The purpose of the Canada Health Act (CHA) "is to protect, promote and restore the physical and mental well-being of residents of Canada and to facilitate reasonable access to health services without financial or other barriers" (Government of Canada, 1985). This is implemented through the criteria to include public administration, comprehensiveness, universality, portability and accessibility for all Canadians. While this sounds all well and good, there are definitely some changes that could be made to our system.
Firstly, government funding is limited to those services and accesses that are deemed to be medically necessary. These services are excluding many "vital goods and services such as outpatient pharmaceuticals, dental care, long-term care, and many mental health services" (Flood et al., 2016). The concept of "medically necessary" also varies provincially. While some goods and services are approved for government funding in one province, does not mean they are funded in another. Personally, I deal with this issue very often in my practice. In my province, continuous positive airway pressure (CPAP) and bilevel positive airway pressure (BiPAP) devices are not funded through Medicare. So then, one would think that these devices are not considered medically necessary and are not funded as per the CHA. Wrong. These devices are funded in other provinces, such as Ontario and Alberta. So why then is a treatment considered medically necessary in one province but not another? Does that not speak to lack of universality as per the CHA? Improving universality of coverage between provinces is going to help improve continuity of care for patients moving around the country but also provide all Canadians with the same access to services no matter what province they reside.
Who deems certain treatments to be medically necessary anyway? Why is a treatment that can reduce the risk of hypertension, diabetes, heart attack, stroke, depression, etc., not considered medically necessary? The symptoms that come along with untreated sleep apnea can have detrimental effects such as falling asleep at the wheel. The thought that we could be preventing these diseases from occurring or reducing the severity instead of letting them come to light and having to treat them makes sense doesn't it? So then, next, we reevaluate what treatments and services are considered medically necessary.
While there are many ways to improve, to me, implementing universal coverage to all the same goods and services across all provinces and territories and reevaluating what goods and services are deemed to be medically necessary are where we need to start. Canadians are suffering because of these flaws in our system and it is time for change.
Resources
Canada Health Act, c. C-6, (1985). https://laws-lois.justice.gc.ca/eng/acts/c-6/page-1.html#docCont
Flood, C. M., & Thomas, B. (2016). Modernizing the Canada Health Act. Dalhousie Law Journal, 397. https://www.canlii.org/en/commentary/doc/2016CanLIIDocs4119#!fragment/zoupio-_Tocpdf_bk_1/BQCwhgziBcwMYgK4DsDWszIQewE4BUBTADwBdoAvbRABwEtsBaAfX2zhoBMAzZgI1TMAjAEoANMmylCEAIqJCuAJ7QA5KrERCYXAnmKV6zdt0gAynlIAhFQCUAogBl7ANQCCAOQDC9saTB80KTsIiJAA
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