Under the Canada Health Act (CHA), the federal government is in the driver’s seat to ensure all the Act’s principles are respected. The federal Minister of Health should refuse to grant funding for any province that ignores its principles. The five criteria guiding the provincial public health insurance plans, which should be non-negotiable, are:
- Public Administration: The public health insurance plan must be managed in a public, not-for-profit fashion.
- Comprehensiveness: All residents must be covered for “medically necessary” health services.
- Universality: All residents must be covered by the public insurance plan on uniform terms and conditions.
- Portability: All residents must be covered by their public plan, wherever they are treated in Canada.
- Accessibility: All residents must have access to insured health care services on uniform terms and conditions without financial charges, or discrimination based on age, health status or financial circumstances.
If the federal government walks away from enforcing these standards, some provinces may choose to privatize parts of the health care system, while others will offer a lower standard of care than their wealthier neighbours. This is almost inevitable if the provinces with booming economies receive more in health care transfers than their poorer cousins.