Revised article 4
Article 4 should be changed to: "to establish criteria and conditions in respect of health promotion and disease prevention, insured health services and extended health care services provided under provincial law that must be met before a full cash contribution may be made."
This change then triggers a number of additional amendments to the current Act:
Revised article 2 Definitions
health care practitioner means a person lawfully entitled under the law of a province to provide health services (including health promotion) in the place in which the services are provided by that person
health promoter means a person lawfully entitled under the law of a province to provide health promotion services in the place in which the services are provided by that person;
hospital includes any facility or portion thereof that provides hospital care, including health promotion, acute, rehabilitative or chronic care, but does not include
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(a) a hospital or institution primarily for the mentally disordered, or -
(b) a facility or portion thereof that provides nursing home intermediate care service or adult residential care service, or comparable services for children;
hospital services means any of the following services provided to in-patients or out-patients at a hospital, if the services are medically necessary for the purpose of promoting, maintaining health, preventing disease or diagnosing or treating an injury, illness or disability, namely, [......]
insured health services means health promotion services, hospital services, physician services and surgical-dental services provided to insured persons, but does not include any health services that a person is entitled to and eligible for under any other Act of Parliament or under any Act of the legislature of a province that relates to workers’ or workmen’s compensation;
Revised article 7
7 In order that a province may qualify for a full cash contribution referred to in section 5 for a fiscal year, the health care insurance plan of the province must, throughout the fiscal year, satisfy the criteria described in sections 8 to 12 respecting the following matters:
(a) health promotion and disease prevention to improve population health and reduce the demand for health care services;
[Lettering of the rest re-ordered]
- (b) public administration;
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(c) comprehensiveness;
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(d) universality;
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(e) portability; and
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(f) accessibility.
New article 8
8. In order to satisfy the criterion regarding health promotion and disease prevention,
a) the provincial health care budget must allocate 20% of total expenditures to health promotion and disease prevention activities;
b) administrative systems must be put in place by the designated public authority to capture acute care savings associated with reduced demand for health care services so that they can be reinvested in health promotion activities, with the long term objective of increasing total expenditures on health promotion and disease prevention as a percentage of total health care spending;
Revised article 13 (formerly 12)
Accessibility
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13 (1) In order to satisfy the criterion respecting accessibility, the health care insurance plan of a province
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(a) must provide for insured health and health promotion services on uniform terms and conditions and on a basis that does not impede or preclude, either directly or indirectly whether by charges made to insured persons or otherwise, reasonable access to those services by insured persons;
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(b) must provide for payment for insured health services in accordance with a tariff or system of payment authorized by the law of the province and that tariff must include payments for health promotion services;
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(c) must provide for reasonable compensation for all insured health services rendered by health promoters, medical practitioners or dentists; and
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(d) must provide for the payment of amounts to health promotion facilities, hospitals, including hospitals owned or operated by Canada, in respect of the cost of insured health services.
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Reasonable compensation
(2) In respect of any province in which extra-billing is not permitted, paragraph (1)(c) shall be deemed to be complied with if the province has chosen to enter into, and has entered into, an agreement with the health promoters, medical practitioners and dentists of the province that provides
