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Time is dangerously running out for Canada’s unhealthy, uncaring health-care system

10 5 219
31.01.2019

This May Hurt a Bit: Reinventing Canada’s Health Care System, a new book from Ontario political consultant Stephen Skyvington, will be released on Feb. 2nd. The following excerpt looks at how politicians have used and misused the Canada Health Act in ways that makes the system less caring — and Canadians less healthy. It has been edited for space.

Should any province decide not to comply, something that has happened from time to time over the past three-decades-plus since the act became the law of the land, the federal government had the right to withhold all or part of a transfer payment, depending upon how egregious the offence. For instance, Section 20 states quite clearly that should a province violate the prohibition on extra-billing or user fees, an amount equal to that collected would be deducted, dollar for dollar, from that province’s transfer payment.

In 1993, the federal government reduced British Columbia’s transfer payments by more than $2 million after it was discovered the province had allowed roughly 40 doctors to extra-bill patients over a four-year period. Three years later, it was Alberta’s turn. The province had its transfer payments reduced by more than $3 million because it turned a blind eye when private clinics started charging patients user fees. Newfoundland and Manitoba also suffered government clawbacks during the late 1990s, for much the same reason as Alberta. Nova Scotia was similarly dinged for allowing user fees in private clinics. It’s important to note, though, that to date all issues regarding non-compliance have been, for the most part, settled through negotiation or discussions between ministers.

Those are some of the conditions and administrative details. Let’s take a closer look at the five principles of the Canada Health Act:

Public Administration

Section 8 of the act says that in order to be eligible for health-transfer payments from the federal government, all provincial health plans must be administered and operated on a non-profit basis by a public authority appointed or designated by the government of the province; the public authority must be responsible to the provincial government for that administration and operation; and the public authority must be subject to audit of its accounts and financial transactions by such authority as is charged by law with the audit of the accounts of the province. Again, it’s important to note that we’re talking here about the funding of health care, not the delivery of services. Nowhere does it say that health-care services can’t be privately delivered, or even, I would argue, privately funded.

Comprehensiveness

Section 9 says that provincial plans must cover all insured health........

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