1. Canadian Health Care An American’s Perspective

2. Canada Health Act Received “Royal Assessment” on April 1, 1984 Evolved from “universal hospital insurance” legislation passed in Saskatchewan in 1947 By 1961, 10 provinces and two territories had public insurance for in- patient hospital care In 1962, Saskatchewan pioneered inclusion of physician’s services By 1972, all provinces/territories included physician services

3. Canada Health Act Passed by Parliament in 1984 Discouraged imposing of “user charges” and “extra-billings” by hospitals and physicians Imposes dollar-for-dollar penalties for such charges Defines the financing mechanism for transfer payments between the Federal government and the provinces

4. Canada Health Act The principal objective is… “to protect, promote and restore the physical and mental well-being of residents of Canada and to facilitate reasonable access to health services without financial or other barriers”

5. Sets down general Federal principals Leaves much “detail” to individual provinces and territories Canada Health Act

6. Canadian vs. U.S. Systems Access issues Expense becoming overwhelming Services being “delisted” in name of cost cutting New tax or premiums necessary to pay increasing costs Rx costs soaring for those covered under Pharamcare Access issues Growing number of uninsured and under-insured Cost growing overwhelming Government intervention “looming” Rx costs staggering to individuals and business

7. Taxation in Canada Federal Tax rates for 2003 were: 16% of first $32,183 22% of next $32,285 26% of the next $40,280 29% on income over $104,648 Ontario Provincial Tax: 6.05% on first $32,183 9.16% on next $32,185 11.16% above $64,871

8. Taxation in Canada Ontario Provincial Sales Tax (PST): 8% on most goods, Except 10% on liqueur and 5% on accommodations Goods and Services Tax (GST): 7% on most goods On a $40,000 vehicle = $6,000 (not including “air tax” for A/C, plus luxury tax, plus gas tax...) The “cumulative effect” become oppressive!!

9. Taxation in Canada New July 1, 2004: Health Premium or Health Tax?? > If “premium”, Labor wants company to pay it. > Then, Gov’t will further “tax” it as a benefit. > Comes immediately after election promise by Liberals to NOT RAISE TAXES!! > Included $60 million for water and waste-water programs, and to encourage physicial activity among children and the poor.

10. Taxation in Canada Ontario Heath Premium (or Tax): > Exempt if earnings under $20,000 > Earning $20,000 to $36,000 pay $300 > Earning $36,000 to $48,000 pay $450 > Earning $48,000 to $72,000 pay $600 > Earning $72,000 to $200,000 pay $750 > Earning $200,000 plus: $900 Premium is per tax payer.

11. Personal Observations “No technician on duty” “We’re waiting to see the specialist” “I’m waiting to be transfered to London, eh”