The five principles of the Canada Health Act

All provincial and territorial health plans are governed
by and must abide by the principles of the CHA

The Canada Health Act  (CHA) establishes criteria and conditions required for insured health services and extended health care services that the provinces and territories must fulfill to receive the full federal cash contribution under the Canada Health Transfer (CHT).

It is the aim of the CHA is to ensure that all eligible residents of Canada have reasonable access to insured health services. Residents who hold a Health Card, issued by a territory or province, receive  the specified health services on a prepaid basis. 

The CHA  is federal legislation.  The principles set forth must be adhered to by the insurance plans of the provinces and territories if they wish to receive federal money to support their program.

The CHA sets down five basic principles.

• Administration.  All administration of provincial health insurance must be carried out by a public authority on a non-profit basis. This authority must be accountable to the province or territory, and their records and accounts are subject to audits.

• Comprehensiveness.  All necessary health services, including hospitals, physicians and surgical dentists, must be insured.

• Universality.    All insured residents are entitled to the same level of health care.

• Portability.  A resident that moves to a different province or territory is still entitled to coverage from their home province during a minimum waiting period. This also applies to residents which leave the country.

• Accessibility.  All insured persons have reasonable access to health care facilities. In addition, all physicians, hospitals, etc, must be provided reasonable compensation for the services they provide.

Although the CHA requires that insured health services are provided to insured persons in a manner that is consistent with the criteria and conditions set in the Act, not all Canadian residents or health services fall under the scope of the Act.

Two categories of exclusion for insured services:

1.services that fall outside the definition of insured health services

2.certain services and groups of persons are excluded from the definitions for insured services and insured persons.
 

Services that fall outside the basic health care requirement of the CHA are  controlled exclusively and vary between the provinces and territories. Some of the provinces and territories provide  supplementary health benefits not covered by the Act, such as prescription drug coverage.  The level and scope of coverage for supplementary benefits varies between jurisdictions.

Persons excluded under the Act include serving members of the Canadian Forces or Royal Canadian Mounted Police and inmates of federal penitentiaries.

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