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

. Government must define medical necessity: Report. BCMJ, Vol. 55, No. 10, December, 2013, Page(s) - News.

Above is the information needed to cite this article in your paper or presentation. The International Committee of Medical Journal Editors (ICMJE) recommends the following citation style, which is the now nearly universally accepted citation style for scientific papers:
Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.

About the ICMJE and citation styles

The ICMJE is small group of editors of general medical journals who first met informally in Vancouver, British Columbia, in 1978 to establish guidelines for the format of manuscripts submitted to their journals. The group became known as the Vancouver Group. Its requirements for manuscripts, including formats for bibliographic references developed by the U.S. National Library of Medicine (NLM), were first published in 1979. The Vancouver Group expanded and evolved into the International Committee of Medical Journal Editors (ICMJE), which meets annually. The ICMJE created the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.

An alternate version of ICMJE style is to additionally list the month an issue number, but since most journals use continuous pagination, the shorter form provides sufficient information to locate the reference. The NLM now lists all authors.

BCMJ standard citation style is a slight modification of the ICMJE/NLM style, as follows:

  • Only the first three authors are listed, followed by "et al."
  • There is no period after the journal name.
  • Page numbers are not abbreviated.

For more information on the ICMJE Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals, visit

BCMJ Guidelines for Authors

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