ur se and C ommuni t y H ea l th : Func t i ons an d Qua l i f i ca t i on s f or Pr a ct i ce

i n Canada .

I n1990 , CPHA r e l eas ed i t s popu l a r Communi t y Hea l t h ~ Pub l i c Hea l t h

N ur s ing in Ca na da: Pr epar a t i on & Pr ac t i ce , known as t he Gr een Book ,

and r ep r i n t ed i t e i gh t t i mes . I n t he yea r s s i nce t he 1990 ed i t i on ,

p ro f ess io n a l s f r om ac r o ss C an ad a ha ve wo rked h a r d t o d es c r i b e th e

p ra c t i ce o f pub l i c hea l t h / communi t y hea l t h nu r s i ng .

CPHA and Communi t y Hea l t h Nur s es o f Canada ( CHNC) wor ked c l os e l y

t oge t he r t o p r oduce t h i s upda t ed 2010 ve r s i on . I t i s i n t ended t o

compl emen t Canad i an Communi t y Hea l t h Nur s i ng S t andar ds o f Pr ac t i ce ,

Cor e Compe t enc i es f o r Pub l i c Hea l t h i n Canada Re l eas e and Pub l i c

He al th Nu rs i ng Disc i p l i ne Sp eci f i c C ompe t en ci es V ers i on .

Pub l i c hea l t h / communi t y hea l t h nu r s es con t r i bu t e i n many i mpor t an t

ways t o t he i mpr ovement o f peop l e s hea l t h i n t he communi t y . The y a r e

l eade r s o f changes t o s ys t ems i n s oc i e t y t ha t s uppor t hea l t h , and t hey p l ay

key r o l e s i n d i s eas e , d i s ab i l i t y , a nd i n j u r y p r even t i on , a s we l l a s i n h ea l t hp rom ot i on .

Defini t ions of Public Health/Community Health Nurse

A pub l i c hea l t h / communi t y hea l t h nu r s e has a bacc a l au r ea t e degr ee i n

nur s i ng and i s a member i n good s t and i ng o f a p r o f es s i ona l r egu l a t o r y

b o dy fo r r eg i s t e r ed nur ses .

The pub l i c hea l t h / communi t y hea l t h nu r s e :

C ombi nes knowl edge f r om pub l i c hea l t h s c i ence , p r i mar y hea l t h ca r e

( i nc l ud i ng t he de t e r mi nan t s o f hea l t h ) , nu r s i ng s c i ence , and t he s oc i a l

s c i ences .


11/17

Focus es on p r omot i ng , p r o t ec t i ng , and p r es e r v i ng t he hea l t h o f

p o pu l a t io ns .

l i nks t he hea l t h and i l l nes s expe r i ences o f i nd i v i dua l s , f ami l i e s , and

communi t i e s t o popu l a t i on hea l t h p r omot i on p r ac t i ce

Recogn i zes t ha t a c ommuni t y s hea l t h i s c l os e l y l i nked t o t he hea l t h o f

i t s member s and i s o f t en r e f l ec t ed f i r s t i n i nd i v i dua l and f ami l y hea l t h

expe r i ences .

Recogn i zes t ha t hea l t hy communi t i e s and s ys t ems t ha t s uppor t he a l t h

con t r i bu t e t o oppor t un i t i e s f o r hea l t h f o r i nd i v i dua l s , f am i l i e s , g r oups ,

and popu l a t i ons and

P r ac t i ces i n i nc r eas i ng l y d i ve r s e s e t t i ngs , s uch a s communi t y hea l t h

cen t r e s , s choo l s , s t r ee t c l i n i c s , you t h cen t r e s , and nur s i ng ou t pos t s , and

wi t h d i ve r s e pa r t ne r s , t o mee t t he hea l t h needs o f s pec i f i c popu l a t i ons .

The bas i s f o r pub l i c hea l t h / communi t y hea l t h nu r s i ng i nc l udes a w i de

r ange o f mode l s and t heor i e s , s uch a s :

P opu l a t i on hea l t h p r omot i on and p r i mar y hea l t h ca r e ( wher e t he f ocus i s

on p r omot i ng and ma i n t a i n i ng hea l t h ) ,

I l l nes s and i n j u r y p r even t i on ,

C ommuni t y pa r t i c i pa t i on , and

C ommuni t y deve l opmen t .

Roles of the Public Hea lth/Community Health Nurse

To f unc t i on i n t he i r r o l e s , pub l i c hea l t h / communi t y hea l t h nu r s es mus t

us e advanced dec i s i on - mak i ng s t r a t eg i e s s uch a s t he nu r s i ng p r oces s ,

wh i ch combi nes j udgment , ac t i on , r e s pons i b i l i t y , and accoun t ab i l i t y .

Pub l i c hea l t h / communi t y hea l t h nu r s es mus t t ake t he t i me t o i n f o r m

t hems e l ves abou t cu r r en t communi t y hea l t h i s s ues and new t echno l og i es ,

s o t hey can p r ope r l y app l y pub l i c hea l t h s c i ence a nd ep i demi o l og i ca l

p r i nc i p l es t o t he i r wo rk .


12/17

Thes e a r e t he a r eas i n wh i ch pub l i c hea l t h / communi t y hea l t h nu r s es p l ay

key r o l e s :

I . Role in Heal th Promot ion

Encour ages t he adop t i on o f hea l t h be l i e f s , a t t i t udes , and behav i our s t ha tcon t r i bu t e t o t he ove r a l l hea l t h o f t he popu l a t i on t h r ough pub l i c po l i cy ,

communi t y - bas ed ac t i on , pub l i c pa r t i c i pa t i on , and advocacy o r ac t i on on

env i r onmen t a l and s oc i o - economi c de t e r mi nan t s o f hea l t h , a s we l l a s

hea l t h i nequ i t i e s .

Suppor t s pub l i c po l i cy changes t o modi f y phys i ca l and s oc i a l

env i r onmen t s t ha t con t r i bu t e t o r i s k .

As s i s t s communi t i e s , f ami l i e s , and i nd i v i d ua l s t o t ake r e s pons i b i l i t y f o r

e s t ab l i s h i ng , ma i n t a i n i ng , and / o r i mpr ov i ng t he i r hea l t h by add i ng t o

t he i r knowl edge o r con t r o l ove r ( and ab i l i t y t o i n f l uence ) hea l t h

de t e r mi nan t s .

Wor ks wi t h o t he r s and l eads p r oces s es t o enhance communi t y , g r oup , o r

i nd i v i dua l p l ans t ha t w i l l he l p s oc i e t y t o p l an f o r , cope wi t h , and manage

change .

Encour ages s k i l l bu i l d i ng by communi t i e s , f a mi l i e s , and i nd i v i dua l s s o

t hey can l ea r n t o ba l ance cho i ces w i t h s oc i a l r e s pons i b i l i t y and , i n t u r n ,

c r ea t e a hea l t h i e r f u t u r e f o r a l l .

I n i t i a t e s and pa r t i c i pa t e s i n hea l t h p r omot i o n ac t i v i t i e s i n pa r t ne r s h i p

wi t h o t he r s s uch a s t he communi t y and co l l eagues i n o t he r s ec t o r s .

I I . Ro l e i n D i s eas e and I n j u r y P r even t i on

Reduces t he r i s k o f i n f ec t i ous d i s eas e ou t b r eaks ; t h i s i nc l udes ea r l y

i den t i f i ca t i on , i nves t i ga t i on , con t ac t t r ac i ng , p r even t i ve meas ur es , and

ac t i v i t i e s t o p r omot e s a f e behav i our s .

App l i e s ep i demi o l og i ca l p r i nc i p l e s and knowl edge o f t he d i s eas e p r oces s

s o a s t o manage and con t r o l communi cab l e d i s eas es us i ng p r even t i ont echn i ques , i n f ec t i on con t r o l , behav i our change couns e l i ng , ou t b r eak

managemen t , s u r ve i l l ance , i mmuni za t i on , ep i s od i c ca r e , hea l t h educa t i on ,

and cas e managemen t .

Us es appr opr i a t e t echno l og y f o r r epor t i ng and f o l l ow- up .


13/17

Us es e f f ec t i ve s t r a t eg i es t o r educe r i s k f ac t o r s t ha t may con t r i bu t e t o

chr on i c d i s eas e and d i s ab i l i t y ; t h i s may i nc l ude ch anges t o s oc i a l and

economi c env i r onmen t s and i nequ i t i e s t ha t i nc r eas e t he r i s k o f d i s eas e .

He l ps i nd i v i dua l s and f ami l i e s t o adop t hea l t h behav i our s t ha t r educe

t he l i ke l i hood o f d i s eas e , i n j u r y , and / o r d i s ab i l i t y .

Encour ages behav i our changes t o i mpr ove hea l t h ou t comes .

I I I . Role in Heal th Protec t ion

Ac t s i n pa r t ne r s h i p wi t h pub l i c hea l t h co l l eagues , gove r nmen t , and o t he r

agenc i e s t o :

ens ur e s a f e wa t e r , a i r , and f ood ,

con t r o l i n f ec t i ous d i s eas es , and

pr ov i de p r o t ec t i on f r om env i r onmen t a l t h r ea t s ( i nc l ud i ng de l ega t i ng o r

ca r r y i ng ou t de l ega t ed r egu l a t o r y f unc t i ons ) .

Takes t he l ead i n i den t i f y i ng i s s ues t ha t may need a t t e n t i on and o f f e r s

p u bl i c h ea l t h a dv ice to g rou ps su ch a s mu n i c i pa l go v e rnm en ts o r r eg i on al

d i s t r i c t s abou t t he pub l i c hea l t h i mpac t o f po l i c i e s and r egu l a t i ons .

Wor ks wi t h i nd i v i dua l s , f ami l i e s , and comm un i t i e s t o c r ea t e o r ma i n t a i n

a s a f e env i r onmen t wher e peop l e may l i ve , wor k , and p l ay .

IV . Role in Heal th Survei l lance

I s awar e o f hea l t h s u r ve i l l ance da t a and t r ends ; app l i e s t h i s knowl edge

t o day- t o - day wor k .

I n t eg r a t e s eco - s oc i a l s u r ve i l l ance t ha t f ocus es on b r oad , mul t i - l eve l

cond i t i ons t ha t con t r i bu t e t o hea l t h i nequa l i t i e s .

Mobi l i zes f o r ma l and / o r i n f o r mal ne t wor ks t o s ys t ema t i ca l l y and

r ou t i ne l y co l l ec t and r epor t hea l t h da t a f o r t r ack i ng and f o r ecas t i ng hea l t h

even t s o r hea l t h de t e r mi nan t s .

Co l l ec t s and s t o r es da t a w i t h i n conf i den t i a l da t a s ys t ems ; i n t eg r a t e s ,

ana l yzes , and i n t e r p r e t s t h i s da t a .

P r ov i des exper t i s e t o t hos e who deve l op and / o r con t r i bu t e t o

s u r ve i l l ance s ys t ems , i nc l ud i ng r i s k s u r ve i l l ance .


14/17

V. Role in Popula t ion Heal th Assessment

Us es hea l t h s ur ve i l l ance da t a t o l aunch new s e r v i ces o r r ev i s e t hos e t ha t

ex i s t .

Con t r i bu t es t o popu l a t i on hea l t h a s s es s men t s and i nc l udes communi t y v i ewpo i n t s .

P l ays a key r o l e i n p r oduc i ng and us i n g knowl edge abou t t he hea l t h o f

communi t i e s ( o r ce r t a i n popu l a t i ons o r a ggr ega t e s ) and t he f ac t o r s t ha t

s uppor t good hea l t h o r pos e p o t en t i a l r i s ks ( de t e r mi nan t s o f hea l t h ) , t o

p rod uc e be t t e r po l i c i es an d s e rv i ces .

VI . Ro l e i n Emer gency Pr epa r ednes s and Res pons e

Con t r i bu t es t o and i s awar e o f pub l i c hea l t h s r o l e i n r e s pond i ng t o a

p u bl i c h ea l t h e mergen c y.

P l ans f o r , i s pa r t o f , and eva l ua t es t he r e s pons e t o bo t h na t u r a l d i s as t e r s

( s uch a s f l oods , ea r t hquakes , f i r e s , o r i n f ec t i ous d i s eas e ou t b r eaks ) and

man- made d i s as t e r s ( s uch a s t hos e i nvo l v i ng exp l os i ves , chemi ca l s ,

r ad i oac t i ve s ubs t ances , o r b i o l og i ca l t h r ea t s ) t o mi n i mi ze s e r i ous i l l nes s ,

dea t h , and s oc i a l d i s r up t i on .

Communi ca t e s de t a i l s o f r i s k t o popu l a t i on s ubgr oups a t h i ghe r r i s k and

i n t e r venes on t he i r beha l f du r i ng pub l i c hea l t h emer genc i e s us i ng a

va r i e t y o f communi ca t i on channe l s and engagemen t t echn i ques .

Activi t ies of the Public Health/ Community Health Nurse

1 . Advocacy

Hel ps i nd i v i dua l s , f ami l i e s , and g r oups become awar e o f i s s ues t ha tmay i mpac t on t he i r hea l t h ; t he f ocus may be on t hos e who a r e

d i s advan t aged due t o s oc i oeconomi c s t a t us , age , i s o l a t i on , cu l t u r e ,l ack o f knowl edge , e t c .

Wor ks t o deve l op c l i en t s capac i t y t o s peak f o r t hems e l ves .

Us es adve r t i s i ng and med i a i n s k i l f u l ways , f o r advocacy .

Pr omot es r e s our ce deve l opmen t t ha t w i l l l ead t o equa l acces s t ohea l t h and hea l t h - r e l a t ed s e r v i ces .


15/17

1 . Bui l d i ng Capac i t y

Encour ages and s uppor t s t he communi t y t o be ac t i ve i n s t a t i ng and

t ak i ng owner s h i p o f hea l t h i s s ues t ha t need t o be r e s o l ved .

Educa t e s communi t y member s abou t t he po l i t i ca l p r oces s a s i t

r e l a t e s t o communi t y hea l t h i s s ues and abou t how t hey can become

ac t i ve i n dec i s i ons abou t hea l t h i s s ues .

Hel ps t he communi t y ( and i t s member s ) be t t e r unde r s t and t ha t t he i r

own ab i l i t i e s may be t he i r bes t hea l t h r e s our ce .

Us es g r oup p r oces s and l eade r s h i p s k i l l s .

2 . Car e and Couns e l i ng

Es t ab l i s hes a t he r apeu t i c r e l a t i ons h i p bas ed on t r us t , r e s pec t ,ca r i ng , and l i s t en i ng .

Us es c l i n i ca l s k i l l s t o a s s es s t he c l i en t s ab i l i t y t o pa r t i c i pa t e i n

j o i n t p l a nni n g , impl eme n t a t i on , an d eva l u a t i on o f nu rs i ng

i n t e r ven t i ons .

Us es hea l t h p r omot i on , i l l nes s , and i n j u r y p r even t i on t echn i ques

t ha t a r e c l i en t - cen t e r ed , c l i en t - d r i ven , and s t r eng t hs - bas ed .

3 . Cas e Managemen t

Act i ve l y engages w i t h i nd i v i dua l s , g r oups , and communi t i e s ; t h i s

may i nvo l ve cas e - f i nd i ng , a p r o ces s o f i den t i f y i ng i nd i v i dua l s

and / o r f ami l i e s who may be a t r i s k and who mee t t he agency s

c r i t e r i a f o r cas e managemen t .

As s es s es t he r e s our ces and s e r v i ces t ha t w i l l be needed t o bu i l d on

t he c l i en t s s t r eng t hs and s k i l l s and t hus he l p t he c l i en t t o a t t a i n

and / o r ma i n t a i n a des i r ed hea l t h s t a t us o r s e t o f hea l t hy beh av i our s

f o r i mpr oved qua l i t y o f l i f e .

Bui l ds t r us t i ng r e l a t i ons h i ps and wor ks w i t h c l i en t s t o i den t i f y and

r es o l ve hea l t h i s s ues .

4 . Communi ca t i on

Us es o r a l and wr i t t en s k i l l s , a l ong wi t h v i s ua l , p r i n t , and o t he r

med i a t o : bu i l d t r us t i ng , he l p i ng r e l a t i ons h i ps , convey hea l t h

i n f o r ma t i on , i nc l ud i ng de t a i l s on r i s k .


16/17

Nego t i a t e s o r co n t rac t s wi t h h ea l t h ca re , s oc i a l s e rv i ce s , o r r e sou rc e

agenc i e s , and a l l s egmen t s o f t he communi t y , t o ens u r e c l i en t s have

acces s t o s e r v i ces .

Us es e f f ec t i ve communi ca t i on wi t h t eam member s .

Ef f ec t i ve l y addr es s es and manages conf l i c t .

5 . Communi t y Deve l opmen t

Appl i e s knowl edge o f communi t y a s s es s men t and communi t y

deve l opmen t mode l s t o s uppor t p ub l i c pa r t i c i pa t i on i n i den t i f y i ng

and r e s o l v i ng hea l t h i s s ues .

W or ks wi t h t he communi t y t o make dec i s i ons abou t , and c l a i m

owner s h i p o f , changes needed t o enhance communi t y hea l t h .

I n deve l op i ng p r ogr ams , us es awar enes s o f f ac t o r s wh i ch i mpac t on

or a f f ec t hea l t h s uch a s s oc i a l , cu l t u r a l , and economi c i s s ues , a swe l l a s env i r onmen t a l haza r ds .

6 . Hea l t h Thr ea t Res pons e

Suppor t s ea r l y i den t i f i ca t i on o f a hea l t h t h r ea t by ga t he r i ng da t a

f r om many s our ces a t t he s ame t i me . ( t o unde r s t and t he caus e ,

na t u r a l cour s e , and expec t ed ou t comes o f t he d i s eas e o r hea l t h

t h r ea t ) .

Pub l i c hea l t h compe t enc i e s and communi t y hea l t h nu r s i ng

S t anda r ds : -

Compe t enc i e s

Pub l i c Hea l t h and Nur s i ng Sc i ences

As s es s men t and Ana l ys i s

Pol i cy and Pr ogr am P l ann i ng , I mpl emen t a t i on , and Ev a l ua t i on Par t ne r s h i ps , Co l l abor a t i on , and Advocacy

Di ver s i t y and I nc l us i venes s

Communi ca t i on

Leader s h i p


17/17

Bot h a Compe t ency and a S t anda r d

P r o f es s i ona l r e s pons i b i l i t y and accoun t ab i l i t y

S t anda r ds

Pr omot i ng hea l t h

Bui l d i ng i nd i v i dua l and communi t y capac i t y

Bui l d i ng r e l a t i ons h i ps

Fac i l i t a t i ng acces s and equ i t y

Conclusion

Canad i an pub l i c hea l t h / communi t y hea l t h nu r s es mus t con t i nue t o exe r c i s e

con t r o l ove r t he i r p r ac t i ce . Two ways t o ens u r e t h i s happens a r e :

To r ema i n awar e o f t he evo l v i ng na t u r e o f communi t y hea l t h needs ,

and

To make s u r e nu r s es a r e we l l p r epa r ed t o r e s pond t o t hos e needs .

Peop l e wor k i ng i n t he f i e l d have a r e s pons i b i l i t y t o s peak ou t andadvoca t e f o r pub l i c hea l t h / communi t y hea l t h nu r s i ng . I t i s an a r ea o f

nu r s i ng p r ac t i ce t ha t makes a un i que con t r i bu t i on a l ong t he con t i nuum of

ca r e . Pub l i c hea l t h / communi t y hea l t h nu r s es mus t be v i s i ona r i e s ; t hey

ho l d t he key t o un l ock i ng t he i r own enhanced p r ac t i ce and s t a t us i n t he

21s t cen t u r y .

Date post:	14-Apr-2018
Category:	Documents
Upload:	snehaoct
View:	216 times
Download:	0 times

Health Practices of Canada

Documents