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Understanding Access to Healthcare

Written by: Lauren Anderson

Edited by: Jacqueline Cheung


Dear CCP Readers,


Welcome back to the CCP blog! We hope our blog posts continue to educate our community on areas relating to homelessness, mental health, youth education, and how non-profit organizations can provide support to each of these areas. Today’s blog post will provide an overview of access to healthcare in Canada.


Access to healthcare is an important topic relating to homelessness for many reasons. People experiencing homelessness are at increased risk of physical and mental health conditions. Homelessness is often associated with a large range of conditions, including infectious diseases, substance abuse issues, and chronic conditions, such as diabetes and heart disease. In light of this, it is crucial that people experiencing homelessness have equal and accessible access to healthcare. Without continuous medical care, chronic conditions can be exacerbated and therefore, medical necessity is increased. Access to equitable healthcare is a critical issue as it should be a fundamental right for every human, and it can also play an important role in supporting the transition from homelessness.

If you would like to learn more information regarding the current state of homelessness in Canada and the Greater Toronto and Hamilton Area (GTHA), welcome! If you are returning for more information about the particular challenges faced by youth experiencing homelessness and those with animal companions, welcome back! If you are new to our blog, welcome to the community and thank you for your interest in learning more about issues regarding the homelessness crisis in Canada and beyond - you are one step closer to becoming a changemaker in your community, and you are in great company.


Overview of the Canada Health Act


Here in Canada, we have a publicly funded healthcare system, understood as Medicare. We do not have a federal healthcare plan, but rather a plan administered at the provincial/territorial level. The federal government administers this program called the Canada Health Act. The Canada Health Act requires the provinces/territories to meet certain criteria to receive funding. These criteria include:

  1. Public administration

  2. Comprehensiveness

  3. Universality

  4. Portability

  5. Accessibility


Each of these standards are in place to make sure that citizens in each province/territory are afforded equal healthcare services. All Canadians are granted free services that are deemed medically necessary and essential under the Canada Health Act. These services include primary care services, but not prescription drugs, dental care, vision care, mental health services and other “non-essential” services. For this care, Canadians must purchase private insurance or pay out-of-pocket. This healthcare system has its pros and cons which we will further explain in this blog post.


Social Inequities of the Healthcare System


Although the Canadian healthcare system allows Canadians from all backgrounds equal access to essential primary care services, there are still challenges faced by many. Aside from long wait times for procedures, surgeries, and specialists, there are also specific challenges faced by different groups. For example, mental illnesses are experienced in 1 in 5 Canadians, yet it is difficult for citizens to receive proper mental health care within this system.


Also, income and socioeconomic status still largely affect access to equitable healthcare. For from a low income background, it may be difficult to purchase prescription medications not covered by the Canada Health Act. For those who are unemployed or experiencing homelessness with concurrent chronic health conditions, this makes it difficult to properly take care of oneself. Preventative care is also a luxury for those who can afford private insurance for this type of care. Preventative healthcare promotes population health and well-being, but some services under this type of care might not be covered under the publicly funded system.


Another inequity faced by Canadians within this system is based on geographical location. Since the healthcare system is broken down by provinces, healthcare services provided vary. Those who live in rural areas of the country have limited resources including physical resources, but also a lack of doctors and other healthcare providers. We will build upon this in the next section.




Rural Healthcare


A large portion of our country is remote/rural, so the topic of rural healthcare is critical. As of 2021, 18% of Canada's population is rural. Only 9.3% of Canadian physicians practice in remote/rural areas, leaving a large discrepancy in accessible care. Aside from the shortage of primary care services, Canadians who live in rural Canada often need to travel long distances to receive specialized care, which is usually necessary as people age or if they have chronic conditions. Overall, there is an incredible need for increased funding and resources in these areas.


Intersectionality


Indigenous peoples in Canada experience unique challenges relating to access to equitable healthcare. Most Indigenous communities are located in isolated areas making it very difficult to access healthcare services, but there is also a history of discrimination faced by Indigenous peoples within the healthcare system. There are cultural barriers that are left to be recognized. The government of Canada has introduced specialized legislation and funding to assist in closing the gaps of unequal services for Indigenous communities, but there is a lot more work to do. There are significant health disparities experienced by Indigenous people in Canada in comparison to non-Indigenous Canadians due to systemic factors often leaving these groups to lead their own healthcare.


Comparison to Neighboring Country- USA


So far, we have addressed many of the challenges to accessing healthcare in Canada, but we want to end on a positive note of recognizing the benefits of a publicly funded healthcare system as well. Although there are significant gaps in our system, we are lucky to be afforded with baseline primary care services and essential healthcare with no cost. Healthcare is a fundamental human right, and our universal healthcare system provides coverage to all residents regardless of their employment status or living situation. In comparison, our neighbouring country, the U.S., does not provide universal healthcare to all of its citizens. Their healthcare services are based on a person’s ability to pay for private insurance or pay cash prices for healthcare services. The cost of healthcare in the U.S. is far more expensive.


On the other hand, access to healthcare in the U.S., for those who can afford private insurance, it is readily available. There may be shorter wait times in the U.S. for specialized healthcare, procedures, and surgeries, in comparison to Canada, however, this is only a luxury afforded to insured people.


Overall, universal coverage provided in Canada is cheaper and more accessible in comparison to our neighbouring country. There are challenges in both countries, but the Canadian healthcare system provides universal coverage, lower healthcare costs and prescription costs, and better access to care for everyone from all socioeconomic backgrounds.


Our CCP team hopes that you found this blog post both informational and resourceful. We hope to continue this important conversation and we hope that you do too! Our goal at the CCP is to better the well-being of people facing homelessness. If you would like to join our team or support us on our mission, please contact us! Thank you for reading our blog! Feel free to leave a comment with your feedback and/or insights to help us enrich the quality of future posts and cater to the interests of our community of changemakers.


- The CCP Team


Sources

Canada.ca. (n.d.). Canada's health care system. https://www.canada.ca/en/health-canada/services/health-care-system.html Veall, M. (2021, April 6). When will Canadians benefit from the promised mental health transfer? IRPP. https://irpp.org/blog/when-will-canadians-benefit-from-the-promised-mental-health-transfer/ Village Missions. (n.d.). Health & Healthcare in Rural Canada. https://villagemissions.org/healthcare-in-rural-canada/ The World Bank. (n.d.). Rural population (% of total population) - Canada. https://data.worldbank.org/indicator/SP.RUR.TOTL.ZS?locations=CA Koller, D., & Atav, S. (2017). Indigenous Healthcare in Canada. Harvard University. https://scholar.harvard.edu/files/dkoller/files/koller_atav_indigenous_healthcare.pdf AIMS Education. (n.d.). US vs Canadian Healthcare: What Are the Differences? https://www.aimseducation.edu/blog/us-vs-canadian-healthcare-differences/



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