Canadian Health Care System: Who Should Pay for All Medically Beneficial Treatments? A Burning Issue. (April 2018)

• Record Type: Journal Article
• Authors: Chowdhury, Mohammad Ziaul Islam; Chowdhury, Monsur Ahmed
• Is Part Of: International journal of health services. Volume 48:Number 2(2018)
• Page Start: 289
• Page End: 301
• Publication Date: 2018-04
• Subjects: Canadian health care system -- treatment coverage -- prescription drug; Medical care -- Periodicals; 362.1
• DOI: 10.1177/0020731417738976
• Languages: English
• ISSNs: 0020-7314

Abstract

The Canadian health care system can be characterized as a mix of public and private participation, although it is often described as a publicly funded system. In Canada, "medically necessary" services are covered with public funds; however, the Canada Health Act provides no formal definition of medical necessity. The provincial and territorial health care insurance plans decide which services are medically necessary. As a result, coverage of hospital and medical services differs among provinces. Outpatient prescription drugs are not covered by public plans. The coverage for diagnostics and medications for rare diseases is also limited. Private insurance plans, often provided by employers, are an expensive solution, although coverage is not sufficient. Those who are unemployed, self-employed, or informally employed and those with rare diseases that require expensive treatments and drugs frequently are not covered by any plan and face financial difficulty paying for their prescriptions and treatments. As a result, many Canadians are struggling and facing inequality in acquiring medical services for rare diseases and outpatient prescription drugs due to an unfair Canadian health care system. This paper proposes some recommendation to make medical services more accessible and affordable to every Canadian.