The Canada Health Act established universal access to health care in Canada, it is 14 pages long..

[Fumesucker]

It's also in both English and French so in reality the Act is only 7 pages.

Here is a link to the entire legislation (PDF):

http://laws.justice.gc.ca/PDF/Statute/C/C-6.pdf

And the HTML version (English only):

http://laws.justice.gc.ca/en/C-6/FullText.html

Now why does the USA need 1000+ pages of legislation to "reform" health care?

Edited for speling..

[Pavlovs DiOgie]

1. I would say mostly because

That act for the most part just punted it to the individual provinces to deal with as they wished to. Theres no reason we couldnt do the same but is that really what you want to see happen?

[Fumesucker]

2. That's not quite how I read it..

3. It is hereby declared that the primary objective of Canadian health care policy 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.

1984, c. 6, s. 3.
PURPOSE

Purpose of this Act
4. The purpose of this Act is to establish criteria and conditions in respect of insured health services and extended health care services provided under provincial law that must be met before a full cash contribution may be made.

R.S., 1985, c. C-6, s. 4; 1995, c. 17, s. 35.
CASH CONTRIBUTION

Cash contribution
5. Subject to this Act, as part of the Canada Health and Social Transfer, a full cash contribution is payable by Canada to each province for each fiscal year.

[elleng]

3. Without knowing more,

it does appear that they 'punted' to provinces, and said Canada would pay each province in full. Pay what, tho, is not clear from this.

And they don't have 50 provinces!

[Canuckistanian]

6. It's actually both

The federal government does "tranfer payments" to each province to compensate for heatlh care and other expenses.

But the provinces themselves also pay for and administer their own their own systems.

I'm not sure what the ratio is, but there's a formula for determining the amout of transfer payments to the provinces.

The "rich" provinces like Ontario and Alberta get less transfer payment, while "poorer" provinces like Newfoundland-Labrador get more.

[Pavlovs DiOgie]

4. I suggest more reading

[Fumesucker]

5. OK..

7. In order that a province may qualify for a full cash contribution referred to in section 5 for a fiscal year, the health care insurance plan of the province must, throughout the fiscal year, satisfy the criteria described in sections 8 to 12 respecting the following matters:
(a) public administration;
(b) comprehensiveness;
(c) universality;
(d) portability; and
(e) accessibility.

1984, c. 6, s. 7.

Public administration
8. (1) In order to satisfy the criterion respecting public administration,
(a) the health care insurance plan of a province must be administered and operated on a non-profit basis by a public authority appointed or designated by the government of the province;
(b) the public authority must be responsible to the provincial government for that administration and operation; and
(c) 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.

Designation of agency permitted

(2) The criterion respecting public administration is not contravened by reason only that the public authority referred to in subsection (1) has the power to designate any agency
(a) to receive on its behalf any amounts payable under the provincial health care insurance plan; or
(b) to carry out on its behalf any responsibility in connection with the receipt or payment of accounts rendered for insured health services, if it is a condition of the designation that all those accounts are subject to assessment and approval by the public authority and that the public authority shall determine the amounts to be paid in respect thereof.

1984, c. 6, s. 8.

Comprehensiveness
9. In order to satisfy the criterion respecting comprehensiveness, the health care insurance plan of a province must insure all insured health services provided by hospitals, medical practitioners or dentists, and where the law of the province so permits, similar or additional services rendered by other health care practitioners.

1984, c. 6, s. 9.

Universality
10. In order to satisfy the criterion respecting universality, the health care insurance plan of a province must entitle one hundred per cent of the insured persons of the province to the insured health services provided for by the plan on uniform terms and conditions.

1984, c. 6, s. 10.

Portability
11. (1) In order to satisfy the criterion respecting portability, the health care insurance plan of a province
(a) must not impose any minimum period of residence in the province, or waiting period, in excess of three months before residents of the province are eligible for or entitled to insured health services;
(b) must provide for and be administered and operated so as to provide for the payment of amounts for the cost of insured health services provided to insured persons while temporarily absent from the province on the basis that

(i) where the insured health services are provided in Canada, payment for health services is at the rate that is approved by the health care insurance plan of the province in which the services are provided, unless the provinces concerned agree to apportion the cost between them in a different manner, or

(ii) where the insured health services are provided out of Canada, payment is made on the basis of the amount that would have been paid by the province for similar services rendered in the province, with due regard, in the case of hospital services, to the size of the hospital, standards of service and other relevant factors; and
(c) must provide for and be administered and operated so as to provide for the payment, during any minimum period of residence, or any waiting period, imposed by the health care insurance plan of another province, of the cost of insured health services provided to persons who have ceased to be insured persons by reason of having become residents of that other province, on the same basis as though they had not ceased to be residents of the province.

Requirement for consent for elective insured health services permitted

(2) The criterion respecting portability is not contravened by a requirement of a provincial health care insurance plan that the prior consent of the public authority that administers and operates the plan must be obtained for elective insured health services provided to a resident of the province while temporarily absent from the province if the services in question were available on a substantially similar basis in the province.

Definition of "elective insured health services"

(3) For the purpose of subsection (2), “elective insured health services” means insured health services other than services that are provided in an emergency or in any other circumstance in which medical care is required without delay.

1984, c. 6, s. 11.

Accessibility
12. (1) In order to satisfy the criterion respecting accessibility, the health care insurance plan of a province
(a) must provide for insured health services on uniform terms and conditions and on a basis that does not impede or preclude, either directly or indirectly whether by charges made to insured persons or otherwise, reasonable access to those services by insured persons;
(b) must provide for payment for insured health services in accordance with a tariff or system of payment authorized by the law of the province;
(c) must provide for reasonable compensation for all insured health services rendered by medical practitioners or dentists; and
(d) must provide for the payment of amounts to hospitals, including hospitals owned or operated by Canada, in respect of the cost of insured health services.

Reasonable compensation

(2) In respect of any province in which extra-billing is not permitted, paragraph (1)(c) shall be deemed to be complied with if the province has chosen to enter into, and has entered into, an agreement with the medical practitioners and dentists of the province that provides
(a) for negotiations relating to compensation for insured health services between the province and provincial organizations that represent practising medical practitioners or dentists in the province;
(b) for the settlement of disputes relating to compensation through, at the option of the appropriate provincial organizations referred to in paragraph (a), conciliation or binding arbitration by a panel that is equally representative of the provincial organizations and the province and that has an independent chairman; and
(c) that a decision of a panel referred to in paragraph (b) may not be altered except by an Act of the legislature of the province.

1984, c. 6, s. 12.
CONDITIONS FOR CASH CONTRIBUTION

Conditions
13. In order that a province may qualify for a full cash contribution referred to in section 5, the government of the province
(a) shall, at the times and in the manner prescribed by the regulations, provide the Minister with such information, of a type prescribed by the regulations, as the Minister may reasonably require for the purposes of this Act; and
(b) shall give recognition to the Canada Health and Social Transfer in any public documents, or in any advertising or promotional material, relating to insured health services and extended health care services in the province.

R.S., 1985, c. C-6, s. 13; 1995, c. 17, s. 37.
DEFAULTS

Referral to Governor in Council
14. (1) Subject to subsection (3), where the Minister, after consultation in accordance with subsection (2) with the minister responsible for health care in a province, is of the opinion that
(a) the health care insurance plan of the province does not or has ceased to satisfy any one of the criteria described in sections 8 to 12, or
(b) the province has failed to comply with any condition set out in section 13,
and the province has not given an undertaking satisfactory to the Minister to remedy the default within a period that the Minister considers reasonable, the Minister shall refer the matter to the Governor in Council.

Consultation process

(2) Before referring a matter to the Governor in Council under subsection (1) in respect of a province, the Minister shall
(a) send by registered mail to the minister responsible for health care in the province a notice of concern with respect to any problem foreseen;
(b) seek any additional information available from the province with respect to the problem through bilateral discussions, and make a report to the province within ninety days after sending the notice of concern; and
(c) if requested by the province, meet within a reasonable period of time to discuss the report.

Where no consultation can be achieved

(3) The Minister may act without consultation under subsection (1) if the Minister is of the opinion that a sufficient time has expired after reasonable efforts to achieve consultation and that consultation will not be achieved.

1984, c. 6, s. 14.

Order reducing or withholding contribution
15. (1) Where, on the referral of a matter under section 14, the Governor in Council is of the opinion that the health care insurance plan of a province does not or has ceased to satisfy any one of the criteria described in sections 8 to 12 or that a province has failed to comply with any condition set out in section 13, the Governor in Council may, by order,
(a) direct that any cash contribution to that province for a fiscal year be reduced, in respect of each default, by an amount that the Governor in Council considers to be appropriate, having regard to the gravity of the default; or
(b) where the Governor in Council considers it appropriate, direct that the whole of any cash contribution to that province for a fiscal year be withheld.

Amending orders

(2) The Governor in Council may, by order, repeal or amend any order made under subsection (1) where the Governor in Council is of the opinion that the repeal or amendment is warranted in the circumstances.

Notice of order

(3) A copy of each order made under this section together with a statement of any findings on which the order was based shall be sent forthwith by registered mail to the government of the province concerned and the Minister shall cause the order and statement to be laid before each House of Parliament on any of the first fifteen days on which that House is sitting after the order is made.

Commencement of order

(4) An order made under subsection (1) shall not come into force earlier than thirty days after a copy of the order has been sent to the government of the province concerned under subsection (3).

R.S., 1985, c. C-6, s. 15; 1995, c. 17, s. 38.

Reimposition of reductions or withholdings
16. In the case of a continuing failure to satisfy any of the criteria described in sections 8 to 12 or to comply with any condition set out in section 13, any reduction or withholding under section 15 of a cash contribution to a province for a fiscal year shall be reimposed for each succeeding fiscal year as long as the Minister is satisfied, after consultation with the minister responsible for health care in the province, that the default is continuing.

R.S., 1985, c. C-6, s. 16; 1995, c. 17, s. 39.

When reduction or withholding imposed
17. Any reduction or withholding under section 15 or 16 of a cash contribution may be imposed in the fiscal year in which the default that gave rise to the reduction or withholding occurred or in the following fiscal year.

R.S., 1985, c. C-6, s. 17; 1995, c. 17, s. 39.
EXTRA-BILLING AND USER CHARGES

Extra-billing
18. In order that a province may qualify for a full cash contribution referred to in section 5 for a fiscal year, no payments may be permitted by the province for that fiscal year under the health care insurance plan of the province in respect of insured health services that have been subject to extra-billing by medical practitioners or dentists.

1984, c. 6, s. 18.

User charges
19. (1) In order that a province may qualify for a full cash contribution referred to in section 5 for a fiscal year, user charges must not be permitted by the province for that fiscal year under the health care insurance plan of the province.

Limitation

(2) Subsection (1) does not apply in respect of user charges for accommodation or meals provided to an in-patient who, in the opinion of the attending physician, requires chronic care and is more or less permanently resident in a hospital or other institution.

1984, c. 6, s. 19.

Deduction for extra-billing
20. (1) Where a province fails to comply with the condition set out in section 18, there shall be deducted from the cash contribution to the province for a fiscal year an amount that the Minister, on the basis of information provided in accordance with the regulations, determines to have been charged through extra-billing by medical practitioners or dentists in the province in that fiscal year or, where information is not provided in accordance with the regulations, an amount that the Minister estimates to have been so charged.

Deduction for user charges

(2) Where a province fails to comply with the condition set out in section 19, there shall be deducted from the cash contribution to the province for a fiscal year an amount that the Minister, on the basis of information provided in accordance with the regulations, determines to have been charged in the province in respect of user charges to which section 19 applies in that fiscal year or, where information is not provided in accordance with the regulations, an amount that the Minister estimates to have been so charged.

Consultation with province

(3) The Minister shall not estimate an amount under subsection (1) or (2) without first undertaking to consult the minister responsible for health care in the province concerned.

Separate accounting in Public Accounts

(4) Any amount deducted under subsection (1) or (2) from a cash contribution in any of the three consecutive fiscal years the first of which commences on April 1, 1984 shall be accounted for separately in respect of each province in the Public Accounts for each of those fiscal years in and after which the amount is deducted.

Refund to province

(5) Where, in any of the three fiscal years referred to in subsection (4), extra-billing or user charges have, in the opinion of the Minister, been eliminated in a province, the total amount deducted in respect of extra-billing or user charges, as the case may be, shall be paid to the province.

Saving

(6) Nothing in this section restricts the power of the Governor in Council to make any order under section 15.

1984, c. 6, s. 20.

When deduction made
21. Any deduction from a cash contribution under section 20 may be made in the fiscal year in which the matter that gave rise to the deduction occurred or in the following two fiscal years.

1984, c. 6, s. 21.
REGULATIONS

Regulations
22. (1) Subject to this section, the Governor in Council may make regulations for the administration of this Act and for carrying its purposes and provisions into effect, including, without restricting the generality of the foregoing, regulations
(a) defining the services referred to in paragraphs (a) to (d) of the definition "extended health care services" in section 2;
(b) prescribing the services excluded from hospital services;
(c) prescribing the types of information that the Minister may require under paragraph 13(a) and the times at which and the manner in which that information shall be provided; and
(d) prescribing the manner in which recognition to the Canada Health and Social Transfer is required to be given under paragraph 13(b).

Agreement of provinces

(2) Subject to subsection (3), no regulation may be made under paragraph (1)(a) or (b) except with the agreement of each of the provinces.

Exception

(3) Subsection (2) does not apply in respect of regulations made under paragraph (1)(a) if they are substantially the same as regulations made under the Federal-Provincial Fiscal Arrangements Act, as it read immediately before April 1, 1984.

Consultation with provinces

(4) No regulation may be made under paragraph (1)(c) or (d) unless the Minister has first consulted with the ministers responsible for health care in the provinces.

R.S., 1985, c. C-6, s. 22; 1995, c. 17, s. 40.
REPORT TO PARLIAMENT

Annual report by Minister
23. The Minister shall, as soon as possible after the termination of each fiscal year and in any event not later than December 31 of the next fiscal year, make a report respecting the administration and operation of this Act for that fiscal year, including all relevant information on the extent to which provincial health care insurance plans have satisfied the criteria, and the extent to which the provinces have satisfied the conditions, for payment under this Act and shall cause the report to be laid before each House of Parliament on any of the first fifteen days on which that House is sitting after the report is completed.

1984, c. 6, s. 23.

[Pavlovs DiOgie]

8. Well its a great cut and paste

But you ignore the part where this is not mandatory unless the province wishes to accept the funding. You also ignore that fact that each province is left to its own devices as to how they achieve compliance with the provisions laid out in this act.

heres some history from wikipedia cause i cut and paste gud too!



The beginning of coverage
It was not until 1946 that the first Canadian province introduced near universal health coverage. Saskatchewan had long suffered a shortage of doctors, leading to the creation of municipal doctor programs in the early twentieth century in which a town would subsidize a doctor to practice there. Soon after, groups of communities joined to open union hospitals under a similar model. There had thus been a long history of government involvement in Saskatchewan health care, and a significant section of it was already controlled and paid for by the government. In 1946, Tommy Douglas' Co-operative Commonwealth Federation government in Saskatchewan passed the Saskatchewan Hospitalization Act, which guaranteed free hospital care for much of the population. Douglas had hoped to provide universal health care, but the province did not have the money.

In 1950, Alberta created a program similar to Saskatchewan's. Alberta, however, created Medical Services (Alberta) Incorporated (MS(A)I) in 1948 to provide prepaid health services. This scheme eventually provided medical coverage to over 90% of the population.<20>

In 1957, the federal government passed the Hospital Insurance and Diagnostic Services Act to fund 50% of the cost of such programs for any provincial government that adopted them. The HIDS Act outlined five conditions: public administration, comprehensiveness, universality, portability, and accessibility. These remain the pillars of the Canada Health Act.

By 1961, all ten provinces had agreed to start HIDS Act programs. In Saskatchewan, the act meant that half of their current program would now be paid for by the federal government. Premier Woodrow Lloyd decided to use this freed money to extend the health coverage to also include physicians. Despite the sharp disagreement of the Saskatchewan College of Physicians and Surgeons, Lloyd introduced the law in 1962 after defeating the Saskatchewan Doctors' Strike in July.

[supernova]

12. Interesting paradigm difference between Canada and US

Here, we talk about insuring people, how many people, and how much is it gonna cost, usually. Because presumably, an infinite number of things can go wrong with an infinite number of people that must be paid for.

In the Canadian law, you have:

9. In order to satisfy the criterion respecting comprehensiveness, the health care insurance plan of a province must insure all insured health services provided by hospitals, medical practitioners or dentists, and where the law of the province so permits, similar or additional services rendered by other health care practitioners.

Meaning, there seems to be an emphasis on the idea that all services usually provided by practioners must be paid for, regardless of the amount of people.

[Posteritatis]

18. You read it incorrectly. The provinces each have fairly complex systems of health law. (nt)

[ejpoeta]

7. they need 1000 pages to hide all the ways we get screwed and loopholes

and how much we give the health insurance companies.... if it were 14 pages long then it would be easy to spot all that stuff.

[SammyWinstonJack]

11. +1 nt

[Kansas Wyatt]

9. The bigger the contract (law)

The more you can count on being screwed.

Yes, it is that simple.

[SoCalDem]

10. Because whe have to build in loopholes for the campaign-financers

and to ingratiate our legislators to them, so they can "retire" to a 7-figure income as a lobbyist someday:(

[polly7]

13. A good link for anyone interested in it ...

http://www.hc-sc.gc.ca/hcs-sss/medi-assur/index-eng.php

[treestar]

14. It was the 40s and the world was simpler

pre-existing legislation was much less. And the population of Canada is much lower than that of the U.S.

Not comparable at all.

[Posteritatis]

17. The 80s aren't the 40s. (nt)

[eridani]

19. In the 90s, Taiwain instituted single payer. n/t

[Trillo]

20. Yeah. Nobody wants to talk about Taiwan's system. nt

[treestar]

22. Taiwan is very small

the US code is already huge, any bill that amends it will refer to prior provisions changed. It would be irresponsible to leave a lot of inconsistent laws on the books. It would cause litigation. Lawyers would make the money saved on doctors.

[Cleita]

15. It creates confusion so that the insurance companies, who have unlimited

access to the White House and Capitol Hill, can gut anything meaningful out of the legislation and it seems that they have succeeded. What has emerged is the same old health care system in a new package with new words, but it's still the same old dysfunctional system.

[Posteritatis]

16. You're vastly oversimplifying it

That's a "let there be universal health care!" act with little else in it. There's none of the implementation, none of the provincial regulations - I imagine you don't know that health care's a provincial and not a federal matter here in almost all circumstances - and so on.

That act is nowhere near the entirety of Canadian health law, and it's kind of silly to suggest otherwise. I'm looking at the Mental Health Act in one of the smaller provinces right now. It's several times longer than the act you linked, and a good chunk of it consists of amendments to other pieces of legisation of varying lengths.

The American reform bill, at least in theory, has all that implementation and amendments and loophole closures and loopholes and so on in it. If there was a single act called The Canadian Health Care System, I would be deeply surprised if it wasn't in the four-digit range.

[TexasObserver]

21. Recommend

[Egnever]

23. Really?

Why? its complete missinformation.

[Posteritatis]

24. But it feels good, so people swallow it nonetheless. (nt)

[redqueen]

25. Thanks for your post explaining the situation...

at least you tried, right?

[Posteritatis]

27. For what good it's worth; I've seen this 14-page silliness come up several times here lately

I explained why that take on it's wrong a few times, nary a peep from the people who just gobble the incorrectness all up.

[TexasObserver]

26. Yes, really. Because Canada decided they would guarantee the right.

They didn't spend years bargaining with the health care industry for whatever crumbs they'd throw the public, and call it Health Care reform. They made a commitment and developed a system.

[Posteritatis]

28. And do you think we did it in fourteen pages? (nt)

[TexasObserver]

30. If I had wanted to say that, I would have said that.

Why do you feel a need to imagine things that aren't there?

[Posteritatis]

32. Because the OP is doing that and people are refusing to look beyond the fact. (nt)

[TexasObserver]

33. I get it. It's way more than 14 pages. Surely anyone reading knows that.

The OP made a simple point. Canada made a decision to implement a comprehensive public health care system, and then set about to do it.

A good analogy would be the Declaration of Independence of the USA. It was the mission statement that set in motion the country. It is the core document which would ultimately help lead to the Constitution under which we live, where the ideals set out in the Declaration of Independence are given a plan of action.

Fourteen pages could not possibly be anything more than a mission statement.

[Posteritatis]

34. Surely quite a few people don't get that, or the OP wouldn't have existed

Anyone drawing a comparison between the health act up here and the reform bill in the States, as many people throwing tantrums over the length of the American HCR bill are, is already on ridiculous ground.

The two are apples and oranges, and would still be even if they had identical goals. All anyone doing this "why was their bill 14 pages and ours 1990?" song and dance is simply failing to understand one or both pieces of legislation, and so, as is mentioned elsewhere here, the OP's just misinformation.

[TexasObserver]

35. Clearly, the distinction means far more to you than to me.

If some think it was really 14 pages, and that's it, well, that isn't surprising. There is a strong contingent of not very bright people here, and they do love to post. I haven't read most of this thread, but I like the thought represented in the OP, which is why I recommended it. In media, the headline is the story for most people.

This story is simple. If we want to have the kind of health care Canada has, we have to commit to do it, then figure out how to get there. We are not doing that, or even coming close.

You read the OP and see only that it says something you deem incorrect, so you miss the macro point.

I look at it and see a message I want to promote at DU and on the Greatest Page.

[Egnever]

36. Oh i see you recomended it because you dont have a clue what canada did

So you buy into the fable the op is spewing. Canadas trek to their system bears resemblance to ours only in that they took what they had going and improved on it.

[mmonk]

29. Because ours doesn't have the people's welfare as its center piece.

Ours has to figure out how to benefit the for profit insurance companies as a priority while having to deal with promising the people they are going to improve access and lower cost. The game is to get the health insurance lobby and big pharma dollars into Democratic Party coffers and away from the Republicans.

[SammyWinstonJack]

31. +1 nt