Canadian Social Research Links

The Medicare Funding Debate
in Canada

Sites de recherche sociale au Canada

Le débat sur le financement
de l'assurance-maladie au Canada

Updated January 13, 2015
Page révisée le 13 janvier 2015

[ Go to Canadian Social Research Links Home Page ]

NOTE: for more information about the Council of the Federation,
go to the Canadian Social Research Links Council of the Federation page


The Federal Role in Health and Health Care
By Marlisa Tiedemann
Parliamentary Information and Research Service
Library of Parliament
22 September 2011

NOTE : Revised 20 September 2013

HTML version:

PDF version (172K, 11 pages)


1 Health and the Constitution Act, 1867
2 The Criminal Law Power
3 The Federal Spending Power
4 Peace, Order and Good Government
5 Other Federal Responsibilities that Bear on Health
Selected Bibliography

Library of Parliament Research Publications

From Finance Canada - Regularly Updated

NOTE: This is a key resource for anyone who wants to know about federal transfers to provinces and territories for health, post-secondary education, social assistance (welfare) and social services (including early childhood development). Federal Transfers to Provinces and Territories is a permanent - and helpful (thanks, Finance Canada folks!) feature of the Department's website; it was most recently updated in January 2009.

Federal Transfers to Provinces and Territories
This is the most comprehensive collection of federal government information you'll find online concerning federal transfers to the provinces and territories for health, post-secondary education, social assistance and social services (including early childhood development). From April 1996 until March 2004, federal government contributions for these program areas were combined in a single block transfer called the Canada Health and Social Transfer. In April 2004, the CHSt was split into (1) the Canada Health Transfer, to cover a portion of provincial-territorial health costs, and (2) the Canada Social Transfer, to cover the rest of the areas listed in the first sentence in this paragraph

Major Federal Transfers to Provinces and Territories
- transfers to each province and territory, covering the latest five-year period, for the four major transfer programs:
the Canada Health Transfer, the Canada Social Transfer, Equalization and Territorial Formula Financing.
The following links are to brief descriptions of each of those transfers.

Canada Health Transfer
"the primary federal transfer to provinces and territories in support of health care"

Canada Social Transfer
"...a federal block transfer to provinces and territories in support of post-secondary education, social assistance and social services, including early childhood development and early learning and childcare"

Equalization Program

Associated Equalization

Territorial Formula Financing

Tax Transfers<===NOTE : On January 13, 2015, this link took me to an error page. I did a search using the Finance Canada search engine, but came up empty-handed. Here's the Internet Archive version of the content of that "Tax Transfers" page:
[NOTE: Be patient --- Internet Archive pages often take up to a minute to open...]


Brief History of the Health and Social Transfers
- covers the period from the launch of the Canada Assistance Plan in 1966 until 2007

Federal Support for Children (and investments over time)
- incl. a brief description of, and payment information for, the Universal Child Care Plan (2006 and 2007), the Early Learning and Child Care Initiative (2005), the Early Learning and Child Care Framework Agreement (2003), Support for First Nations and Aboriginal Children (ongoing) and the Early Childhood Development Agreement (2000)

Related link:

A Study of Federal Transfers to the Provinces and Territories
December 2008
"(...) The federal government uses a number of mechanisms to transfer funds to the provinces and territories for general areas of spending such as health or for specific purposes such as improving infrastructure. In 2006–07, these federal transfers amounted to approximately $50 billion, or just under 23 percent of federal spending. Our study examined the three main mechanisms used by the federal government to transfer funds to the provinces and territories. We also looked at the nature and extent of conditions attached to these transfers."
Chapter 1 of the
2008 December Report of the Auditor General of Canada

February 5, 2009

Office of the Auditor General of Canada ]

- Go to the Canada Assistance Plan / Canada Health and Social Transfer / Canada Social Transfer Resources page:
- Go to the Federal Government Department Links (Agriculture to Finance) page:

NOTE: The rest of this page is organized in reverse chronological order, more or less...

Five ways the government has put medicare on life support
January 12, 2015
Months away from a federal election, no one's really talking about the elephant in the emergency room: medicare.
The diagnosis isn't good.
Government critics believe that medicare as Canadians know it will face serious hurdles in the years ahead -- the direct result of a combination of government policy and funding cuts. For a quick refresher, we've outlined five major ways the Harper goverment has eroded medicare:
[Click the link above for more info on each of the points below.]

1. No new Health Accord.
2. No national pharmaceutical strategy.
3. Defunding the Health Council of Canada.
4. Painful new federal health transfer formula.
5. Offloading cost.

The federal share of health care spending is projected to nosedive from its current level of 20% to below 12% in the next few decades.


Canada: What universal health care?
September 15, 2012
By Reuel S. Amdur
It is claimed that Canada has universal health care. Unfortunately, that is an overstatement.
Canadian Medical Association president-elect Anna Reid ... points to the issue of poverty and social determinants of health. If not everyone has an adequate quality of life, then we increase the burden of health care expenses. The poor are sicker than the rest of us. Hence, progress toward greater equality means better health, and greater equality depends on government policy. Thus, in the grander scheme of things, universal health care needs to encompass progressive social policy, or vice versa.

More articles by Reuel Amdur:

The Canadian Charger

Three news releases from the
Council of the Federation:

Growing the Economy (small PDF file - 1 page)
VICTORIA, January 17, 2012 – Premiers emphasized the importance of growing the Canadian economy and focused on key actions to enhance prosperity [more...]

Premiers Appoint Working Group on Fiscal Arrangements (small PDF file - 1 page)
VICTORIA, January 17, 2012 – Mindful of both the uncertainty in the global economy and the economic value of Canada’s health systems, Canada’s Premiers committed to working together on fiscal arrangements to find solutions that will work for the benefit of all Canadians – in all provinces and territories. [more...]

Premiers Announce Health Care Innovation Working Group (small PDF file - 1 page)
VICTORIA, January 17, 2012 – Premiers announced that Prince Edward Island Premier Robert Ghiz and Saskatchewan Premier Brad Wall will co-chair a Health Care Innovation Working Group composed of all provincial and territorial health ministers. While acknowledging that Canada’s provinces and territories are pursuing innovation in their own jurisdictions, Premiers recognize that more can be done together

Council of the Federation
Version française du site:
Conseil de la Fédération

On December 5, 2003, Canada’s Premiers proudly announced in Charlottetown the creation of the Council of the Federation. It is a new institution for a new era in collaborative intergovernmental relations*. The Council of the Federation was created by Premiers because they believe it is important for provinces and territories to play a leadership role in revitalizing the Canadian federation and building a more constructive and cooperative federal system.
[ About Us: ]

New from
the Health Action Lobby (HEAL):

News Release:
The Federal Role in the
Future of Health and Health in Canada
(PDF - 52K, 4 pages)
January 12, 2012
For Canada to rank among countries with the healthiest populations, we need a broadly shared vision of health and health care, sustained leadership by the federal government, as well as action and accountability on the parts of provincial and territorial governments, health care providers and the public. This is the main conclusion of the report on the role of the federal government in health and health care that was commissioned by the Health Action Lobby (HEAL) – a coalition representing 34 national health organizations. HEAL is releasing the report in advance of this month’s meeting of the Council of the Federation at which Canada’s premiers will discuss the future of health and health care.
[ Version française du Communiqué (format PDF): ]

The report:

Functional Federalism and the Future of Medicare in Canada 
-  A Report to the Health Action Lobby (HEAL)
 (PDF - 1.5MB, 138 pages)
By Bill Tholl and Guy Bujold
January 2012
This project is a response to concerns about quality, access and the sustainability of Canada’s health and health care systems, an attempt to spark the public discussions needed as the 2003 First Ministers’ Accord on Health Care Renewal, and 2004 First Ministers’ 10­year Plan to Strengthen Health Care (which we refer to here as “the health accords”) come to an end in the Spring 2014. There are critical discussions to be had and decisions to be made if we are going to make the right choices — especially since how engaged the federal government will be in leading those discussions is uncertain.
[ NOTA : L'étude complète n'est pas disponible en français.]

Executive summary (PDF - 236K, 8 pages)

[ Version française du Sommaire (format PDF): ]

Health Action Lobby (HEAL)
The members of the Health Action Lobby are committed to sustaining and enhancing the health of Canadians, and in the continuous improvement of fair, equitable, efficient and effective health services and system(s).

HEAL Publications


Related link from the
Council of the Federation:

Final Details of Council of the Federation Meeting in Victoria on January 16-17, 2012 (2-page PDF file)
January 9, 2012 – British Columbia Premier Christy Clark will host a meeting of the Council of the Federation on January 16 and 17 in Victoria at the Inn at Laurel Point. Premiers’ discussions will focus on health care and fiscal arrangements.
Council of the Federation
Version française du site:
Conseil de la Fédération

On December 5, 2003, Canada’s Premiers proudly announced in Charlottetown the creation of the Council of the Federation. It is a new institution for a new era in collaborative intergovernmental relations*. The Council of the Federation was created by Premiers because they believe it is important for provinces and territories to play a leadership role in revitalizing the Canadian federation and building a more constructive and cooperative federal system.
[ About Us: ]

* NOTE: I crack up every time I read the Council's About Us statement re. "...a new era in collaborative intergovernmental relations". The Council of the Federation was set up by provincial-territorial Premiers *specifically* to exclude federal representation and to gang up on Stephen Harper's evidently uncollaborative federal government, notably on the subject of health care funding in Canada.


From the Canadian Union of Public Employees (CUPE):

How rising drug costs swallowed my health care*
October 6, 2006
"The Fraser Institute’s third annual report on the financial sustainability of provincial health insurance just found, to no-one’s surprise, that “health care financing, as it is currently structured in Canada, is not financially sustainable” and that reform is needed to increase privatization of the system. But their approach is highly faulty. It extrapolates 60 years ahead based on the recent averages and it doesn’t confront the fastest growing component of health care: the rising costs of drugs. The study simply took the most recent five-year annual average for provincial health care spending for each province and projected that rate of growth 60 years into the future. It then measured “sustainability” by comparing this to similar projections for provincial revenues and GDP. They claim that health care spending is on track to bankrupt all provinces within 60 years."
...and here's my favourite part, from the "bio notes" at the bottom of the article [Gilles]
"Toby Sanger is an economist with the Canadian Union of Public Employees (...) If he continues to gain weight at the same rate that he has over the past month, he will weigh approximately 132,735 pounds when he is 64 years old – and will weigh more than the Empire State Building if he lives to 91."
PDF version of this article (198K, 3 pages)
*NOTE: the PDF version includes a graph showing "escalating provincial spending on drugs"which doesn't appear in the HTML online version unless you click on the mysterious wavy lines beside the title of the article.

From the Canadian Health Coalition:
["The Canadian Health Coalition is a public advocacy organization dedicated to the preservation and improvement of Medicare. Our membership is comprised of national organizations representing nurses, health care workers, seniors, churches, anti-poverty, women and trade unions as well as affiliated coalitions in 9 provinces and one territory."]

National Pharmaceutical Strategy:
Where’s the Federal Government?
Press Release
September 21, 2006
(Ottawa) - The Canadian Health Coalition today welcomed the Progress Report on the National Pharmaceutical Strategy (NPS). The Strategy to improve pharmaceutical management will lead to more equitable access, better health outcomes and better value for money spent on drug therapy.


Health Council of Canada (R.I.P.)
"Created in December 2003, as a result of the 2003 First Ministers' Health Accord, and following the recommendations of the Romanow and Kirby Reports, the Health Council of Canada is mandated to monitor and report on the progress of health care renewal in Canada."


“Recommitting to the Miracle of Canada” (PDF file - 40K 14 pages)
Time to unleash Canada's "miracle potential", says Roy Romanow
Hon. Roy J. Romanow, P.C., O.C., Q.C.
On the Occasion of the 20th Anniversary of the
Council of Canadians
Ottawa, ON
November 4, 2005
"It's time to dream big about how we will shape the future of Canada, said Roy Romanow in a speech marking the 20th anniversary of the Council of Canadians. 'Canada is a nation with miracle potential. It is a nation that needs to be put back on track. We must get back to that Canadian balance between the individual and community, between nation and enterprise,' said Romanow. A sense of a shared destiny has nurtured Canada's legacy of fairness for its people, diversity, civility, respect, and the pursuit of peace. But today this legacy seems in jeopardy as the gap between rich and poor grows, Canada's medicare system calls out for reform, and major challenges face us in terms of a cleaner environment and the improvement of life prospects for Aboriginal peoples."

Related Links:

Council of Canadians
Atkinson Charitable Foundation


The Existence, Extent and Elimination of Canada's Fiscal Imbalance:
Report of the Subcommittee on Fiscal Imbalance

Yvan Loubier, M.P. (Chair of the Subcommittee)
Standing Committee on Finance
June 2005
PDF version (1.6MB, 92 pages)
House of Commons Committees
Reports and Responses


"Provincial/Territorial Government Health Spending Expected to Reach $84 Billion in 2004–2005,
Reports Canadian Institute for Health information:
Projected growth lowest in seven years"
News Release
November 3, 2004
"A new report on provincial and territorial government health spending released today by the Canadian Institute for Health Information (CIHI) shows continued growth in health care spending from provincial and territorial governments. Today’s report, Preliminary Provincial/Territorial Government Health Expenditure, 1974–1975 to 2004–2005, reveals provincial and territorial governments are expected to spend $83.9 billion in 2004–2005, an increase of 5.1% over the previous year, the lowest growth recorded since 1997–1998. Provincial and territorial government health spending was projected to reach $74.0 billion in 2002–2003 and $79.8 billion in 2003–2004, reflecting annual growth rates of 7.0% and 7.9% respectively. After removing the effects of inflation, health care expenditures in constant 1997 dollars are projected to reach $72.6 billion in 2004–2005, reflecting a real growth rate of 2.9%."
- incl. links to info about : Proportion of Provincial GDP | Per Capita Spending | Proportion of Governments’ Programs | Category of Service | About NHEX | About CIHI | Charts and Tables | Report | Contact

Canadian Institute for Health Information (CIHI)

Also from CIHI:

Inpatient Hospitalizations Continue to Decline, Same-Day Surgery Visits on the Rise,
Reports Canadian Institute for Health Information
News Release
October 29, 2004
"New data available today from the Canadian Institute for Health Information (CIHI) show that inpatient hospitalizations declined by 14.4% between 1995–1996 and 2002–2003, and by 1.7% between 2001–2002 and 2002–2003. Overall, there were 2,770,128 inpatient hospitalizations in Canada in 2002–2003, down from 3,235,313 in 1995–1996. The age-adjusted inpatient hospitalization rate (per 100,000 population) reflects this trend, declining by 22.3% since 1995–1996 and by 3.3% between 2001–2002 and 2002–2003. While most provinces and territories reported a decrease in inpatient hospitalizations between 2001–2002 and 2002–2003, increases were observed in Alberta (2.0%) and the Yukon Territory (6.5%). The largest decreases in inpatient hospitalizations between 2001–2002 and 2002–2003 were reported by the Northwest Territories (8.0%) and New Brunswick (4.9%)."
- incl. in this release: Same-Day Surgery | Length of Stay | Hospitalizations | About CIHI | Charts/Tables | Contact


Prime Minister announces new equalization
and territorial funding formula framework

News Release

News Release
October 26, 2004
"Ottawa --- Prime Minister Paul Martin today announced a new framework that, subject to approval by Parliament, will increase the support provided to provinces and territories under the Equalization and Territorial Financing Formula (TFF) programs by $33 billion over ten years.The increased funding will assist Canada’s less prosperous provinces and the three territories in meeting their commitments under the Ten-Year Plan to Strengthen Health Care as well as their other priorities."
Office of the Prime Minister

Conference of Federal-Provincial-Territorial Ministers of Health
News Release
Toronto - May 13, 2006
"Federal, Provincial and Territorial Ministers of Health have agreed to step up their efforts to strengthen public health capacity in preparing for an influenza pandemic and other public health threats."
- includes two backgrounders : Canadian Pandemic Influenza Plan and Antivirals
Canadian Intergovernmental Conference Secretariat

Annual Conference of Federal-Provincial-Territorial Ministers of Health
Toronto, Ontario
October 22-23, 2005
News Release
"At their annual meeting this weekend Canada's Federal, Provincial and Territorial Ministers of Health reaffirmed their commitment to the implementation of the 10-Year Plan to Strengthen Health Care, signed last year by all First Ministers."

"Canada’s National and International Collaboration on Pandemic Influenza Planning"

Annual Conference of the Federal/Provincial/Territorial Ministers of Health
October 17, 2004
" In their first opportunity to gather after the recent First Ministers' Meeting (FMM), Canada' s federal, provincial and territorial Ministers of Health have begun to work out the details behind the First Ministers' 10-Year Plan to Strengthen Health Care. 'I am pleased with the progress which has been made at this Vancouver meeting,'said BC Health Services Minister and co-chair Colin Hansen. 'The commitment and active participation of all Health Ministers has added to the momentum begun by First Ministers in September.'"
- incl. Next Steps in Implementing the 10-Year Plan
Health Canada


(PDF file - 41K, 12 pages)
September 16, 2004
Canadian Intergovernmental
Conference Secretariat


Health Care Renewal
Health Canada: A 10-year Plan to Strengthen Health Care
September 2004
- incl. links to :
First Ministers' Meeting on the Future of Health Care, September 2004 - News Releases, Backgrounders, Speeches, Interactive, Transcripts
Health Accord 2003 - News Releases, Fact Sheets, Other Related Information
Commission on the Future of Health Care in Canada - the Romanow Commission, incl. the final report (Nov/02), all discussion papers and summary reports by the Commission
[NOTE: the Resources/Research page alone is worth a visit just to see the excellent collection of health research info!]


From the Ontario Health Coalition:

First Ministers' Agreement:
Implications for Ontario
September 16, 2004

Outline of the First Ministers' Deal on Healthcare

Public Health Agency of Canada
- incl. links to : About the Agency - Media Room - Chronic Diseases - Emergency Preparedness - Health Promotion - Immunization - Infectious Diseases - Injury Prevention - Surveillance - Travel - Health - Quick Links - Centres and Labs - Publications - Guidelines - A-Z Index - Child Health - Adult Health - Seniors' Health - Surveillance - Health Canada

Health Care Renewal Accord 2003
Health Canada
"On February 5, 2003, Canada's First Ministers agreed to a new health plan to improve access to quality care for all Canadians. The Government of Canada will provide $34.8 billion over five years..."
- incl. links to : Health Accord 2003 - News Release - Fact Sheets - Other Related Information

Federal Health Investments
Health Care Renewal Accord Backgrounder
February 5, 2003
"Total increases to the CHST, including scheduled increases and the extension to 2007-08, will be $9.5 billion over the next five years. In addition, the federal government will add an immediate infusion of $2.5 billion for health to be drawn by the provinces as they require. This means that transfers available for health will increase by $12 billion over the next 5 years. To increase accountability and transparency, the federal government commits to create a separate Canada Health Transfer (CHT) within the year which will include the notional health component of the CHST and will provide predictable annual increases in 2008 and beyond." [bolding added]

The Romanow Commission on the Future of Health Care in Canada
"The task before us is to draw upon the ingenuity of all Canadians to ensure . . . that our health system meets the challenges of the 21st century."
[Roy Romanow ]

Building on Values: The Future of Health Care in Canada
Final Report of the Commission on the Future of Health Care in Canada
November 28, 2002
Complete Report (PDF file - 2.4MB, 357 pages)

Resources/Research - links to all 40 research and discussion papers covering a range of health topics, plus Key Public Opinion Documents
- also incl. links to : Submissions to the Commission - International Roundtables - Canadian Reports - pan-Canadian health care research groups - International Resources - Provincial/Territorial Health Department Resources - U.S. Resources - and much more...

Council of the Federation Website

[ Conseil de la fédération - version française ]
Official website of the Premiers' Council of the Federation
"On December 5, 2003, Canada’s Premiers proudly announced in Charlottetown the creation of the Council of the Federation. It is a new institution for a new era in collaborative intergovernmental relations. The Council of the Federation was created by Premiers because they believe it is important for provinces and territories to play a leadership role in revitalizing the Canadian federation and building a more constructive and cooperative federal system.The Council of the Federation’s objectives are to:
* Promote interprovincial-territorial cooperation and closer ties between members of the Council, to ultimately strengthen Canada;
* Foster meaningful relations between governments based on respect for the Constitution and recognition of the diversity within the federation;
* Show leadership on issues important to all Canadians."
- incl. links to : About the Council - Meetings - Key Initiatives and Workplan - Newsroom - Contact Us - Useful Links

Premiers' Council on Canadian Health Awareness
"In January 2002, the Premiers of all the Canadian provinces and territories agreed to launch a jointly funded Premiers' Council on Canadian Health Awareness to improve Canadians access to information and enhance public awareness of the challenges of and solutions for the future of health care in each jurisdiction. The Premiers' Council has a mandate, budget and full time staff to gather and disseminate information to Canadians on issues such as health care funding, health services innovation and best practices, human resource planning and management, drug effectiveness and assessment, and statistical comparisons provided by provinces and territories."
- incl. links to : About the PCCHA - Communicating with Canadians - [Health] Funding Facts - Improving Health Care - Working Together - Newsroom

NOTE: As at October 28/04, the Premiers' Council on Canadian Health Awareness link refers visitors to the Council of the Federation website.
However, the links below still work...

NOTE: The Funding Facts page of this sub-site is where you'll find some of specific provincial-territorial views on how much the federal government is contributing (16% of the total cost), and how much it should be contributing ("a fair share"), towards the cost of insured health care in Canada.

Premiers Launch New Public Awareness Campaign on Health Care Funding
OTTAWA, March 8, 2004 - Premiers of all 13 provinces and territories launched a national advertising campaign today to inform Canadians about health care challenges and the need for increased federal funding for health care.
Premiers' Council on Canadian Health Awareness

A new study confirms the existence of fiscal imbalance (PDF file - 9K, 1 page)
Press Release
"Ottawa, March 8, 2004 — The Treasurer of Prince Edward Island, Mr. Mitch Murphy, the Québec Finance Minister, Mr. Yves Séguin, the Manitoba Finance Minister, Mr. Greg Selinger and the New Brunswick Finance Minister, Mr. Jeannot Volpé, on behalf of all Provincial and Territorial Ministers of Finance, released today a new study of the Conference Board of Canada that confirms the existence of fiscal imbalance in Canada. The study clearly underlines the fact that widening fiscal prospects between Federal and Provincial-Territorial governments will dampen Provinces’ and Territories’ efforts to balance their budgets now and moving forward."

Complete report:

Update February 2004:
Fiscal Prospects for the Federal and Provincial/Territorial Governments
(PDF file - 526K, 61 pages)
"In December 2003, the provinces and territories asked The Conference Board of Canada to update the July 2002 study, Fiscal Prospects for the Federal and Provincial/Territorial Governments [see the link below]. The purpose of this study is to project the federal Public Accounts and the aggregate provincial/territorial government Public Accounts over the long term, with a particular emphasis on determining the impact of demographic changes on the cost of public health care and education spending to 2019/20. The results are presented in the tables included in this updated study."

Conference Board of Canada

Senate Committee on Social Affairs, Science and Technology

The Health of Canadians – The Federal Role
Final Report
Volume Six: Recommendations for Reform

Chair: The Honourable Michael J.L. Kirby
Deputy Chair: The Honourable Marjory LeBreton
October 2002

Senate Committee recommends $5B national health care premium new money to reform and expand health care system
News Release
October 25, 2002
"Canadians need to contribute an additional $5 billion per year to health care in order to make the publicly funded system financially sustainable and avert the emergence of a parallel private health care system. The decision facing Canadians is whether they are prepared to make that investment in order to overhaul Medicare."

Speaking Notes for Senators (on the release of Volume Six)

Report - Table of Contents and Part One, plus links to the rest of the report
(HTML - 186K, 29 pages)
Complete report - PDF file - 1169K, 392 pages

Highlights (HTML - 240K, 43 pages)
Highlights (PDF version - 158K, 54 pages)

Recent Senate Reports
(37th Parliament, 2nd Session)
- incl. links to volumes one to five in this series (from 37th Parliament, 1st Session)


"Increasingly, in Canada, public-private partnerships (P3s) are being touted as an innovative method for governments to provide public infrastructure such as hospitals. Faced with tight budgets, some governments are hailing P3s as the salvation of public infrastructure. P3Watch is an independent, non-profit, grassroots information resource for people and organizations concerned about the growing threat of P3s to Canada’s public medicare system."
- coalition of individuals, public health care advocacy groups, unions, social justice groups, and other community organizations
- incl. News (on the home page) - Campaigns - Privateers - Research - Resources - Links - About us - Search


From the Canadian Union of Public Employees:

“Innovation” Exposed:
An Ongoing Inventory of Major Privatization Initiatives in Canada's Health Care System
Updated July 28, 2004
"Private, for-profit health care has proliferated since the First Ministers’ Accord on Health Care was signed in January 2003. This inventory lists many of those initiatives including public private partnerships, evidence of two-tier access to services, private for-profit clinics and other threats to sustainable, equitable public health care.
The inventory, in this version, distinguishes three major forms of privatization:
- private, for-profit hospitals (often P3s);
- private facilities and services (clinics, for example); and
- contracting out.
Word file - 219K, 39 pages
PDF file (149K, 39 pages)

Canadian Union of Public Employees (CUPE)


Martin backs right of his physician to run private clinic
May 8, 2004
"SAGUENAY -- Prime Minister Paul Martin defended his family doctor's right to operate private clinics where patients who pay the price gain quick access to certain medical tests. He said yesterday he has never received any health-care services at his doctor's Montreal clinic that were not available to the general public."
The Globe and Mail


Martin's MD runs for-profit clinics
PM says he's no health queue-jumper; Opposition parties label him hypocrite
May 8, 2004
"OTTAWA—Federal Liberal plans for an election campaign focused mainly on health care suffered a setback after Prime Minister Paul Martin's personal physician was dragged into the political fray.
Martin was forced to acknowledge yesterday that he goes to a Montreal doctor who founded a series of private, for-profit clinics — Medisys Health Group Inc*., which bills itself as "one of Canada's leading national providers of health care services to corporations and insurance companies."
The Toronto Star


Three Choices for the Future of Medicare
Gregory P. Marchildon
April 2004
This paper argues that Canadians are at a crossroads in terms of the future of medicare. Critical directional decisions will be made at the First Ministers Meeting in a few months. Ottawa must decide its role before it negotiates with the provinces the future of a policy that is an integral part of the country’s identity.
Complete report - (PDF file - 88K, 20 pages)
Caledon Institute of Social Policy

Provincial Government Health Ministries

British Columbia - Alberta - Saskatchewan - Manitoba - Ontario - Québec - New Brunswick - Nova Scotia - Prince Edward Island - Newfoundland and Labrador - Northwest Territories - Yukon - Nunavut


Two Excellent multimedia presentations* from CBC Archives!

Medicare and Social Welfare: Tommy Douglas and the NDP
"Tommy Douglas was the most influential politician never to be elected Prime Minister. He pursued his radical ideas relentlessly until they became so mainstream rival politicians claimed them as their own. Called a communist and threatened by in-party fighting, Douglas battled hard to bring the New Democratic Party to legitimacy in its first ten years. He was often criticized for his singular idealism but through it all Douglas was undeterred, convinced that he was helping to create a better, more humane society."
- incl. : A new brand of Canadian social democracy - From minister to MP: T.C. Douglas enters the political fray - CCF Victory in Saskatchewan - The story of Mouseland: A political allegory - New leader for a new party - Poverty, swingers, and hoopla - Douglas steps down - Tommy Douglas, Canadian funny-man - Tommy Douglas remembered - Evaluating Douglas - Fighting for Medicare

The Birth of Medicare
"Since its establishment in 1967, Canada's Medicare system has earned the envy of the international community. Many Canadians see free public health care as the hallmark of what Pierre Elliott Trudeau called 'The Just Society.' Yet, as the Medicare debate has proven, it's a system that is not without its flaws or opponents."
- incl. links to the following audio and video files : Tommy Douglas, Canada's Father of Medicare - Canadians ponder the Welfare State - An appeal to Canada's women - The Saskatchewan Doctors Strike -
The pros and cons of Medicare - Medicare gets a rough ride in Regina - The strike is over - The Royal Commission on Health Services - Medicare becomes Canadian law - Emmett Hall on Canada's health care system in 1980

- you should be able to view and listen to these files if you have a reasonably recent computer
- this is streaming audio/video (recorded from radio and TV), which is sometimes blocked on office or university computer networks. If clicking on the files doesn't activate your media player, try opening the files on a non-networked computer (e.g., your home computer).
- this will likely be slower if you use a dial-up connection, but it's well worth it!

Politics and Economy
[ CBC Archives ]

Odette Madore
Economics Division
Revised 16 June 2003
"This document gives an overview of the Canada Health Act. It does not set out to offer a legal interpretation of the Act; rather, it seeks to take stock of the evolution of the way it is implemented and examine its future prospects. The first section reviews the justifications for government intervention in the health care sector, while the second describes the respective roles of the federal government and the provinces. The third section traces the historical background of the Act, and the fourth presents an overview of the requirements attached to it. In the fifth section, penalties for defaults under the Act are described, and in the sixth and final section, some options are set out for maintaining the Act or improving it.
Source : Parliamentary Research Branch (Library of Parliament)

Towards A Consensus On Continuing Chaos (PDF file - 140K, 19 pages)
Claude E. Forget
February 2003
C.D. Howe Institute Commentary
"The Romanow and Kirby reports on the Canadian health-care system fail to provide a basis for lasting reform. In fact, the reports and their findings are destined for the overflowing dustbin of the history of health-care studies in Canada. Fortunately, that does not mean that we have to throw our cherished health-care system itself on the rubbish heap. It does mean that any reconstructive program has to be based on realistic expectations and real-world realities."
Source : C.D. Howe Institute

"Response to the Romanow Report"
December 2002
Remarks to the Canadian Club of Toronto and to the Halifax Chamber of Commerce
by Senator Michael Kirby
"The national health care debate has now been joined. This debate will come to a head at the First Ministers’ meeting in late January."

Responses to the final report by the Romanow Commission on the Future of Health Care in Canada
Updated to December 31, 2002
Full text of reactions to the Romanow Report from the websites of dozens of non-governmental organizations and unions, from the Canadian Council on Social Development to Canadian Auto Workers (CAW) and the Ontario New Democratic Party
--- and the Ontario Premier and Health Minister too.
Source : DAWN DisAbled Women's Network - Ontario

Fiscal Federalism and Health (PDF file - 765K , 35 pages)
November 15, 2002
Federal-Provincial Relations and Health Care: Reconstructing the Partnership
by The Institute of Intergovernmental Relations
School of Policy Studies
Queen’s University
November 2002


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