The private sector
In Canada there is a single tier for insured hospital and medical services, meaning that while
health care services may be delivered privately, the private sector is excluded as a payer from
most health care. The private sector's role as a payer is limited to those services which are not
completely covered by provincial health programmes. These include pharmaceuticals, vision care,
dental care, and the services of allied health professions such as chiropractors and podiatrists.
The health care payers in the private sector include private insurance companies, employers who
provide supplementary health benefits as an employment benefit, and individuals who pay for
supplementary health care out-of-pocket.
With respect to service provision, health care providers are predominantly private. Institutions in
provincial hospital systems are largely individual private not-for-profit organizations with their
own governance structures. They operate under the auspices of provincial ministries of health and
are funded by public monies, but are not owned by the public sector. Physicians are mostly in
private practice and are remunerated on a fee-for-service basis by provincial health insurance
plans, though a trend is developing toward salaried remuneration of specialists in teaching
hospitals and capitation for primary care providers.
8 Health care systems in transition – Canada
Other partners
Many other groups and players help to make up the overall Canadian health care system. Their
scope of responsibility and function vary widely. They may be national, provincial, regional or
local in scope. They may be funded primarily through public, private or charitable sources, and
they may be voluntary or compulsory in nature. They serve education, research, support or
political functions.
These groups include both national and provincial professional associations of physicians, nurses,
allied providers, administrators, or hospitals. These professional groups represent their members
in negotiations with government, assist in professional self-regulation and may add their voice to
policy debate. Accreditation bodies assure the quality of institutional and professional health care
services. Research organizations contribute evaluation of health care services or valuable
interpretation of research. Voluntary organizations may represent researchers, professionals, or
special interest groups or viewpoints. Other groups coordinate the development of data and
information, which supports ongoing evaluation and assessment. Some organizations provide
support, education and funding directed at specific diseases or groups of people. Finally, political
action or consumer groups seek to give citizens a stronger voice in influencing health care
policies.
