Unlike germany, Canada has severed the link between employment and health insurance.

Wealthy or poor, employed or jobless, retired or under age 18, every Canadian receives the same health insurance, financed in the same way. No Canadian would even imagine that leaving, changing jobs, retiring from, or losing a job has anything to do with health insurance. In Canada, no distinction is made between the two public financing mechanisms of social insurance (in which only those who contribute receive benefits) and public assistance (in which people receive benefits based on need rather than having contributed). Everyone contributes through the tax structure and everyone receives benefits. The benefits provided by Canadian provinces are broad, oncluding hospital, physician, and ancillary drugs, although the scope of drug coverage and also long-term care benefits-varies across provinces. The Canadian health care system is unique in its prohibition of private helath insurance for coverage of services included health plans. Hospitals and physician that receive payments from the provincial helath plans are not allowed to bill private insurers for such services thereby avoiding the preferential treatment of privately insured patients that occurs in many helath care systems. A small number of upper- income canadins purchased health insurance policies for the few gaps in provincial health insurance plan coverage or for such amenities as private hospital rooms. GENERAL TAXES PROVINCI AL HEALTH PLAN Global budget hospital

Fee For service

Specialist and primary care care service

Fify percents of Canadian physicians are GPs or family phycians who act as gatekeepers to the medical care delivery system. Canadians have free choice of physicians, as a rule, Canadians see their GP for routine medical problems and visit specialists only through referral by the GP. Specialists are allowed to see patients without referral, but only receive the higher specialist fee if they include the referral slip in their billing; for that reason most specialists will not see patients without a refferal. Family of GP can see and help treated her/his family in hospital.

Canadians on average wait longer for elective operations than do insured people in US, although more vital operations such a kidney and bone marrow transplants are performed in a more timely fashion overall in Canada than in the united stated. Canada universal insurance program has created a fairer system for distributing helath services. Low income Canadians are much less likely than their counterparts in the US to report experiencing financial barriers to medical care. Several studies have shown that low income Canadians receive more services than Canadians from higher income groups. A GP collecting fees is a simple matter, each week they sends a computer disk to the provincial government, listing the patients they saw and the services they provided. Within a month, she is paid in full according to a fee schedule. Most physicians in Canada GP and specialists are paid on a feee for services basis, with fee levels negotiated between provincial governments and provincial medical associations.