Ten years after the 2015 Canada Health Transfer reform: A persistent equity concern of insufficient risk-equalization

Mohammad Hajizadeh and Daniel Keays

Health Policy, 2023, vol. 129, issue C

Abstract: Two guiding principles related to equity in healthcare, both in Canada and internationally, are that healthcare should be financed according to the ability-to-pay and utilized based on need. The Canada Health Act (CHA, 1984) aims to remove financial barriers and provide equitable access to healthcare in Canada. Contingent on meeting the conditions set out in the CHA, each province receives federal funding through the Canada Health Transfer (CHT). In 2014–2015, the CHT underwent a major change in that all provinces are now receiving funds on a per capita basis. We highlight equity concerns regarding the CHT allocations by reviewing the three main provincial level healthcare need indicators of its population: aging populations, the prevalence of chronic conditions, and population density. Results show that there are significant variations in all the three indicators among Canadian provinces. Specifically, Atlantic provinces have high values for all indicators, thus making per capita healthcare costs larger in these provinces. In contrast, larger provinces, particularly Alberta, are low in all indicators compared to the rest of Canada. Having a per capita CHT allocation means that provinces with a high range of healthcare need indicator values are in a more difficult situation to deliver sufficient healthcare to its population. A need-based allocation system can better meet the important policy objective of equity in healthcare for Canada.

Keywords: Healthcare; Funding; Canada Health Transfer; Equity; Canada (search for similar items in EconPapers)
Date: 2023
References: View references in EconPapers View complete reference list from CitEc
Citations:

Downloads: (external link)
http://www.sciencedirect.com/science/article/pii/S0168851023000064
Full text for ScienceDirect subscribers only

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:eee:hepoli:v:129:y:2023:i:c:s0168851023000064

DOI: 10.1016/j.healthpol.2023.104711

Access Statistics for this article

Health Policy is currently edited by Katrien Kesteloot, Mia Defever and Irina Cleemput

More articles in Health Policy from Elsevier
Bibliographic data for series maintained by Catherine Liu () and ().