Health Care Coverage for Older People Canada

During the 1990s, both the federal government and provincial governments in Canada took steps to control budget deficits. During this period the federal government restricted its role to the maintenance of the five Medicare principles, and the provincial governments were left with the main responsibility for funding health services. Mergers, amalgamations, regional planning, and governance models emerged in most Canadian provinces. Major cost-containment initiatives resulted in a reduction of hospital bed capacity and the closure of rural hospitals— without first creating the necessary capacity for community-based and primary health care. This restructuring destabilized the delivery of health services and the health care workforce. However, one positive outcome has been that administrative accountability for community or population health services and for continuing care now rests with the same governing authority as acute care services. In this model, the regional health boards can plan and administer all health services within a region as if they were one large health maintenance organization. The exceptions continue to be physician fees and, in most provinces, diagnostic and pharmaceutical services.