© 2001 by Oxford University Press
Journal of the National Cancer Institute, Vol. 93, No. 16, 1196,
August 15, 2001
© 2001 Oxford University Press
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The Canadian Health Care System
Under Canada’s Constitution, the federal government only guarantees that all citizens receive "medically necessary" universal care. The planning, organization, and delivery of that care, however, are left up to provincial and territorial officials who pick up the majority of all health care costs.
Contrary to what many Americans believe, Canada does not have "socialized medicine" in the European sense but a more varied, single-payer public system, termed "Medicare," where provinces each allocate hospital budgets for personnel, equipment, and infrastructure and approve the number of training slots for medical personnel, usually based on the recommendations of professional groups. Professional salaries and health care costs are tightly controlled but are nevertheless reimbursed by each province on a predetermined fee-for-service basis.
Because Medicare coverage varies by province, many Canadians carry supplemental private insurance through their employers that often pays for dental, optical, prescription drug, and other services that are not reimbursed by their provincial Medicare plans. In addition, some provinces require a minimal Medicare premium while a national debate has been stirred by others calling for a limited United States-style two-tiered approach that allows for both public and private care.
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