Canada Health Act

The Canada Health Act (CHA; French: Loi canadienne sur la santé), adopted in 1984, is the federal legislation in Canada for publicly-funded health insurance, commonly called "medicare", and sets out the primary objective of Canadian healthcare policy.

As set out in the Act, the main objective of healthcare policy in Canada is to facilitate reasonable, continued access to quality healthcare to all Canadians, regardless of income or geographic location by establishing criteria and conditions in respect of insured health services and extended health care services.

The statute establishes the framework for federal financial contributions to the provincial and territorial healthcare insurance programs under the Canada Health Transfer. With that said, the CHA deals only with how the system is financed: under the constitutional division of powers in Canadian federalism, adherence to Canada Health Act conditions is voluntary on the part of the provinces/territories; the federal government cannot compel the provinces to comply with the Act. However, if a province does not comply with the terms, it would not receive the federal financial contribution to healthcare. Those fiscal levers have helped to ensure a relatively consistent level of coverage across the country.

Establishing the principle of universal, single-payer healthcare, the Act's basic requirement is universality: to qualify for federal funding, provinces and territories must provide universal coverage of all "insured health services" for all "insured persons." "Insured health services" include hospital services, physician services, and surgical-dental services provided to insured persons, if they are not covered by any other programme. "Insured persons" means anyone who is resident in a province or territory and lawfully entitled to be or to remain in Canada.

Governments' fiscal position will influence health spending trends. As of 2020, Canada’s per capita spending on healthcare was among the highest internationally, placing Canada above the OECD average in terms of per-person spending on healthcare. However, Canada's healthcare spending per capita is less than 60 % of its neighbour's, the USA. In addition, prior to the COVID-19 pandemic health spending growth was constrained due to federal and provincial/territorial governments running budget deficits. In 2005, international data shows that approximately 70% of Canadian health expenditures were paid from public sources, thereby placing Canada below the OECD average.