HealthcarePapersPub Date : 2025-01-01DOI: 10.12927/hcpap.2025.27559
Colleen M Flood, Bryan Thomas
{"title":"Medicare Makeover: A Response to Peer Commentaries.","authors":"Colleen M Flood, Bryan Thomas","doi":"10.12927/hcpap.2025.27559","DOIUrl":"https://doi.org/10.12927/hcpap.2025.27559","url":null,"abstract":"<p><p>In responding to the <i>Canada Health Act</i> reforms proposed in Medicare Makeover, our peers provide valuable insights and suggestions. We appreciate, for instance, underscoring complexities inherent in implementing our call for evidence-based processes to define publicly-funded services and concerns regarding variation in accessibility and coverage standards across Canada. While some responses advocate for greater federal direction, we argue that fractured accountabilities have contributed to current challenges. It is essential that reforms establish a clear line of accountability: the federal government must ensure provinces, territories and Indigenous governments implement transparent processes to set standards for reasonable access and coverage and, in turn, provincial, territorial and Indigenous governments must be accountable for delivering on those standards to their voters.</p>","PeriodicalId":101342,"journal":{"name":"HealthcarePapers","volume":"22 3","pages":"69-73"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143675150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
HealthcarePapersPub Date : 2025-01-01DOI: 10.12927/hcpap.2025.27535
Carlos Quiñonez
{"title":"Dealing With Oral Healthcare Within Broader Healthcare Policy: The Need for Conceptual Before Operational Steps.","authors":"Carlos Quiñonez","doi":"10.12927/hcpap.2025.27535","DOIUrl":"https://doi.org/10.12927/hcpap.2025.27535","url":null,"abstract":"<p><p>Should oral healthcare be part of Canada's universal healthcare system? If so, how? To effectively deal with oral healthcare within broader healthcare policy, we must first gain clarity on what comprehensiveness and access should mean for oral healthcare. To do this, we will need a fair process of deliberation to determine what Canadians think is a reasonable level of oral health and what oral healthcare services go alongside it, irrespective of how that ultimately becomes organized, financed and delivered.</p>","PeriodicalId":101342,"journal":{"name":"HealthcarePapers","volume":"22 3","pages":"58-62"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143675146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
HealthcarePapersPub Date : 2025-01-01DOI: 10.12927/hcpap.2025.27534
Erika Dyck
{"title":"The <i>Canada Health Act</i> and Mental Health and Addiction Services.","authors":"Erika Dyck","doi":"10.12927/hcpap.2025.27534","DOIUrl":"https://doi.org/10.12927/hcpap.2025.27534","url":null,"abstract":"<p><p>The 40th anniversary of the <i>Canada Health Act</i> (CHA) (1985) comes at an auspicious time in healthcare history, having just experienced a major global pandemic that tested both the foundations and the flexibility of Canadian medicare. Several services suffered under the pressure of the pandemic, including mental health. Despite its historic position as a public or charitable service, mental health and addiction care has been pushed to the edges of our publicly funded health system. On this anniversary of the CHA, the author reflects on this historical trajectory by revisiting the origins of medicare and the impact of psychiatric deinstitutionalization.</p>","PeriodicalId":101342,"journal":{"name":"HealthcarePapers","volume":"22 3","pages":"54-57"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143675157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
HealthcarePapersPub Date : 2025-01-01DOI: 10.12927/hcpap.2025.27536
Jane Philpott, Duncan Sinclair
{"title":"Medicare Makeover and More.","authors":"Jane Philpott, Duncan Sinclair","doi":"10.12927/hcpap.2025.27536","DOIUrl":"https://doi.org/10.12927/hcpap.2025.27536","url":null,"abstract":"<p><p>In \"Medicare Makeover: Reimagining the Canada Health Act at 40,\" Flood and Thomas (2025) study access and comprehensiveness in the <i>Canada Health Act</i> (1985). They note a decline in timely access to care and advocate for the establishment of benchmarks for access, suggesting provinces should meet those standards in exchange for federal funding. They call for a re-evaluation of what constitutes \"medically necessary\" services, proposing a broader list of supports while ensuring equitable access regardless of financial status. Building on their recommendations, we argue for deeper systemic reform to Canadian medicare. Collaborative care models and decision making by local teams will enhance service delivery and outcomes. We also expand on the process for determining insured services, including a multi-government task force and public consultation. We suggest that proactive measures should be implemented immediately while advocating for a stronger legislative framework as proposed by Flood and Thomas to ensure the sustainability of Canadian medicare.</p>","PeriodicalId":101342,"journal":{"name":"HealthcarePapers","volume":"22 3","pages":"63-67"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143675149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
HealthcarePapersPub Date : 2025-01-01DOI: 10.12927/hcpap.2025.27531
Antonia Maioni
{"title":"Portability and the <i>Canada Health Act</i>.","authors":"Antonia Maioni","doi":"10.12927/hcpap.2025.27531","DOIUrl":"https://doi.org/10.12927/hcpap.2025.27531","url":null,"abstract":"<p><p>This commentary responds to Flood and Thomas (2025) by focusing on the often-overlooked principle of portability in the <i>Canada Health Act</i> (1985). It argues that Canada's healthcare system remains essentially the sum of its parts: provincial and territorial health plans, guided by similar values, adhering to principles that have financial strings attached and <i>bound</i> together by portability and the spirit of reciprocity. To strengthen this sense of shared purpose and responsibility, we need to allow space for the federal government to encourage such reciprocity and to find ways of allowing intergovernmental relationships between the provinces/territories to be enhanced.</p>","PeriodicalId":101342,"journal":{"name":"HealthcarePapers","volume":"22 3","pages":"35-39"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143675153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
HealthcarePapersPub Date : 2025-01-01DOI: 10.12927/hcpap.2025.27526
Arjumand Siddiqi
{"title":"There is No Medicare Without Tommy Douglas.","authors":"Arjumand Siddiqi","doi":"10.12927/hcpap.2025.27526","DOIUrl":"https://doi.org/10.12927/hcpap.2025.27526","url":null,"abstract":"<p><p>A new book, by Greg Marchildon, of interest to all health system leaders, provides a riveting and detailed account of the origins of our health system by tracing the life and influence of arguably one of the greatest Canadians.</p>","PeriodicalId":101342,"journal":{"name":"HealthcarePapers","volume":"22 3","pages":"E1"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143675161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
HealthcarePapersPub Date : 2025-01-01DOI: 10.12927/hcpap.2025.27530
Amélie Quesnel-Vallée, Emmanuelle Arpin
{"title":"The Canada Health Act Viewed Through an Equity Lens.","authors":"Amélie Quesnel-Vallée, Emmanuelle Arpin","doi":"10.12927/hcpap.2025.27530","DOIUrl":"https://doi.org/10.12927/hcpap.2025.27530","url":null,"abstract":"<p><p>The <i>Canada Health Act</i> (CHA) (1985) stands as a symbol of Canada's commitment to universal healthcare. However, there remain critical gaps that undermine the original vision of equity in healthcare. In this rejoinder to Flood and Thomas's (2025) analysis, we recommend a fundamental reinterpretation of the CHA to address persistent inequities. While the CHA has succeeded in removing financial barriers to medically necessary services, it has not fully achieved vertical or horizontal equity. A broader understanding of equity, extending beyond income, is necessary to address deeper, structural determinants of health. We provide theoretical reflections on equity and applied examples to advance our policy recommendations.</p>","PeriodicalId":101342,"journal":{"name":"HealthcarePapers","volume":"22 3","pages":"29-34"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143675159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
HealthcarePapersPub Date : 2025-01-01DOI: 10.12927/hcpap.2025.27529
Bill Tholl, Greg Marchildon
{"title":"The Time is Ripe for Canada Health Act 2.0.","authors":"Bill Tholl, Greg Marchildon","doi":"10.12927/hcpap.2025.27529","DOIUrl":"https://doi.org/10.12927/hcpap.2025.27529","url":null,"abstract":"<p><p>Although the <i>Canada Health Act</i> (CHA) (1985) has largely achieved its original purpose over the past 40 years, the challenges facing the Canadian health system today call for substantive updating and strengthening. This CHA 2.0 would recognize a major shift in primary care and include as insured services primary care providers beyond physicians. Other areas that should be addressed include ensuring substantive and timely access to insured services (with a proposed primary care guarantee) and provisions for greater transparency and accountability. These improvements would be better achieved through a CHA 2.0 and a more accountable Canada Health Transfer rather than companion legislation or time-limited federal transfers to provinces and territories. Unlike the CHA, companion legislation would be more easily dismantled by future governments and work against efforts to better integrate health services.</p>","PeriodicalId":101342,"journal":{"name":"HealthcarePapers","volume":"22 3","pages":"23-28"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143675160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
HealthcarePapersPub Date : 2025-01-01DOI: 10.12927/hcpap.2025.27527
Sara Allin, Audrey Laporte
{"title":"Is the <i>Canada Health Act</i> Untouchable?","authors":"Sara Allin, Audrey Laporte","doi":"10.12927/hcpap.2025.27527","DOIUrl":"https://doi.org/10.12927/hcpap.2025.27527","url":null,"abstract":"<p><p>This special issue marks the 40th anniversary of the <i>Canada Health Act</i> (1985). Though it remains an iconic symbol of national pride, it may not be untouchable. The papers in this issue critically examine the strengths and limitations of the <i>Canada Health Act</i> in the context of persistent health system challenges and gaps in coverage. They also provide constructive recommendations for a path forward for a reimagined legislative framework to better achieve the agreed-upon goals of reasonable and equitable access to a comprehensive basket of health services in Canada.</p>","PeriodicalId":101342,"journal":{"name":"HealthcarePapers","volume":"22 3","pages":"5-7"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143675148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
HealthcarePapersPub Date : 2025-01-01DOI: 10.12927/hcpap.2025.27533
Sydney Dianne Pearce, Danyaal Raza, Pierre-Gerlier Forest, Danielle Martin
{"title":"Reimagining Primary Care: A Pan-Canadian Perspective on the Canada Health Act.","authors":"Sydney Dianne Pearce, Danyaal Raza, Pierre-Gerlier Forest, Danielle Martin","doi":"10.12927/hcpap.2025.27533","DOIUrl":"https://doi.org/10.12927/hcpap.2025.27533","url":null,"abstract":"<p><p>As pressure mounts to improve access to the front door of Canada's health systems, primary care has become a lightning rod. The <i>Canada Health Act</i> (CHA) (1985) has the necessary components to help health systems achieve shared goals, but it has not been sufficient to meet contemporary challenges. Unimaginative and over-restrictive interpretations of this iconic legislation by federal and provincial/territorial governments, as well as opportunistic workarounds of private actors, are pushing health systems away from the vision of the Act's authors and the expectations of Canadians. Nowhere is this more critical than in primary care. Public expectations of primary care have been profoundly shaped by the CHA, and we suggest leveraging the well-timed and rigorously produced OurCare Standard to guide the path forward. While legislative reform is an option to achieve the Standard and the CHA principles, another is a pan-Canadian health organization mandated to build equity and evidence-informed recommendations for public coverage, bolstering the CHA rather than re-opening it.</p>","PeriodicalId":101342,"journal":{"name":"HealthcarePapers","volume":"22 3","pages":"46-53"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143675154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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