Government must define medical necessity: Report
An article published by the University of Calgary School of Public Policy says that because the Canada Health Act does not define services that are medically necessary, provincial governments must make these kinds of decisions, resulting in policies differing across the provinces and territories.
The article, entitled “The Challenge of Defining Medicare Coverage in Canada,” states that decisions about whether a medical treatment is termed necessary or unnecessary are determined by the financial interest of medical stakeholders, hospital budgets, and the financial constraints of provincial governments, and that this method of decision making undermines the equity principle of the Canada Health Act.
The authors point out that the wealthiest Canadians get annual physicals paid for by taxpayers, while the poorest are still required to pay out of pocket to cover services like rehabilitation for a traumatic brain injury.
The article also points out that many Canadians assume that coverage exists where it does not, resulting in many people being inadequately prepared for a catastrophic accident or illness, or conditions common to the aging process. To address these issues, the article concludes that policy-makers must define which services are publicly funded and which are not.
The article can be viewed at www.policyschool.ucalgary.ca/?q=content/challenge-defining-medicare-cove...