Overview

Key points

• Canada’s publicly funded, single-payer health system (Medicare) guarantees citizens and permanent residents universal coverage free at the point of use for hospital and physician services.
• Canada’s health system is decentralized, and provincial/territorial (PT) governments are primarily responsible for the governance, regulation, co-financing, administration and delivery of health services for their populations.
• The federal government sets pan-Canadian standards for publicly funded health services through the Canada Health Act (CHA), 1984.
• Roughly 70% of health spending is derived from public sources.
• Funding mechanisms have been stable over time: hospitals are funded primarily through global budgets paid for either directly by PT governments or through health authorities. Physicians are primarily paid fee-for-service; PT governments set rates of remuneration for physicians that are negotiated with provincial medical associations.
• Medicare acts as a social safety net, ensuring Canadians are protected against the financial consequences of ill-health. However, financial barriers may prohibit access to non-Medicare services, such as prescription drugs, dental care, medical devices, home and facility-based long-term care, vision care, physical and occupational therapy, and mental health and addiction services.
• Though life expectancy at birth has increased since 2000, it has plateaued in recent years (81.6 as of 2021) due to the opioid crisis and the COVID-19 pandemic.
• Cancer continues to be the leading cause of death, followed by heart disease and accidents.
• Health inequities are prominent in Canada, with low-income and racialized populations being disproportionately affected. During the first year of the COVID-19 pandemic (March 2020 to early March 2021) Canada saw an increase in both avoidable and excess mortality. Notably, older adults above 84 years represented one third of excess mortality and over half of the deaths caused by COVID‑19.
• Canada is a leader in climate resilience in the health system. The National Adaptation Strategy and the HealthADAPT programme represent commitments by the Government to deliver a climate resilient, low carbon and sustainable health system.