Canada Health Act

The Canada Health Act (CHA) is a piece of Canadian federal legislation, adopted in 1984, which specifies the conditions and criteria with which the provincial and territorial health insurance programs must conform in order to receive federal transfer payments under the Canada Health Transfer . These criteria require universal coverage (for all "insured persons") of insured procedures for all "medically necessary" hospital and physician services, without co-payments.

The CHA deals only with how the system is financed. Because of the constitutional division of powers among levels of government, adherence to CHA conditions is voluntary. However, the fiscal levers have helped to ensure a relatively consistent level of coverage across the country. Although there are disputes as to the details, the CHA remains highly popular.

In popular discussion, the CHA is often conflated with the health care system in general. However, the CHA is silent about how care should be organized and delivered, as long as its criteria are met.

Another cause for debate is the scope of what should be included as "insured services". For historical reasons, the CHA's definition of insured services is largely restricted to care delivered in hospitals or by physicians. As care has moved from hospitals to home and community, it increasingly has been moving beyond the terms of the CHA. International data shows that approximately 70% of Canadian health expenditures are paid from public sources, placing Canada below the OECD average.