From salt in food to transfer payments: Here's what Ottawa has power over when it comes to your health

Most Canadians know it's a provincial or territorial health card they carry in their wallets, not a federal one.

Still, the election April 28 does present an opportunity to have a say on certain aspects of health care the federal government controls, and to hold lawmakers — and would-be lawmakers — to account, health policy experts say.

Medical sociologist Amélie Quesnel-Vallée, Canada Research Chair in Policies and Health Inequalities, says the federal government can "play an important role in aligning our various health systems, especially as we are facing an aging population with increasing needs and burdens."

Although tariffs and annexation threats stemming from the U.S. have eclipsed health care as a major campaign topic, it remains a pressing issue for Canadians, especially the roughly 6.5 million of us who are without a family doctor or nurse practitioner.

Here's what you need to know about the role the federal government plays in our health care system, and how the major parties propose to address the doctor shortage and other challenges Canadians face accessing care.

On a basic level, the federal government's responsibility is to pay for our health care through the Canada Health Transfer (CHT), using funds collected through general taxation, says Quesnel-Vallée, who is also a professor at McGill's School of Population and Global Health in Montreal.

The provinces make most of the decisions about how to spend that money and how health-care services are delivered.

Sometimes, however, the feds earmark funds for particular initiatives, as they did for the COVID-19 response, says Dr. Aaron Jattan, a family doctor and assistant professor at the University of Manitoba's department of family medicine.

"If the party that you're supporting, they value certain things like mental health, substance use [initiatives], they do have the opportunity to provide additional funds to the provinces with direction on how those funds are used to support the patients that are most vulnerable," said Jattan, who is also acting chief medical officer for the Winnipeg Regional Health Authority.

The federal government directly administers health care for First Nations and Inuit peoples, the armed forces, veterans, the RCMP and inmates in federal penitentiaries. 

It's responsible for food and drug safety, too; medications available in this country must first be approved by Health Canada.

In October 2024, the federal government's Pharmacare Act came into force. In its first phase, the act provides free or low-cost access to contraception and diabetes medication.

Through the Public Health Agency of Canada — in partnership with the provinces, territories and regional health authorities — the federal government also monitors the spread of infectious disease.

That's particularly relevant now given that Canada currently has the highest number of measles cases recorded since the disease was eradicated in Canada more than 25 years ago.