Bill 11, the Canada Health Act and the Social Union: The Need for Institutions

Osgoode Hall Law Journal

Volumn 38, Issue 1, 2000, Pages 39-99

  Choudhry, Sujit ^a  

^a at the University of Toronto Wagner is also a faculty member of the Canadian Medical Associations' Physician Management Institute   (Canada)

Author keywords

Canada; Canada. Canada Health Act; Federal government; Framework to Improve the Social Union for Canadians (1999); Health insurance Law and legislation

Indexed keywords

EID: 33846151506     PISSN: None     EISSN: 28175069     Source Type: Journal    
DOI: 10.60082/2817-5069.1509     Document Type: Article

References (79)

1. The federal Minister of National Health and Welfare Jake Epp wrote in Health Canada, Canada Health Act Annual Report 1987-88 (Ottawa: Supply & Services Canada, 1988) at 3:
2. The year 1987-88 has been a landmark in the Canadian health care system. As provided for under the Canada Health Act, by April 1,1987
3. The CHA annual reports between 1987-88 and 1992-93 inclusive make no reference to any deductions in federal transfer payments to the provinces. However, the Canada Health Act Annual Report 1994-95
4. The Canada Health Act Annual Report 1994-95, ibid., contains the following explanation at 14: Subsection 20(5)
5. ‘Running Net Total’ refers to the sum of withheld federal transfer payments of net returned monies.
6. This table covers the period from 17 April 1984, when Royal assent was given to the CHA, to the present. Whereas alleged violations are often described by critics or the media as engaging a particular principle of the CHA, the listed national standard has been reformulated wherever necessary to reflect my own understanding of the relevant CHA condition.
7. Ottawa Withholds Extra-Billing Funds” The Calgary Herald (27 June 1984) A3.
8. Medicare Penalties to Begin July 19” The Globe and Mail (6 July 1984) 5.
9. Provinces to Lose Money” Hie Globe and Mail (19 July 1984) 10.
10. “Ontario Gets $115 million for Banning Extra-Billing” The Globe and Mail (14 July 1986) Al, A2.
11. “Deny B.C. $700 million for its Abortions NDP Health Critic Urges” The Toronto Star (9 February 1988) Al.
12. D. Vienneau, “Health Minister Must Tell B.C. to Pay for Abortions, Critics Say” The Toronto Star (9 March 1988) A4.
13. House of Commons Debates, (10 December 1990) at 16492-93.
14. House of Commons Debates, (17 December 1990) at 16822.
15. House of Commons Debates, (20 March 1991) at 18728.
16. House of Commons Debates, (16 September 1991) at 2195.
17. House of Commons Debates, (19 September 1991) at 2389.
18. Mr. Rey Pagtakhan (Winnipeg North, Lib) later reported in the House of Commons that on 23 March 1992, Quebec Health Minister Marc-Yvan Côté announced that the $5 fee would not be implemented: See House of Commons Debates, (26 March 1992) at 8833.
19. CBC, “B.C. Gets Fined for Health Violation” Prime Time News (19 May 1994).
20. House of Commons Debates, (20 September 1994) at 5900.
21. House of Commons Debates, (28 November 1994) at 8387.
22. N. Ovenden, “Alberta’s Not Only Clinic Culprit: User Fees Common in Other Provinces,” The Calgary Herald (29 November 1994) A2.
23. N. Kennedy, “Government Takes Club to Clinic Fees; Comply or Transfer Payments Will be Cut, Provinces Told” The Ottawa Citizen (7 January 1995) Al.
24. “Alberta Faces Fines in Health-Fee Row” The Toronto Star (7 November 1995) Al.
25. N. Ovenden, “More Provinces Join Marleau's Rogue's Gallery; Alberta's Allies also Pay the Price for Allowing Private Clinics” The Edmonton Journal (18 November 1995) F2.
26. N. Kennedy, “Three Provinces Defy Private Clinics Rule” The Edmonton Journal (30 September 1997) A9.
27. R. Pedersen, “Facility Fees Still Collected on Some Cataract Surgery” The Edmonton Journal (6 September 1996) A7.
28. R. Pedersen, “Patients Paying ‘New Fee’” The Calgary Herald (2 November 1996) A4.
29. Gimbel later bowed to pressure from Alberta Health and agreed to only charge foreign patients extra fees in order to “jump the queue”: See E. Kenny, “Gimbel clinic to drop plan for up-front surgery fees” The Edmonton Journal (11 November 1997) A8.
30. House of Commons Debates, (31 May 1996) at 3261.
31. R. Pedersen, “Private Hospital Start of Two-Tier Medicine Critic; Stronger Federal Response Urged” The Edmonton Journal (5 October 1997) A7.
32. R. Daly, “Patients Pay to Jump Queue for MRI Tests in Hospital: Company Charges $300 More for Private Procedure” The Toronto Star (16 December 1999) A3.
33. The Ontario Ministry of Health Ordered an Investigation the Following Day: See T. Boyle, “MRI Probe Ordered: Patients Reported Paying for Illegal After-Hours Service” The Toronto Star (17 December 1999).
34. “Probes Launched into Allegations of Two Tiered Health Care in Montreal” The Canadian Press (23 March 2000).
35. House of Commons Debates, (4 April 2000) at 5662.
36. House of Commons Debates, (11 May 2000) at 6669.
37. This table covers the period from 17 April 1984, when royal assent was given to the CHA, to the present. Whereas alleged violations are often described by critics or the media as engaging a particular principal of the CHA, the listed national standard has been reformulated wherever necessary to reflect my own understanding of the relevant CHA condition.
38. House of Commons Debates, (23 May 1984) at 3963.
39. House of Commons Debates, (21 May 1987) at 6275.
40. “Deny B.C. $700 million for Its Abortion Stand NDP Health Critic Urges” The Toronto Star (9 February 1988) Al.
41. D. Vienneau, “Health Minister Must Tell B.C. to Pay for Abortions, Critics Say” Die Toronto Star (9 March 1988) A4.
42. House of Commons Debates, (17 March 1988) at 13881-83.
43. L. Surtees, “Patients to Recover Out-of-Province Costs Under New Agreement” The Globe and Mail (31 March 1988) A13.
44. “Quebec Won’t Join Interprovincial Medicare Deal: Deputy Minister” The [Montreal] Gazette (8 December 1988) A5.
45. House of Commons Debates, (28 May 1990) at 11965.
46. House of Commons Debates, (2 December 1991) at 5625.
47. “Medicare Coverage is Slashed for Quebecers Traveling Abroad” The [Montreal] Gazette (3 April 1992) A6.
48. House of Commons Debates, (2 June 1993) at 20201.
49. D. Broome, “Health Hazard: The NDP Government is Continuing the Socred Tradition of Medicare Only for Those Who Pay the Premiums—in Violation of the Canada Health Acf’ The [Vancouver] Province (23 January 1994) A26.
50. A. Riga, “Deal Covering Medical Costs in the Works with Ontario” The [Montreal] Gazette (15 February 1994) A6.
51. House of Commons Debates, (11 May 1994) at 4208.
52. J. Lakey, “Seniors Set to Challenge Province’s OHIP Cuts; Out-of-Country Medical Cutbacks Anger Snowbirds” The Toronto Star (18 May 1994) A21.
53. Kennedy, “Province Won't Delay OHIP Cuts” The Kitchener-Waterloo Record (30 June 1994) A3.
54. L. Papp, “Out-of-Country Health Cuts Spark Opposition Backlash” The Toronto Star (1 July 1994) A10.
55. A. Tobin, “Snowbirds Sue Ontario for Higher Out-of-Country Health Coverage” The [Montreal] Gazette (17 August 1994) A14.
56. “Don’t Look to Us for Help says Federal Health Minister” The Hamilton Spectator (17 August 1994) Al.
57. The Harris government restored out-of-country health insurance to $400 a day on September 6, 1995: See “Tories Increase ‘Snowbird’ Health Coverage” The Kitchener-Waterloo Record (7 September 1995) A3.
58. R. Walker, “Marleau Siding with Snowbirds” The Calgary Herald (23 September 1995) ??.
59. House of Commons Debates, (10 June 1994) at 5160.
60. House of Commons Debates, (4 April 1995) at 11484-85.
61. House of Commons Debates, (18 October 1995) at 15525.
62. “Snowbirds File Suit” The Globe and Mail (29 October 1996) A4.
63. While holding that portability does not extend to medical care outside of Canada, the B.C. Supreme Court in Brown v. B.C. [1998]
64. Kane, “Snowbirds Attack Health Act Ruling” The Vancouver Sun (14 August 1997) DI.
65. R. Pedersen, “Clinics Hope to Sell Dialysis to Visitors” The Edmonton Journal (9 November 1996) B3.
66. “Paying for Grayson: Cooperation needed to ease Wolfe family’s burden” The Calgary Herald (15 January 1997) A14.
67. “Province Offered Couple ‘Hush Money’” The Halifax Daily News (23 May 1997) 3.
68. R. Brennan, “Health-Care Queue Jump Charge” The Hamilton Spectator (10 September 1997) B3.
69. R. Pedersen, “Gimbel Clinics still Charging Out-of-Province Patients; One-third of 3,000 - 4,000 Patients from Outside Alberta” The Edmonton Journal (16 November 1997) A7.
70. R. Pedersen, “Medicare Opting-out Restrictions Called Violation of Health Act” The Edmonton Journal (27 March 1998) A6.
71. N. Hall, “Autistic Child’s Funding Lawsuit Dismissed: A Judge Has Refused to Certify a Class-Action Suit Filed by An Autistic Child and His Mother, Suggesting a Single Claim Instead” The Vancouver Sun (3 April 1999) B4.
72. D. Francis, “Quebec Ignores Health Act Rules: Other Provinces Not Fully Repaid When Treating Quebecers” The National Post (12 June 1999) D3.
73. A. Derfel, “Stay Away, Hospitals Plead: Universal Access to Health Care in Hospitals and CLSCs is Being Threatened by Severe Staff Shortages” The [Montreal] Gazette (7 August 1999) Al.
74. House of Commons Debates, (11 May 2000) at 667.
75. Figures for “Total CHST cash base,” “Budget 1998 cash,” “Health increase to base from 1999 budget,” “1999 supplement,” and “2000 cash supplement” were obtained from Finance Canada, Federal Support for Health in Canada (Ottawa: Finance Canada, 2000), online: Finance Canada
76. The historical (1995-96) share of the CAP/EPF block grant spent by provinces on health was 43 per cent (8.0/18.5). This share is carried over for calculations subsequent to the introduction of the CHST in fiscal 1996-97. However, from fiscal 1999-2000 onwards, “Total CHST health cash” is calculated using the following formula:
77. The historical share of EPF cash allocated by provinces to health spending was 75 per cent; this is the fraction of the “2000 cash supplement” that is used in the above formula, as per Finance Canada estimates: Interview with Nilar Gyi, Department of Finance (26 May 2000).
78. The historical share of CHST tax points apportioned by provinces to health spending is 67.9
79. The Provincial Government Sector includes health spending from provincial/territorial government funds, federal health transfers to the provinces/territories, and provincial government health transfers to municipal governments: Ibid.