Health care in Canada is delivered through a publicly-funded health care system, which is mostly free at the point of use and has most services provided by private entities. It is guided by the provisions of the Canada Health Act. 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 their physician. Canada's Provincially based Medicare systems are cost effective partly because of their administrative simplicity. 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. Private insurance is only a minimal part of the overall health care system. Competitive practices such as advertising, other forms of self promotion activities 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 although three provinces also impose a fixed monthly premium which may be 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. 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, as long as premiums are up to date, 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 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 not only extends life expectancy and quality of life, but cuts down overall costs. Those suspected of abusing the system by over-frequent or frivolous use, can be tracked by the doctor through the ID on their health insurance card and may have to wait longer than those with more urgent needs.
Public opinion
Canadians strongly support the health system's public rather than for-profit private basis, and a 2009 poll by Nanos Research found 86.2% of Canadians surveyed supported or strongly supported "public solutions to make our public health care stronger."
A 2009 Harris/Decima poll found 82% of Canadians preferred their healthcare system to the one in the United States, more than ten times as many as the 8% stating a preference for a US-style health care system for Canada while a Strategic Counsel survey in 2008 found 91% of Canadians preferring their healthcare system to that of the U.S.. In the same poll, when asked “overall the Canadian health care system was performing very well, fairly well, not very well or not at all?” 70% of Canadians rated their system as working either "well" or "very well". A 2003 Gallup poll found only 25% of Americans are either "very" or "somewhat" satisfied with "the availability of affordable healthcare in the nation," versus 50% of those in the UK and 57% of Canadians. Those "very dissatisfied" made up 44% of Americans, 25% of respondents of Britons, and 17% of Canadians.
Conversely, the contrast between Canadians and Americans differs less when consumers are asked to rate their satisfaction with their own health care, rather than about the health care system in general. Two parallel studies between Canadians and Americans show that there is no statistically significant difference between the two countries with regard to the health care they receive Along similar lines, a Gallup Poll of September 2009 shows a marked increase by Americans of "Overall, 80% are satisfied with the quality of medical care available to them, including 39% who are very satisfied. Sixty-one percent are satisfied with the cost of their medical care, including 20% who are very satisfied".
In November 2004, Canadians voted Tommy Douglas, Canada's "father of Medicare," the Greatest Canadian of all time following a nationwide contest sponsored by the CBC.
Economics
The amount Canadians spend on health care in 1997 dollars has increased every year between 1975 and 2009 from $39.7 billion to $137.3 billion or a more than doubling of per capita spending from $1,715 to $4089. In 2009 dollars spending is expected to reach $183.1 billion ( a more than five percent increase over the previous year ) or $5,452 per person. Most of this increase in health care costs has been covered by public funds. The greatest proportion of this money goes to hospitals ($51B), followed by pharmaceuticals ($30B), and physicians ($26B). Total spending in 2007 was equivalent to 10.1% of the gross domestic product which was slightly above the average for OECD countries, and below the 16.0% of GDP spend on health care in the United States.. The proportion spent on hospitals and physicians has declined between 1975 and 2009 while the amount spent on pharmaceuticals has increased.
Of the three biggest health care expenses, the amount spent on pharmaceuticals has increased the most. In 1997 the total price of drugs surpassed that of doctors. In 1975 the three biggest health costs were hospitals ($5.5B/44.7%), physicians ($1.8B/15.1% ), and medications ($1.1B/8.8% ) well in 2007 the three biggest costs were hospitals ($45.4B/28.2% ), medications ($26.5B/16.5% ), and physicians ($21.5B/13.4% ).
In 2009 government funded about 70% of Canadians' health care costs. This covered most hospital and physician cost while the dental and pharmaceutical costs were primarily paid for by individuals. This is slightly below the OECD average. Under the terms of the Canada Health Act, public funding is required to pay for medically necessary care, but only if it is delivered in hospitals or by physicians. There is considerable variation across the provinces/territories as to the extent to which such costs as out of hospital prescription medications, physical therapy, long-term care, dental care and ambulance services are covered.
Canada has a publicly funded medicare system, with most services provided by the private sector. Each province may opt out, though none currently do. Canada's system is known as a single payer system, where basic services are provided by private doctors (since 2002 they have been allowed to incorporate), with the entire fee paid for by the government at the same rate Most government funding (94%) comes from the provincial level.. Most family doctors receive a fee per visit. These rates are negotiated between the provincial governments and the province's medical associations, usually on an annual basis. Pharmaceutical costs are set at a global median by government price controls.
Health care costs per capita vary across Canada with Quebec ($4,891) and British Columbia ($5,254) have the lowest costs and Alberta ($6,072) and Newfoundland ($5,970) having the highest. It is also the greatest at the extremes of age with in 2007 a cost of $17,469 per capita in those older than 80 and $8,239 for those less than 1 year old in comparison to $3,809 for those between 1 and 64 years old.
History
18th century
Hospitals were initially places which cared for the poor; others were cared for at home. In Quebec (formerly known as New France and then as Lower Canada), a series of charitable institutions, many set up by Catholic religious orders, provided such care. As the country grew, hospitals grew with them. They tended to be not-for-profit, and were run by municipal governments, charitable organizations, and religious denominations (both Catholic and Protestant). These organizations tended to be at arm's length from government; they received subsidies from provincial governments to admit and treat all patients, regardless of their ability to pay. Dr. David Parker of the Maritimes was the first to operate using anesthetic. One of the first "modern" operations, the removal of a tumour, was performed by William Fraser Tolmie in British Columbia.
19th century
The first medical schools were established in Lower Canada in the 1820s. These include the Montreal Medical
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