governments. The program would be financed by a federal tax on personal income and federal employer payroll taxes. Physicians for a National Health Program envision a universal coverage system financed by the federal government and operated by the state governments.
Health care delivery in Canada is a provincial responsibility. The funding for the system is shared by the provinces and the federal government, with the federal government making the largest funding contribution in each province, although the level of federal participation in funding varies by province (Statistics Canada, 1990).
Fee schedules are established by the provincial governments. In the past few years, physicians in three provinces have attempted to extra bill patients for charges in excess of the fee schedules. In all instances, the physicians have lost these battles in court.
All persons in Canada are charged an annual fee for health care (in addition to the federal and provincial incomes taxes they pay). These fees vary by province; however, they are less than $100 per year (Canadian dollars) in all provinces. Persons with no or very low income are not required to pay these fees.
The ideology underlying the Canadian health care system is universality. Universality means that all persons are entitled to identical benefits, regardless of their station in life. All polls have indicated that the Canadian population overwhelmingly supports universal health care.
A Plan Requiring Employers to Provide Basic Health Insurance for All Employees
The Pepper Commission recommended in 1990 that all employers be required to provide basic health care insurance for all employees and their dependents (Rovner, 1991d). For unemployed individuals and for employees of small businesses unable to pay for health insurance coverage, health insurance would be provided by a new public health insurance program that would replace the Medicaid program.