The 2003 first ministers accord on health care renewal, February 2003, and the 2004 first ministers 10 year plan to strengthen health care, September 2004, do not deal with the issue of private care.
However, in both of these accords, first ministers reaffirmed their commitment to the five principles of health care insurance as described in the Canada Health Act, namely those of public administration, comprehensiveness, universality, portability and accessibility. For both accords, first ministers agreed to ensure that timely access to medically necessary health services is based on need, not ability to pay. This means that all medically necessary hospital services and all medically required physician services are available to insured residents of a province or territory on a prepaid basis, that is, without direct charges to insured persons.
In addition, the 10 year plan includes funding of $41 billion to meet the funding recommendations of the Romanow report and builds on the 2003 accord which provided $27 billion over five years to ensure timely access to quality health care. The 2004 10 year plan also includes a commitment to the Canada Health Act dispute avoidance and resolution mechanism that requires the federal, provincial and territorial governments to work collaboratively to avoid and resolve intergovernmental disputes while respecting the legislative provisions of the governments involved.