Medical and Healthcare in Canada

Medical and Healthcare in Canada is delivered through a publicly funded healthcare system, which is mostly free at the point of use and has most services provided by private entities. It is a universal system paid through taxes and it is guided by the provisions of the Canada Health Act of 1984. The government assures the quality of care through federal standards. The government does not participate in day-to-day care or collect any information about an individual’s health, which remains confidential between a person and his or her physician. Canada’s provincially based Medicare systems are cost-effective partly because of their administrative simplicity. Governments are responsible for financing, organizing and delivering health services and supervising providers.

Each province and territory have its own healthcare insurance plan. In each province each doctor handles the insurance claim against the provincial insurer. There is no need for the person who accesses health care to be involved in billing and reclaim. The Medicare system covers 70% of Canadians healthcare needs while private health expenditure accounts for 30% of health care financing. This 30% refers to needs such as prescription drugs, eye care and dentistry are not covered or partially covered by Medicare.

Competitive practices such as advertising are kept to a minimum, thus maximizing the percentage of revenues that go directly towards care. In general, costs are paid through funding from income taxes. In British Columbia, taxation-based funding is supplemented by a fixed monthly premium which is waived or reduced for those on low incomes. 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).

A health card is issued by the Provincial Ministry of Health to each individual who enrolls for the program 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 and infertility problems. Each province and territories will provide free emergency Medicare even if you do not have a health card however, there may be restrictions depending on a person’s immigration status. Depending on the province, dental and vision care may not be covered but are often insured by employers through private companies.

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. These can be paid out-of-pocket or through private insurers. Health coverage is not affected by loss or change of jobs, health care cannot be denied due to unpaid premiums (in BC), and there are no lifetime limits or exclusions for pre-existing conditions.

Pharmaceutical medications are covered by public funds for the elderly or indigent, or through employment-based private insurance. Drug prices are negotiated with suppliers by the federal government to control costs. Family physicians (often known as general practitioners or GPs in Canada) are chosen by individuals. If a patient wishes to see a specialist or is counseled to see a specialist, a referral can be made by a GP. Preventive care and early detection are considered important and yearly checkups are encouraged. Early detection extends life expectancy and quality of life, and also reduces overall costs.

Facts About the Canadian Healthcare System:

In a 2020 Statistics Canada Canadian Perspectives Survey Series (CPSS) 69% of Canadians self-reported that they had excellent or very good physical health—an improvement from 60% in 2018.
About 2/3 of Canadians have private insurance.
Canada is the only country with universal healthcare that does not include prescription drugs.
Canada has 15 difference healthcare systems.

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