The health care system in Canada is decentralized and publicly financed through the tax revenues of the federal, provincial, and territorial (FPT) governments. Canadian universal health coverage is known as Medicare, which provides medically necessary care usually free at the point of use, but it does not provide prescriptions, dental, or vision coverage. Despite having one of the most expensive universal health care systems in the OECD, Canada's performance in terms of resource availability and access is typically below that of the average OECD nation. A Commonwealth Funds report in 2021 compared healthcare systems of 11 high-income countries and Canada was placed second to last.
The Canadian healthcare system was founded on the idea that access to care should be determined by need rather than financial capacity, the Canada Health Act ensures this principle is followed when provinces and territories (P/T) offer health plans. Due to multiple factors, the total healthcare expenditure varies between different provinces and territories, Nunavut had the highest per capita spending across all P/T in 2021. Although Canada's total health spending both in terms of per capita and share of GDP is higher than the OECD average, the public sector's share in total healthcare expenditure was slightly less than the OECD average. Similar to other OECD countries, the aging population in Canada is increasing leading to an increased demand for long-term care and end-of-life care homes resulting in higher health expenditure.
Drug costs in Canada have risen more quickly than any other aspect of healthcare spending in recent years, accounting for a large proportion of total healthcare spending. In 2021, Canadians spent an estimated 36 billion Canadian dollars on prescription drugs, of this over 20 billion was private sector health spending. Canada’s prescription drug coverage system is made up of a somewhat uncoordinated mixture of public and private insurance programs that vary in terms of eligibility, patient fees, and pharmaceuticals covered.
Access to care
The federal government in Canada is responsible for administering and setting healthcare standards, while the P/T governments oversee funding, planning, and delivering health services as well as managing the healthcare workforce. Excessive waiting time to access care has been highlighted as a major problem in the Canadian health system, even as provinces have made efforts to reduce long waiting times. Hospitals are a mix of public and private, predominantly not-for-profit, organizations. Physicians and health specialists in Canada are usually self-employed, while nurses are generally employed in hospitals. Health care providers may be regulated or non-regulated, unionized or non-unionized, employed, self-employed, or volunteer. To meet the overall healthcare needs of the population, nearly 90 percent of Canadians believed there should be a focus on improving healthcare capacity and services.
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