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Before analyzing the influence of electoral politics on healthcare, it is important to be familiar with Canada's electoral system. Canada uses the plurality voting system, Canadians vote for their local Member of Parliament (MP), who represents one specific constituency in the House of Commons. The leader of the party caucus with the confidence of the house is by constitutional convention the prime minister of Canada. Although Canada's health care system is delivered by the provinces and territories, the federal government of Canada plays a crucial role in the process in terms of funding levels, setting health care priorities, and ensuring access and availability are achieved equally across the country. Therefore, political parties who are elected in the parliament carry tremendous influence on the healthcare system is therefore important.
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The organization of Canada's health care system is largely determined by the Canadian constitution. The roles and responsibilities are divided between the federal-provincial and territorial governments. The provincial and territorial governments have the most responsibility in delivering health and social services.
The federal government is mainly responsible for setting and administering national principles of the system under the Canadian Health Act; the federal legislation that aims to ensure all eligible residents of Canada have reasonable access to insured health services without direct charges at the point of service. In addition, the federal government is in charge of financial support to the provinces and territories. Furthermore, funding and delivery of primary and supplementary services to certain groups of people including First Nations, Inuit, serving members of the Armed Forces, inmates in federal penitentiaries, and some groups of refugees.
The Canada Health Act executed in 1984 establishes the criteria and conditions for healthcare that must be met by provinces and territories in order for them to receive the full federal cash transfer in support of healthcare. The federal government also provides equalization payments to the less prosperous provinces and territories.
The federal government is responsible for health protection and regulation (e.g., pharmaceuticals, food and medical devices), consumer safety, disease surveillance and prevention, support for health promotion and research. The federal government also institutes health-related tax measures, such as tax credits for medical disability and expenses.
The provinces and territories are in charge of delivering most of Canada's health care services and meeting the principles outlined in the Canada Health Act. Each provincial and territorial health insurance plan covers medically necessary services that are provided on a pre-paid basis without direct charges. Necessary medical services, however, are not defined in the Canada Health Act. It is up to the discretion of provinces and territories' health insurance plans and consultation with respective health groups to determine which services are medically necessary for health insurance purposes. When it is determined that a service is medically necessary, the full cost of that service will be covered by the public health insurance in compliance with the act. If a service is deemed not medically required, then the province or territory does not need to cover it in its health insurance plan.