Thanks to our collective advocacy and persistent efforts, we are thrilled to see the release of the much-anticipated Canada Health Act (CHA) Interpretation Letter
On January 10, 2025, Mark Holland announced the CHA Services Policy, marking a significant step forward for public health care in Canada. This policy introduces several major advancements, including allowing Nurse Practitioners to play a greater role in addressing the primary care crisis.
However, a critical gap remains: the inclusion of virtual care under the public health care system. This oversight increases the possibility and leaves the door open for a two-tier health care system.
Check out our press release: Canadian Doctors for Medicare Says Canada Health Act Policy Interpretation Letter Falls Short
Below, we've included a simple infographic explaining the CHA Services Policy. We also encourage you to explore recent media interviews, publications, and policy analyses for a deeper understanding:
When Corporate Health industry lobbyists win, patients lose again
Authored by CDM Vice-Chair, Dr. Bernard Ho and Board Member, Chaten Jessel, published under CDM Policy Analysis on our website!
We need virtual care that cares for everyone
Our Past-Chair, Dr. Danyaal Raza, and CDM Member Dr. Sheryl Spithoff published an article on the Healthy Debate highlighting the importance of virtual care in modernizing Medicare. They warn that inaction risks deepening the primary care crisis, growing opportunities for private-pay virtual care in a regulatory and legislative vacuum, and a negative feedback loop that increases costs and worsens quality.
Dr. Danyaal Raza on non-physician professionals billing the public system
Check out this episode of the Redeye, where Dr. Danyaal Raza discusses the Canada Health Act Interpretation Letter. He highlights the historic inclusion of nurse practitioners, midwives, and pharmacists under the Act, while addressing the unresolved issue of virtual care.
Ottawa opens up health plans to pay for necessary care by nurse practitioners, pharmacists and midwives
CDM's Chair, Dr. Melanie Bechar is interviewed by Kenyon Wallace from the Toronto Star on the release of the Canada Health Act Interpretation Letter.
Canadian Doctors for Medicare urgently campaigned for the release of the Canada Health Act interpretation letter
Why?
The Canada Health Act prohibits charging patients for medically necessary care delivered by physicians. This is why some Nurse Practitioners have been able to charge privately to deliver primary care. Further, the Canada Health Act, which was passed in 1984, does not specifically mention virtual care. There are several virtual care platforms that charge patients fees, which is harder to justify in a post-pandemic world where provinces and territories do have some public coverage for virtual care in specific situations. The provinces and territories could more broadly fund nurse practitioner and virtual care but have not yet chosen to do so, which presents an opportunity for federal leadership.
We at CDM were pleased to hear that the Minister of Health in March 2023 promised to issue a Canada Health Act interpretation letter to clarify that “no matter where in the country Canadians live or how they receive medically necessary care, they must be able to access these services without having to pay out of pocket.” Many health care advocates were hoping that the interpretation letter would stipulate that nurse practitioner care and virtual care should be publicly-funded. This would be a significant expansion in Canada’s publicly-funded health care services.
Taking Action
On November 19, with support from the Canadian Health Coalition (CHC) and the Canadian Federation of Nurses Unions (CFNU), we hosted a press conference on Parliament Hill, urging the immediate release of the Canada Health Act (CHA) interpretation letter. You can watch the video recording by clicking below.
To view our press release, click here.
Almost two years have passed, and the interpretation letter has yet to be released. This delay continues to put patients at risk of paying out of pocket for essential care. Canadian Doctors for Medicare sent a letter to the Prime Minister’s Office, urging the immediate release of the interpretation letter. You can find the letter below. We have also published an op-ed and participated in media discussions on this urgent issue. Explore recent media stories, articles and op-eds here:
- Don’t have private insurance? You’re still paying for others who do — you deserve better care
- Is paying out-of-pocket for medically necessary care allowed? Doctors and nurses say patients need to know now
- A publicly funded virtual care system would benefit us all
- Procrastination on Canada Health Act interpretation leaves patients with the bill
- Insurance and business groups urge health minister to protect employer-paid virtual care
- Health minister says he will soon issue guidance clarifying limits for out-of-pocket primary care fee