Sick Children embarked on campaign to raise $1.3 billion to equip a new hospital. Charities such as the Canadian Cancer Society provide assistance such as transportation for patients. There are no deductibles on basic health care and co-pays are extremely low or non-existent (supplemental insurance such as Fair Pharmacare may have deductibles, depending on income). In general, user fees are not permitted by the Canada Health Act, but physicians may charge a small fee to the patient for reasons such as missed appointments, doctor's notes, and prescription refills done over the phone. Some physicians charge "annual fees" as part of a comprehensive package of services they offer their patients and their families. Such charges are completely optional and can only be for non-essential health options. Benefits and features Health cards are issued by provincial health ministries to individuals who enroll for the program in the province and everyone receives the same level of care. There is no need for a variety of plans because virtually all essential basic care is covered, including maternity but excluding mental health and home care. Infertility costs are not covered in any province other than Quebec, though they are now partially covered in some other provinces. In some provinces, private supplemental plans are available for those who desire private rooms if they are hospitalized. Cosmetic surgery and some forms of elective surgery are not considered essential care and are generally not covered. For example, Canadian health insurance plans do not cover non-therapeutic circumcision. These can be paid out-of-pocket or through private insurers. Health coverage is not affected by loss or change of jobs, cannot be denied due to unpaid premiums, and is not subject to lifetime limits or exclusions for pre-existing conditions. The Canada Health Act deems that essential physician and hospital care be covered by the publicly funded system, but each province has reasons to determine what is considered essential, and where, how and who should provide the services. There are some provinces that are moving towards private health care away from public health care. The result is that there is a wide variance in what is covered across the country by the public health system, particularly in more controversial areas, such as in-vitro fertilization, sex reassignment surgery, or autism treatments. Canada (with the exception of the province of Quebec) is one of the few countries with a universal healthcare system that does not