Understanding Canadian Healthcare: The Physicians

Discussions about healthcare reform in the United States often contain references to Canada, but many of those references are inaccurate. The intent here is not to discuss healthcare reform in the U.S. nor other healthcare systems (socialized or otherwise). Rather, this is a clarification on what occurs in Canada. This will be a brief (short and to the point like all my posts) three-part summation. First, let’s take a look at the physicians.

The number of physicians in Canada is at an all-time high with more than 75,000 currently in practice. This equates to approximately 215 physicians per 100,000 people, which is up 4% from the prior year. In fact, the number of physicians per capita has increased for the past 6 years. I think it is important to also note that 15.3% (5.3 million people) of the population are of age 65 years or older.

And the structure? Many Canadian physicians are not government employees, but rather are self-employed. Since Canada has a publicly funded healthcare system, patients are entitled to “essential” health services at no charge and may choose the physician they wish to see. Just as in the United States, the self-employed physicians set their own work hours and choose their desired location. They also are responsible for paying their own practice expenses such as staff salaries, office rent, operational expenses, etc.

How are they paid? Canadian physicians bill the government for services rendered in taking care of patients. Although the Canadian system is often classified as socialized medicine, it actually consists of many private practice physicians billing the government for reimbursement. The reimbursement, indeed, comes from a publicly-funded structure. On average, patients over the age of 65 spend approximately $5,400 annually in out-of-pocket expenses.

Tomorrow we will take a brief look into the system funding and patient fees.


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