4. Paying for services
Adequate funding for health is important to manage the excess demands on the health system. This section considers how countries are PAYING FOR COVID-19 SERVICES. Health financing describes how much is spent on health and the distribution of health spending across different service areas. The section also describes who is covered for COVID-19 testing and treatment, whether there are any notable gaps (in population coverage and service coverage), and how much people pay (if at all) for those services out-of-pocket.
4.1 Health financing
On March 13, 2020, the Government of Canada committed over CA$1 billion for various public health measures (PHAC, 2020c). Of this, CA$500 million (50% of the additional funding) was dedicated to supporting provinces and territories (PTs) and their health care system needs (PHAC, 2020c). On March 25, 2020, Bill C-13 was passed, granting an additional CA$107 billion towards COVID-19 relief efforts (Parliament, 2020, p. 13). This additional funding is largely dedicated towards economic relief efforts and additional funds for individuals in the country who are financially struggling as a direct consequence of the COVID-19 crisis (see Section 6). However, the Bill also gives the federal ministers of health and finance the power to approve any borrowing or spending related to the COVID-19 state of emergency through to September 30, 2020 (Parliament, 2020, p. 13).
Each PT has also declared a state of emergency, which allows their governments to dedicate additional funding and services towards their COVID-19 response, in addition to providing other powers. For example:
• The Government of Ontario made an official Declaration of Emergency on March 17, 2020 and the province also invested CA$3.3 billion to increase capacity (Ontario, 2020b, 2020c); other investments have also been made to support COVID-19 measures and economic reliefs.
• In British Columbia (BC), of the CA$5 billion that the BC government has earmarked for COVID-related relief efforts in BC, CA$1.7 billion have been dedicated to funding critical services (Ministry of Finance, 2020). Of these, two areas of funding are for health care pressures from the COVID-19 pandemic and additional support for social services and vulnerable populations (Ministry of Finance, 2020). Additionally, the provincial government has allocated additional funding for the BC First Nations Health Authority (Ministry of Finance, 2020).
On May 18, 2020, the Canadian government announced CA$306 million in funding for international humanitarian organizations, such as the International Red Cross and Red Crescent movement, to support global COVID-19 mitigation efforts (Global Affairs Canada, 2020d). These can include tackling food security, safe drinking water and sanitation, reproductive health and shelter services worldwide (Global Affairs Canada, 2020d).
On July 27, 2020, the Federal government announced an additional investment of CA$4.28 billion for expanding testing and contact tracing efforts to ensure both can continue for the remainder of the year. In addition, CA$7.5 billion was announced for additional PPE (Health Canada, 2020m). This is part of a larger federal investment of CA$19 billion intended to help provinces and territories safely restart their economies following the pandemic (Prime Minister of Canada, 2020a).
Specific PT measures are reported by the North American Observatory on Health Systems and Policies on their dedicated COVID-19 page (https://ihpme.utoronto.ca/research/research-centres-initiatives/nao/covid19/).
See full reference list under ‘Key links and articles: Full list of references’.