The five principles of the Canada Health Act form the cornerstone of the Canadian health care system.  The five principles are:

1. Universality: all eligible residents are entitled to public health insurance coverage on uniform terms and conditions;

2. Portability: coverage for insured services must be maintained when an insured person moves or travels within Canada or travels outside the country;

3. Public administration: the health insurance plan of a province or territory must be administered on a non-profit basis by a public authority;

4. Accessibility: reasonable access by insured persons to medically necessary hospital and physician services must not be impeded by financial or other barriers, and

5. Comprehensiveness: all medically necessary services provided by hospitals and doctors must be insured.
   (Mnemonic = UPPAC)

• The legislation was passed by parliament in 1984 under the guidance of Monique Bégin, then Minister of Health in Pierre Trudeau's Liberal government.  (Mme Bégin later became Dean of Health Sciences at U of Ottawa). 
• The Act aims to ensure that all residents of Canada have access to necessary hospital and physician services on a prepaid basis.
• The act specifies criteria that the provinces and territories must satisfy in order to qualify for federal transfer payments.
• The Canada Health Act also contains provisions that ban extra-billing and user charges:
  • no extra-billing by medical practitioners or dentists for insured health services under the terms of the health care insurance plan of the province or territory;
  • no user charges for insured health services by hospitals or other providers under the terms of the health care insurance plan of the province or territory.

Brief history of the development of the act:

• Saskatchewan first established public, universal hospital insurance in 1947;
• 10 years later, the federal government passed legislation to share in the cost of provincial hospital insurance plans;
• By 1961, all 10 provinces and two territories had public insurance plans that covered in-hospital care;
• Saskatchewan again pioneered by providing insurance for physicians' services outside hospitals, beginning in 1962.
• By 1972, all provincial and territorial plans had been extended to include doctors' services;
• A review of Canadian health services was undertaken by Justice Emmett Hall in 1979. He reported that health care in Canada ranked among the best in the world, but warned that extra-billing by doctors and user fees levied by hospitals were creating a two-tiered system that threatened the accessibility of care;
• In response to these concerns, Parliament passed the Canada Health Act in 1984 to discourage hospital user charges and extra-billing by physicians. The Act provides for an automatic dollar-for-dollar penalty if any province permits such charges for insured health services.

Links:  The Canada Health Act Annual Report