"Why at "taxation time"?"
Medical needs don't wait till pay-day...there are many practical considerations. Below I have bolded some of the walls which are thrown up whenever "at point of service" user fees are suggested. And the arguments are fairly compelling if one insists on not deviating from the principles. Finances ebb and flow. There are many people who might not fit a low income model but whom nevertheless are from time to time just getting by. What DOES a single mother do when she has $20 left for baby food until payday but she is running a high fever? It is easy to consider solutions for one person at a time, but when we are talking about hundreds of thousands and the temptation to fraud, misrepresentation, and so forth set against the hippocratic principle to heal and to help...it leads to chaos.
Also..."at point of service" user fees can only be regulated through a mountain of administrative record keeping and processing--cumbersome, unreliable, and extremely expensive.
On the other hand, everyone could pay for public health insurance just as they pay into a Government pension plan for old age--so that some relationship would obtain between contribution and usage.
Against the point of service user fee argument is also the socialist appeal that it is "unfair" that someone unlucky enough to require overwhelming medical care because of random misfortune should therefore be forced to choose between a minimal lifestyle or minimal health care. For these people, "Universal" means all or none.
Principles of the Canada Health Act
Public Administration: The administration and operation of the health care insurance plan of a province or territory must be carried out on a non-profit basis by a public authority, responsible to the provincial/territorial government and subject to audits of their accounts and financial transactions
Comprehensiveness: The health insurance plans of the provinces and territories must insure all medically necessary health services (insured services — hospital, physician, surgical-dental) and, where permitted, services rendered by other health care practitioners
Universality: All insured persons in the province or territory must be entitled to public health insurance coverage on uniform terms and conditions. Provinces and territories usually require that residents register with the plans to establish entitlement
Portability: Residents moving from one province or territory to another must continue to be covered for insured health services by the "home" province during a minimum waiting period, not to exceed three months, imposed by the new province/territory of residence. Residents temporarily absent from their home provinces or territories, or from the country, must also continue to be covered for insured health care services
Accessibility: Reasonable access by insured persons to medically necessary hospital and physician services must be unimpeded by financial or other barriers, such as discrimination on the basis of age, health status or financial circumstances. Reasonable access in terms of physical availability of medically necessary services has been interpreted under the Canada Health Act as access to insured health care services at the setting "where" the services are provided and "as" the services are available in that setting
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