Health System in Canada
With a population of 35 million people spread over a vast area, Canada is a highly decentralized federation. Provincial governments carry much of the responsibility for the governance, organization, and delivery of health services although the federal government plays an important role in maintaining broad standards for universal coverage, direct coverage for specified populations, data collection, health research, and pharmaceutical regulation. Roughly 70% of total health spending is financed from the general tax revenues of federal, provincial, and territorial governments. Most public revenues are used to provide universal access to acute, diagnostic, and medical care services that are free at the point of service as well as more targeted (nonuniversal) coverage for prescription drugs and long-term care services. In the last decade, there have been no major pan-Canadian health reforms, but individual provincial and territorial governments have focused on reorganizing and fine-tuning their regional health system structure and improving the quality, timeliness, and patient experience of primary, acute, and chronic care services. While Canada’s system of universal coverage has been effective in providing citizens with deep financial protection against hospital and physician costs, the narrow scope of coverage has also produced some gaps in coverage and equitable access (Romanow 2002).
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