Who is covered?
The Canadian provinces and territories administer their own universal health insurance programs covering all provincial and territorial residents. The federal government supports the public programs through fiscal transfers conditional on their meeting the five criteria of the Canada Health Act, including universal coverage for medically necessary hospital, diagnostic, and physician services (Medicare). Each province and territory is responsible for establishing its own specific residency requirements; undocumented immigrants, including denied refugee claimants, those who stay in Canada beyond the duration of a legal permit, and those who enter the country "illegally," are not covered in any federal or provincial program, although the provinces/territories do provide some limited services. Coverage of other health services is generally provided through a mix of public programs and private health insurance, or financed by out-of-pocket payments. The federal government provides additional health care benefits (and compensates provincial/territorial governments) for physician and hospital services provided to First Nations and Inuit, members of the Royal Canadian Mounted Police and the Canadian Forces, veterans, refugee claimants, and inmates in federal penitentiaries. Around two-thirds of Canadians also have private health insurance, which covers services that are not covered under the public programs.
For more information, read a Commonwealth Fund profile of the Canadian health care system.
Harkness Project Title: Minimally Disruptive Improvement: Addressing Workload-Capacity Balance with Quality Improvement Projects Mentor: Donald A. Goldmann, M.D. (Institute for Healthcare Improvement) Placement: Institute for...