HEAL Reports

Over the past 20 years, HEAL has developed an impressive track record when it comes to undertaking policy relevant research to inform the public policy decision-making process.  In this section, you will find a number of seminal policy reports that have contributed to the public dialogue on the future of health and health care in Canada.

The specific purpose of this paper is to stimulate discussion and suggest possible strategies on how to improve the stability, accountability, visibility and flexibility of federal health transfer programs and thus to protect Canadians' most treasured pmgram---Our national health care system. The issues of health care financing and ensuring access to a comprehensive range of services are inextricably linked. In recognition of this link, HEAL has developed and released a discussion paper on comprehensiveness, Getting to the Core of Comprehensiveness.' It is HEAL'S intention that the proposed strategies in this paper and in its comprehensiveness paper reconcile the above mentioned tensions to the greatest extent possible.


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Although Medicare remains a very popular program to which most Canadians remain, at least publicly, committed, it has become under increasing strain. The comprehensiveness condition, in particular, may need re-examination.

the goals of this study were to:

  1. Analyze how provinces are currently interpreting the principle of comprehensiveness, with a focus on how they are determining what services they will pay for,
  2. determine from the literature how comprehensiveness and medical necessity are dealt with, and
  3. based on the analysis, highlight the major policy issues and suggest possible options for dealing with comprehensiveness within canada's universal medicare system.


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Canadians appreciate and value their health system, but they recognize that the broadly cast division of powers between the federal and the pmvincial and tenitorial governments is not enough. There is an underdeveloped social consensus that a more precise role is needed for governments in health and health care. Developing a consistent definition of comprehensive health services offers an opportunity to develop that consensus as a stepping-stone to revitalizing our health system. HEAL is concerned about the ad hoc manner by which the comprehensiveness of benefits is currently determined. Therefore, HEAL proposes a fresh look at comprehensiveness, a look that will place all health services '(i.e., curative, palliative, restorative, preventive and promotive) and all settings (including the home, the community and institutions) on a level playing field for funding support.


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Two years ago, the Health Action Lobby (HEAL) began an unprecedented and concerted effort to build a national consensus on Canadian health policies for the future. It was the first time in Canadian history that such a diverse group of non-governmental organizations had joined together to work toward a common set of goals.

Key among these goals is safeguarding the integrity of Canada's national system of universal health insurance programs. These programs are subject to substantial internal and external pressures. There are pressures to provide higher quality of health services by eliminating those that are of limited benefit and by promoting efficacious services. There are the pressures of a globally competitive environment and of the spillover from the health debate in the United States. Amid economic conditions in Canada that have been more severe and more prolonged than anyone might have imagined, this multifaceted concern about the sustainability of national health programs continues to provide the impetus for HEAL's collaborative efforts. Indeed, while economic prospects are somewhat brighter today than two years ago, the need for continued fiscal responsibility is widely-recognized.

This brief addresses this longer term reality and the concomitant need to redirect our energies toward managed change in the health care system.


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Exploring Options for Canada's Health Care System is a collection of commissioned background documents from the Health Action Lobby. Due to the large size of the publication, HEAL is unable to offer it for download, however requests to obtain a hardcopy of the publication can be sent to This email address is being protected from spambots. You need JavaScript enabled to view it..

Section A - Preface

  • An introduction to the Health Action Lobby
  • Introduction au Group d'intervention action santé


Section B - Commissioned Background Papers

  • Financing Health Care - by Alistair Thompson, PhD, MPA
  • Regulatory and Administrative Options for Canada's Health Care System - by Raisa B. Deber, PhD
  • The Maintenance of National Standards Within the Canadian Health Care System: Legal ad Constitutional Options - by Goodman and Carr, Barristers and Solicitors


Section C - Résumés

  • Le financement des soins de santé - par Alistair Thompson, PhD, MPA
  • Options réglementaires et administratives pour le Régime de soins de santé canadien - par Raisa B. Deber, PhD
  • Le maintien de normes nationales dans le système de santé canadien: options juridiques et constitutionnelles - par Goodman et Carr, avocats


Section D - Aproaching the Federal Government's Constitutional Proposal

  • An Analysis of the Federal Government's Constitutional Proposal - by Goodman and Carr, Barristers and Solicitors

There is a growing concern in Canada that federal support for provincial health and healthcare programs is a bit like the Cheshire Cat, that while the federal government continues to pay lip service to the principles embodied in the Canada Health Act, its real support as measured by contributions under the Established Program Financing arrangements, is declining and will eventually disappear.

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Canada's health care system is one of this country's foremost social accomplishments, a core value that helps define our national identity. But as valued as the health care system is, it is fragile and its importance is in danger of being overlooked in the current policy environment. It is hardly surprising, then, that a generation of post-medicare Canadians looks to Leaders within and outside government to secure the health care system for the future.

One of those leaders is the Health Action Lobby (HEAL), an unprecedented coalition of national health interests dedicated to protecting and strengthening Canada's health care system.


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