Healthcare is consistently one of the most popular issues in Canadian electoral politics. Our system of single-payer healthcare is considered to be an important part of our national identity, though each province has its own distinct system, and there are some substantial differences between the services that are covered under each of these.
Our federal government’s role in healthcare is to distribute funding to the provinces and territories, and to establish standards that each system must meet in order to receive that funding. The main piece of legislation that defines these standards is the Canada Health Act. It requires provincial and territorial healthcare systems to:
Be publicly-operated and non-profit
Cover all “medically necessary” procedures performed within hospitals and by medical doctors
Make sure that every person covered by the plan is subject to the same terms and conditions
Provide every person covered by the plan with “reasonable access to medically necessary hospital and physician services”
Cover all users of the plan when they move within Canada, or travel anywhere outside their home province
Canada is often described as having “universal healthcare”. This refers to the Canada Health Act’s principle of universality, which states that every person covered under a provincial or territorial healthcare system must be covered by the same terms and conditions. It does not mean that every person in Canada has access to unlimited health services. The Canada Health Act refers only to services that are provided by medical doctors, and other practitioners who work within hospital settings. Provincial and territorial healthcare systems are not required to cover prescription medications, routine and preventative dental care, individual mental health counselling and talk therapy, routine vision care, or chronic physiotherapy. Provinces and territories are also not required to provide specific expanded healthcare coverage to members of vulnerable groups, including people who are disabled or low-income. Furthermore, while the Canada Health Act requires that, “provincial and territorial plans must insure all medically necessary services provided by hospitals, medical practitioners and dentists working within a hospital setting,” it does not define what “medically necessary” means. Instead, provinces and territories—and even individual medical practitioners—are allowed to interpret this term on their own.
Disabled people often need different things from their healthcare systems than nondisabled people do. Many disabled people require access to surgeries, therapies and long-term prescription medications in order to survive and to maintain quality of life. Social systems like welfare and education typically take a medical approach to understanding disability, so in order to reliably access financial assistance, independent living supports, and accommodations at school or at work, disabled people first need to be able to access an official diagnosis from a medical professional. Disabled people may also require chronic mental health support, whether this is because they are neurodivergent, mad or mentally ill*, or because they are struggling with things like isolation, ableist discrimination, medical trauma, and intersecting marginalizations such as race, gender identity, sexuality and poverty.
In this online town hall, we will be discussing:
your experiences with accessing healthcare as a disabled person living in Canada
what role the federal government should play in promoting and protecting health justice
how to include disability justice in health policy
* These are all different identity labels that are used by disabled people who are marginalized because of how their minds work. Each label describes a particular community, with a particular perspective on the historical, political and social status of people with non-normative minds.
This discussion will be co-hosted by @djnontario, @alexhaagaard and @mssinenomine who will be tweeting questions every ten minutes starting at ten past the hour. You can see the questions by navigating to the profile of any of these accounts.
@alexhaagaard and @mssinenomine will be retweeting the responses that people post, so you can follow their accounts to see the rest of the discussion. You can also search Twitter for the #CripTheVote#CripTheVote hashtag, and set the search page to "Latest", to see everything that is being tweeted to the hashtag.
We realize that Twitter chats can be hard to follow for some people. While the chat is taking place, @djnontario will be tweeting the chat questions only. If you are having trouble keeping track of the chat, you can click on the @djnontario profile and check that account's feed to find out which questions have been posted.
You can also find the chat questions at the bottom of this post.
This chat is about accessibility and it is also about disability justice. We will be discussing how the marginalization of disabled people intersects with other forms of oppression including racism, colonialism, poverty, cissexism and heterosexism.
Racism, trans antagonism, homophobia, misogyny and lateral ableism are not welcome in this discussion and will not be amplified by the host accounts.
Please introduce yourself! If you’re comfortable with sharing, where in Canada do you live?
As a disabled Canadian, what have your experiences with your healthcare system been like? Have you been able to access the diagnosis and care you needed?
Canada is known for having healthcare that is free at the point of access, but there are many things our provincial healthcare systems don’t cover. What out-of-pocket healthcare costs do you incur? Are there things you’ve needed but have been unable to access because you couldn’t afford them?
What is one thing that you wish nondisabled Canadians understood about Canadian healthcare?
Healthcare engagement and outreach initiatives in Canada often take the view that “we’re all patients”. How do you think this impacts the way we understand healthcare in this country?
One of the only ways in which disability has been visible in this election campaign has been in the discussion around expanding legislation to support medical assistance in dying (MAiD). As a disabled person, what are your feelings about MAiD legislation? (Please add CWs to your responses as appropriate.)
@ChooseWiselyCA is organized by @CMA_Docs @UofT and @StMikesHospital. It has received funding from federal, provincial & territorial ministries of health and describes itself as, “the national voice for reducing unnecessary tests and treatments in health care.” As a disabled or otherwise marginalized patient, how do you feel about the positioning of “unnecessary tests and treatments” as a major issue in Canadian healthcare?
The Canada Health Act requires provincial healthcare systems to provide everyone with “reasonable access to medically necessary hospital and physician services” - but it doesn’t define what “medically necessary” means. Do you think the federal government should amend the Canada Health Act to provide an explicit definition of what “medically necessary” means? Who do you think should be involved in creating that definition?
If you were given the task of helping to write a definition of “medically necessary” for the Canada Health Act, how would you define it?