The Big Picture
Canada’s health care system faces growing pressure from staffing shortages, an aging population, long wait times, and rising costs.
Care is also changing. More services now take place outside hospitals, including clinics, health centres, private clinics, community programs, and people’s homes.
Another major shift focuses on keeping people healthy and preventing illness or injury before treatment becomes necessary.
Look for Nova Scotia CCA Notes throughout this page for current provincial guidance.
Quick tip: Tap, click, or press Enter on any term with a dotted underline and an ⓘ icon to see its plain-English definition.
Start Here If You’re Overwhelmed
Focus on these core ideas:
- Major health care challenges include worker shortages, population aging, long waits, and rising costs.
- Supplementary coverage helps certain people pay for services outside regular publicly funded health care.
- Private insurance helps pay for some services that provincial or territorial insurance does not cover.
- home care provides health care and support services where people live.
- Health promotion focuses on improving or maintaining health and independence.
- Disease prevention focuses on preventing disease or injury from occurring.
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Course Notes: Key Ideas You Need to Know
Major Challenges Facing Canadian Health Care
Several pressures affect Canada’s ability to provide quality, universal health care.
Worker Shortages
Many rural and remote communities have serious shortages of physicians, nurses, and other health care workers.
Movement toward larger cities leaves smaller communities with fewer educated workers. Support workers are increasingly needed in both rural and urban areas across many provinces.
An Aging Population
The baby boomer generation includes people born between 1945 and 1964.
Canada’s population is aging. People aged 65 and older form the fastest-growing age group, and this pattern is expected to continue for decades.
Many older adults live with chronic health challenges, mobility problems, or mental health problems that may require medical intervention.
Supporting older adults to live safely, independently, and with dignity increases health care costs.
Aging Health Care Workers
Health care workers are aging too.
Research into work and aging has found that older workers have fewer injuries, but their injuries tend to be more severe.
Long Waits for Health Services
Long waiting lists affect surgeries, diagnostic services, and medical procedures.
Long waits create stress for clients. A person’s condition might also worsen while treatment is delayed.
Long Waits for Long-Term Care
Some clients who need long-term care placement cannot live safely at home while they wait.
These clients often remain in acute-care hospitals. This contributes to crowded hospital units and emergency departments.
Many hospitals use continuing care units where clients wait for admission to long-term care.
Rising Health Care Costs
Rising costs are described as the greatest challenge facing the health care system.
New drugs and technologies improve the treatment of diseases and disabilities, but developing them costs money. Building costs and labour costs also continue to rise.
Taxpayers carry these health care costs.
Supplementary Health Services
Provincial and territorial governments provide some people with coverage for services outside the regular publicly funded health care system.
People receiving this extra coverage include some:
- older adults
- children
- recipients of social assistance
Supplementary health benefits often include:
- prescription drugs
- dental care
- vision care
- medical equipment and appliances, including prostheses and wheelchairs
- independent-living assistance
- services from other health care providers, such as chiropractors
Coverage differs across Canada.
Additional health insurance, sometimes called benefits, also helps with services that government funding does not cover. Examples include some rehabilitation and extended-care costs.
A benefit is assistance provided through available insurance premiums . One example is a covered dental procedure that does not require an additional payment from the person receiving it.
Private Health Insurance
People who do not qualify for government supplementary benefits pay for uncovered services themselves or use private health insurance.
Many Canadians receive private insurance through an employer or pay for a plan themselves.
Private insurance plans differ. Coverage for ambulance services, drugs, home care, and other services depends on the individual plan.
Some plans provide broad coverage. Others cover only a few services or pay only part of the cost.
People without private insurance receive only the funding provided through their province or territory.
How Health Care Delivery Is Changing
Health care delivery has shifted toward new ways of providing quality care while reducing unnecessary spending.
Care increasingly takes place outside hospitals.
Examples include:
- clinics
- health care centres
- home care
- services from nurse practitioners
- day surgery performed on an outpatient basis
- private clinics for some procedures, including elective cosmetic surgery
- post-acute services provided in homes and communities
- hospital-alternative services provided in homes and communities
Home care means health care and support services provided where a person lives.
Fewer Acute-Care Hospital Beds
Changes in health care delivery and funding have reduced the number of acute-care hospital beds.
In some communities, this reduction has contributed to hospital overcrowding because enough community services are not yet available.
Regional and Local Decision Making
Most provinces and territories have tried to improve service delivery and control costs by moving more health care decisions to regional or local boards.
Regional authorities include elected and appointed members.
These authorities oversee services in their areas, including:
- hospitals
- long-term care homes
- home care
- public health services
Provincial and territorial governments have also increased their focus on two areas:
- health promotion and disease prevention
- home care
Nova Scotia CCA Note
Sorrentino’s Canadian Textbook for the Support Worker, 5th Edition describes a Canadian trend toward regional or local health boards. Nova Scotia currently uses one provincial health authority, the Nova Scotia Health Authority, rather than separate regional health authorities. The provincial authority uses four management zones, Western, Eastern, Northern, and Central, to deliver and manage health services regionally.
Why this matters in Nova Scotia: For Nova Scotia study, treat Sorrentino’s regional-board discussion as a broad Canadian model. Nova Scotia organizes regional health-service delivery through one provincial health authority and four management zones.
Official source: Health Authorities Act General Regulations
Last checked: August 28, 2026
Alternative Health Practices
Alternative health practices use treatments that differ from traditional medical practice and were not traditionally taught or practised within medical communities.
Examples include:
- massage therapies
- homeopathy
- herbal medicines, including cannabis
- acupuncture
These practices have gained wider acceptance within Western medicine .
Physicians now often order these practices alongside traditional treatments. Some provincial and territorial health plans also cover some alternative health services.
Health Promotion
Health promotion involves strategies that improve or maintain health and independence.
It also involves giving individuals, groups, and communities information and tools that support informed decisions about health and wellness.
Health promotion now forms an important part of Canada’s health care system.
Disease Prevention
Disease prevention means using strategies that stop disease or injury from occurring.
Traditional health care focused heavily on diagnosing, treating, and curing illness. A newer approach places greater focus on preventing illness and injury and keeping people healthy.
Health promotion and disease prevention are now important functions of Canada’s health care system.
Preventing illness and injury is described as more effective and less costly than providing hospital treatment.
Examples of Health Promotion and Disease Prevention
Government and industry policies support health and illness prevention in several ways.
Examples include:
- immunization programs
- prenatal and parenting classes
- campaigns addressing drinking during pregnancy, unsafe sex, and tobacco use
- campaigns encouraging healthy eating and physical activity
- efforts to improve housing
- efforts to decrease poverty
- monitoring drinking water for safety
- protecting the environment
The Support Worker’s Contribution
Support workers provide nonmedical care and services that help prevent major health problems.
A person who has remained on bedrest for a long time is at risk for pressure ulcers, pneumonia, and blood clots.
The support worker helps by:
- keeping the person’s skin clean and dry
- changing the person’s position in bed frequently
- helping with range-of-motion exercises
These actions support the person’s quality of life and help prevent future illness or disability.
Nova Scotia CCA Note
In Nova Scotia, the current Continuing Care Assistant Occupational Standards of Practice define CCA roles, responsibilities, functions, competencies, and the limits under which services are provided. The CCA Scope of Practice and Competency Framework also states that a CCA’s scope of employment may vary from one employer to another.
This means a care action described by Sorrentino is not automatically part of every Nova Scotia CCA job. A Certified CCA’s work must fit the provincial CCA framework and the duties set by the employer.
Why this matters in Nova Scotia: When studying care examples, separate what Sorrentino teaches from the duties that form part of a CCA’s job in a specific Nova Scotia workplace.
Official source: CCA Scope of Practice and Competency Framework
Last checked: August 28, 2026
Common Mix-Ups
| Wrong Idea | Better Idea |
|---|---|
| Supplementary benefits cover every person in the same way. | Provinces and territories provide supplementary coverage to certain people, and coverage varies across Canada. |
| Private insurance plans all provide the same coverage. | Private plans differ in the services and percentage of costs they cover. |
| Health promotion and disease prevention mean the same thing. | Health promotion improves or maintains health and independence. Disease prevention aims to stop disease or injury from occurring. |
| Canadian health care takes place mainly in hospitals and doctors’ offices. | More care now takes place through clinics, health centres, home care, private clinics, and community services. |
| Alternative health practices remain completely separate from Western medicine. | Some are now ordered by physicians, used with traditional treatment, and covered by some provincial or territorial plans. |
Fast Review
Keep these points clear when you review this topic:
- Major pressures include health worker shortages, population aging, long wait times, and rising health care costs.
- Baby boomers were born between 1945 and 1964.
- People aged 65 and older are Canada’s fastest-growing age group.
- Long waits for long-term care contribute to crowded hospitals when clients cannot safely return home.
- Supplementary benefits help certain people with services such as drugs, dental care, vision care, equipment, and independent-living assistance.
- Private insurance coverage differs from one plan to another.
- Home care provides health care and support services in a person’s residence.
- Health care delivery increasingly includes outpatient surgery, community care, home care, clinics, and services from nurse practitioners.
- Health promotion focuses on improving or maintaining health and independence.
- Disease prevention focuses on preventing disease or injury.
- Alternative health practices include massage therapies, homeopathy, herbal medicines, and acupuncture.
- Support workers contribute to health promotion and disease prevention through nonmedical care and services.
Final Pep Talk
This topic has several ideas that sound similar, especially supplementary coverage, private insurance, health promotion, and disease prevention. Focus on the differences between them first, then review the major health care challenges and changing care trends.