IssuesHealth Care

Health Care

First Published: Oct 04, 2019
Last Updated: Oct 04, 2019
Monitored by: Naomi Shuman

Background

Public health care has evolved into a defining Canadian value, while at the same time health care costs have been increasing at an unsustainable rate. Canada’s publicly funded health care system covers medically necessary hospital and physician services. Coverage has not kept pace with changes in technology and changes in the way health care is provided.

It is  accurate to portray the system as 13 provincial and territorial health care insurance plans instead of as a single national plan. Provincial or territorial governments are responsible for provision of health care services including management, organization and delivery to the majority of their residents. The federal government is responsible for delivering care to a few specific populations like First Nations people living on reserves and inmates in federal penitentiaries. The different plans must meet the standards (public administration, comprehensiveness, universality, portability and accessibility) set by the federal government and described in the Canada Health Act to get payment from the federal government through the Canada Health Transfer. The actual care that is available and publicly funded differs depending on where you live.

The federal government is responsible for the regulation of products including food, pharmaceuticals and medical devices. In addition, the federal government supports health promotion and protection, disease monitoring and prevention and health research.

Health care in Canada has experienced a doubling of the Canada Health Transfers to the provinces, from $20 billion (2006) to $40 billion (2019-20) and continues to face Canada’s aging population. This total represents only a small portion of overall public expenditures in health care, with the majority of the funding coming from provincial taxes.  In many provinces, healthcare costs are approaching 50% of their total expenditures.

Note: Access to prescription drugs is discussed in a separate issue brief on Pharmacare.

Current Status

Recent Liberal Government budgets have contained additional funding to address a number of large issues facing the Canadian health care system including mental health, home care, dementia, organ donation, suicide prevention and the opioid crisis. In Budget 2017, the federal government committed $11 billion over 10 years to provincial and territorial governments to support home care and mental health. Budget 2018 announced an investment of $20 million over five years to support programs for people living with dementia. In June 2019, the federal government released Canada’s first national dementia strategy and Budget 2019 included $50 million over five years to support implementation of the strategy. Budget 2019 included $36.5 million over five years to develop a Pan-Canadian Database for Organ Donation and Transplantation. The federal government committed over $350 million in funding since 2017 to address the opioid crisis in Canada. Budget 2018 provided a $150 million Emergency Treatment Fund to respond to the crisis. Budget 2019 contained further funding of $30.5 million over 5 years to address gaps in harm reduction and treatment. Budget 2019 contained $25 million over five years to support a Pan-Canadian Suicide Prevention Service.

In addition, Budget 2019 contained funding to implement improvements for health services for First Nations children. It also included health-related tax relief and health regulation modernization.

Liberal

In advance of additional measures that could be announced in a Liberal Party platform, the Liberal position is reflected in the announcements and priorities already stated over the last several years.

Conservatives

A Conservative government will deliver a comprehensive, recovery-oriented plan to tackle the addictions crisis. Further commitments specific to healthcare are expected as Mr. Scheer continues to roll out his major policy planks through a series of major speeches across the country.

NDP

The NDP announced a promise of free dental care for household earning less than $70,000 starting next year. Dental care would also be provided with a sliding co-payment for those earning between $70,000 and $90,000. The initial plan would cover 4.3 million Canadians. The party estimates a family of four (if the household makes $70,000 or less) would save roughly $1,240. This program has been costed by the Parliamentary Budget Office an is estimated to cost nearly $1.9 billion for 2020-2021 with costs dropping to $824 million in 2021-2022 and remains relatively stable at $856 million by 2028-2029. The high cost in the first year of the program is caused by the assumption that untreated oral diseases that occurred prior to 2020 would be treated in the first year.

The NDP has publicly stated it will uphold and enforce the Canada Health Act and reinvest in the health system to help Canadians get the care they need to live healthy lives. It will protect against privatization and user fees and work with the provinces and territories to address wait times and improve access to primary car. It will expand services covered by the national health care system to include dental care in the Canada Health Act, mental health care, eye care, hearing care and infertility procedures and care. It will establish a national suicide prevention action plan. It will declare a national public health emergency for the opioid crisis, launch an investigation into the role of drug companies may have had in feeding the opioid crisis and determine whether criminal charges or civil action is warranted. It will work in collaboration with others to develop national care standards for home and long-term care and make necessary changes to the Canada Health Act. It will make seniors health care a priority, including a funded national dementia strategy. It will act immediately to prevent the sale of blood products and to make sure that safe abortion services are accessible in all regions of the country. It will create a health human resources plan to recruit and retain health professionals in regions of the country that have gaps in providers. And it will create stand-alone legislation to regulate natural health products.

Green Party

A Green government will restore federal/provincial Health Accord formula to a formula based on demographics and real health care needs. It will negotiate the Canada Health Accord to prioritize the expansion of mental health and rehabilitation services, reduction in wait times, access to safe abortion services and access to gender-affirming health services. It will also improve health care for Indigenous Peoples.

It will advocate to establish a national health strategy and a suicide prevention strategy. It will address the opioid crisis as a health-care issue by declaring it a national health emergency and decriminalize drug possessions.

The Green party will establish a dementia strategy and amend the Medical Assistance in Dying legislation to allow advanced directives and the right to create a “living will” that gives individuals the power to limit or refuse medical intervention and treatment.

The Green Party is committed to the principles of universal primary health care model and opposes privatization. It supports expanding the Canada Health Act to include universal pharmacare and dental care for low-income Canadians. It will create a bulk drug buying agency and reduce drug patent protection period.

A Green government will develop national health care guidelines that incentivize active lifestyles, health diets and choices. It will expand public health services to include basic dental care and fund non-institutionalized, community-based support for addiction prevention and rehabilitation programs. In addition, it will create a national drug reduction strategy, develop more safe injection sites and treat drug addiction as a public health issue.

People's Party

The People’s Party of Canada suggests that health care is an exclusive jurisdiction of the provinces and that a clearer more distinct approach on responsibility is needed to create health systems that are more efficient and less costly. To that end, a People’s Party government will replace the Canada Health Transfer cash payments to the provinces and territories with a permanent transfer of tax points (the Goods and Services Tax) to give a stable source of revenue. It will establish a temporary program to compensate poorer provinces whose revenues from tax will be lower than the transfer payments they are accustomed to receiving. This new approach will make provincial and territorial governments fully responsible for health care funding and management, accountable to their citizens. It will also create an environment that would force provincial and territorial governments to innovate.

Bloc Quebecois

October 4, 2019
Naomi Shuman

A Liberal government will make sure that all Canadians have access to a family doctor or primary health care team, as well as mental health services. It will end the blood donation ban on men who have sex with men.

Will co-develop distinctions-based Indigenous Health legislation to ensure that Indigenous Peoples have access to high-quality, culturally relevant health care and mental health services.

The Liberal government has made a number of commitments related to research. It will increase the investment in pediatric cancer research by $30 million next year. It will work with Canadian Institutes of Health Research to integrate sex and gender-based analyses, as well as diversity analyses. It will create a National Institute for Women’s Health Research to tackle gaps in research and care.

September 13, 2019
Naomi Shuman

Singh made a commitment to build a new hospital in the City of Brampton. Hospitals are provincial jurisdiction which Singh acknowledged, so it is unclear how this would work.

The NDP provided a figure for its healthcare promises. It would invest $10 billion to tackle wait times, expand access to care and deliver universal pharmacare.

September 23, 2019
Naomi Shuman

The Liberals announced Monday a commitment of $6B over four years as “down payment” to improve the health system, including improving access to family doctors and mental health services, expanding home care and reducing the cost of prescription drugs. The money committed would act as a “down payment” to launch negotiations with the provinces on pharmacare. The announcement promises a rare-disease drug strategy and to negotiate a national pharmacare program with the provinces. Trudeau did not provide details on the plans for a universal pharmacare system or costing but indicated the system would be based on the report “A Prescription for Canada: Achieving Pharmacare for All,” provided by an advisory council appointed by the Liberal government. The press release indicated that the promises would cost $750 million in 2020-21, rising to $1.75 billion in 2023-24.

September 23, 2019
Naomi Shuman

A Conservative government has committed to invest $1.5 billion to replace and update MRI and CT machines in the next four years. The money would help reduce wait times by funding more equipment to meet the growing demands for these tests.

On Saturday, Green Party Leader Elizabeth May said that if elected in October, her party would decriminalize all drug possession, saying it’s a necessary step to curb Canada’s opioid crisis, which has hit particularly hard in B.C. She also said it's possible her government would reverse that position if the drug crisis subsides in the future.

September 20, 2019

On September 18th, NDP Leader Jagmeet Singh said a federal government led by him would implement the proposal in 2020 as a first step toward universal dental care. A co-payment formula would apply to households with incomes between $70,000 and $90,000.

September 18, 2019
Naomi Shuman

NDP leader Jagmeet Singh has promised to help build a medical faculty at UPEI in partnership with the province. Adding a medical faculty to UPEI would help P.E.I.’s health-care services. P.E.I. is facing a nurse shortage and a number of doctors are considering retirement in the next five years making maintaining services on the Island difficult.

September 18, 2019
Naomi Shuman

The NDP announced a promise of free dental care for household earning less than $70,000 starting next year. Dental care would also be provided with a sliding co-payment for those earning between $70,000 and $90,000. The initial plan would cover 4.3 million Canadians. The party estimates a family of four (if the household makes $70,000 or less) would save roughly $1,240. This program has been costed by the Parliamentary Budget Office an is estimated to cost nearly $1.9 billion for 2020-2021 with costs dropping to $824 million in 2021-2022 and remains relatively stable at $856 million by 2028-2029. The high cost in the first year of the program is caused by the assumption that untreated oral diseases that occurred prior to 2020 would be treated in the first year.

September 18, 2019
Naomi Shuman

A Green government will restore federal/provincial Health Accord formula to a formula based on demographics and real health care needs. It will negotiate the Canada Health Accord to prioritize the expansion of mental health and rehabilitation services, reduction in wait times, access to safe abortion services and access to gender-affirming health services. It will also improve health care for Indigenous Peoples.

It will advocate to establish a national health strategy and a suicide prevention strategy. It will address the opioid crisis as a health-care issue by declaring it a national health emergency and decriminalize drug possessions.

The Green party will establish a dementia strategy and amend the Medical Assistance in Dying legislation to allow advanced directives and the right to create a “living will” that gives individuals the power to limit or refuse medical intervention and treatment.

September 18, 2019
Naomi Shuman

The Green Party is committed to the principles of universal primary health care model and opposes privatization. It supports expanding the Canada Health Act to include universal pharmacare and dental care for low-income Canadians. It will create a bulk drug buying agency and reduce drug patent protection period.

September 18, 2019
Naomi Shuman

The pharmaceutical industry has filed two legal challenges against the Trudeau government’s efforts to reduce the cost of prescription drugs by altering the Patented Medicine Prices Review Board (PMPRB). The first legal challenge, a constitutional challenge, was filed in Quebec in late August by five drug companies, including Merck Canada Inc., Janssen Inc. and Boehringer Ingelheim Canada Ltd. The companies argue that the federal government does not have constitutional authority to regulate the prices of medicines or manage heath care systems; these issues are within provincial jurisdiction. The second legal challenge, an application for judicial review, was brought by Innovative Medicines Canada (IMC), the industry group for makers of brand-name drugs and the Canadian branches of 16 pharmaceutical companies. The case contends that the federal government overreached when it used regulatory amendments to fundamentally alter the purpose of the review board instead of changing the Patent Act, the legislation that gives the agency its powers. IMC has said that the industry group has filed this legal challenge because the regulations will have a significant impact on patient access to medicines and on the life sciences sector. Health Minister Ginette Petitpas Taylor has not commented on these two challenges because the matter is before the courts.

August 26, 2019
Naomi Shuman

Minister of Health Ginette Petitpas announced an investment of more than $7.7 million over eight years for the National Collaborating Centre for the Determinants of Health (NCCDH) to support research and evidence-based knowledge exchange to improve health equity for Canadians. This funding ensures that the Centre, located at St. Francis Xavier University, will have stable funding over the next eight years and will enable advancements in research on the social determinants of health.

August 23, 2019
Naomi Shuman

The Honourable Ginette Petitpas Taylor, Minister of Health announced that the Government of Canada, through the Canadian Institutes of Health Research (CIHR), is making an investment of $1.4M to create and develop a national research network, headquartered at Sainte-Justine Hospital Research Centre in Montreal, to improve the quality of life of people living with myalgic encephalomyelitis, formerly known as chronic fatigue syndrome.

August 20, 2019
Naomi Shuman

Pam Damoff, Parliamentary Secretary to the Minister of Health, announced $3M in support for autism programs across the country. The six federally funded community-based projects address a broad range of issues, from mental health to sexuality to employment. They will support Canadians living with Autism Spectrum Disorder, their caregivers and family. The funding is not new money, it is part of the $20 million autism fund budgeted in 2018. The federal government does not have a national autism strategy but is working on the “pillars” of such a plan. It is not in a position to deliver services for people living with autism, which is a provincial job.

August 9, 2019
Naomi Shuman

The federal government announced final amendments to the Patented Medicines Regulation, which will modernize the Patented Medicine Prices Review Board and change the way new drug prices are evaluated. In the Advisory Council on the Implementation of National Pharmacare’s final report, they deemed strengthening the Patent Medicines Regulations to lower drug prices as essential and as a move towards National Pharmacare. These changes will come into affect in July 2020 and will protect Canadians from excessive prices.

The amendments will:

  • Change the “basket” of countries we compare ourselves to when setting drug prices. The Board will no longer compare prices with the United States and Switzerland which have the highest drug prices in the world.
  • Consider whether the drug price reflects the value to patients.
  • Consider a medication’s true market price when setting a price ceiling.
August 8, 2019
Naomi Shuman

The NDP are pressuring the Trudeau government to disclose how they are planning to ensure that Canadians can continue to access needed medication after Trump’s decision to allow importing prescription drugs from Canada into the United States.

August 1, 2019
Naomi Shuman

The Trump administration reversed decisions by previous administrations and announced that it will create a system to allow Americans to legally import prescription drugs from Canada. Prescription drugs in Canada often have lower prices because the government plays a role in setting prices of generic and brand-name medication. It is unclear what impact this will have on the Canadian drug supply, which has experienced an increasing number of shortages in recent years. There is concern that Canadian suppliers will have capacity issues in meeting the demands of Canada and the much larger U.S. market. Recently, 15 organizations representing patients, health professionals, hospitals and pharmacists warned the Minister of Health that there would be potential for increased drug shortages if the Canadian medicine supply tries to support both Canadian and U.S. consumers. Health Minister Ginette Pepitas Taylor made a statement in response to the U.S. announcement and said, "(We) will be working closely with health experts to better understand the implications for Canadians and will ensure there are no adverse effects on the supply or cost of prescription drugs in Canada.”

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