Health care in Canada is publicly funded, with an interlocking set of ten provincial and three territorial health insurance plans known as ‘Medicare’. The Medicare system provides universal access to treatment, utilising both public and private hospital and physician services. There are 706 general public hospitals in Canada, 193 specialised public hospitals (such as chronic care and cancer centres) and 45 hospitals run by the private sector. The federal ministry in charge of Canada’s health care policy is called Health Canada, though provincial and territorial governments are responsible for the management, organisation and delivery of health services to their residents. There is a large pharmaceutical industry in Canada, which accounts for around 2.5 per cent of the global pharmaceutical market, making Canada the ninth largest pharmaceutical manufacturer in the world. The most recent act relating to mental health in Canada is the Mental Health Act 1996. Main health concerns and plans for remedial action: Canada currently has a life expectancy of 81 years, showing a sustained increase from 77 in 1990 and 80 in 2000. Gains have been primarily due to improved longevity for chronic diseases, particularly for older people with heart disease and cancer. As with most developed countries, a low rate of communicable diseases is countered by a prevalence of NCDs. Risk factors such as obesity, raised cholesterol and blood pressure, as well as physical inactivity and tobacco use, are common in Canada and directly linked to cancer, diabetes, heart disease and respiratory diseases. As of 2011 nearly one in four Canadians had been diagnosed with diabetes or pre-diabetes, and this rate is increasing with projections suggesting that by 2020 nearly ten per cent of the Canadian population will be living with diabetes. Health Canada has a number of policies specifically targeting these risk factors with the aim of reducing the number of preventable non-communicable diseases; strategies include the Canadian Diabetes Strategy, the Federal Tobacco Control Strategy and the Integrated Pan-Canadian Healthy Living Strategy. The Preventing Chronic Disease Strategic Plan 2013–16 roadmap for the public health agency outlined maintaining a healthy weight as a priority for preventing chronic disease, as common risk factors – including unhealthy eating and physical inactivity – are increasing the proportion of people who are overweight or obese. Particular focus is being placed on diabetes, cancer, cardiovascular diseases and chronic respiratory diseases. The work towards achieving healthy weights, and consequently healthier lives, is being carried out by a wide range of partners throughout Canada. The strategic plan identifies effective programmes and disseminates relevant information through the Canadian Best Practices Portal, providing a basis for community programme development. For definitions and sources see page 314. Universal health coverage Only a third of health care in Canada (30 per cent) was paid for by patients or funded by other non-governmental entities – such as private insurers, charities or employers – in 2012. Total health expenditure constituted 10.9 per cent of GDP in 2012, of which 70 per cent (US$4,022 per capita) was covered by the government. Ca n a d a Medicare, established on Canada Day (1 July) in Saskatchewan in 1962, quickly spread across the country. The proposal aimed to create the first government-run, universal health care coverage in North America. Each province and territory regulates its own health system. Private health insurance can also be taken to cover needs not met by Medicare coverage, such as dental insurance. Private insurance is often available through employers. Reforms to the policy on federal and provincial levels are expected to continue on a regular basis in order to keep up with the rapidly evolving demands of the growing population. Improving indigenous disparities in health and its determinants is currently a priority of the Canadian government. As of 2001, life expectancy for the registered First Nations population is around 6.6 and 6.5 years lower than the Canadian average for males and females, respectively. Suicide among registered First Nations in Canada accounts for greater premature mortality than either circulatory diseases or cancer, with a suicide rate of 161 deaths per 100,000 people – 11 times the rate in the general population (29 deaths per 100,000 people) in 2010. The Aboriginal Health Transition Fund acts to improve health care service planning, delivery and access for Canada’s indigenous populations, with specific projects addressing mental health, substance abuse and chronic disease management. Health Canada works with various federal departments, as well as provincial and territorial partners, to support the health of First Nations and Inuit people and communities. This is achieved through facilitating improved access to health services, improving health outcomes and helping First Nations and Inuit to gain greater control of the health system. Some of the methods undertaken by Health Canada to improve the overall health of people are community-based health promotion and disease prevention programmes; primary, community and home care services; noninsured health benefits to supplement those provided by insurers; and programmes to control communicable diseases and address environmental health issues. Canada was not an original signatory to the International Covenant on Economic, Social and Cultural Rights, but acceded to it in 1976 and has written the covenant into law. It includes ‘the right of everyone to the enjoyment of the highest attainable standard of physical and mental health’. The covenant commits signees to providing healthy and hygienic environmental conditions, controlling epidemic diseases, improving child health and facilitating access to health services without discrimination. Care of the elderly: Approximately 5.3 million people in Canada are over the age of 65 – 15 per cent of the population (2013). At the age of 60, a person in Canada can be expected to live for an additional 24 years on average. The Pension de la Securite Vieillesse Population over 65 15% Commonwealth Health Partnerships 2015 163
Commonwealth Health Partnerships 2015
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