Canada’s healthcare system is popularly known as ‘free’ among global audiences. It is universal coverage for medically necessary healthcare services provided on the basis of need, rather than the ability to pay. However, we have a myriad of systems and they aren’t truly free. To capture a high-level picture of the cost of healthcare in Canada, we look at the price of public healthcare insurance and examine how long Canadians wait to receive necessary care.
Public Healthcare
Canada is an anomaly among other countries with a universal healthcare system because ours does not include coverage for prescription drugs unless you are in the hospital. We also have a dual coverage system. Canadians can receive coverage for healthcare services, products, and prescription drugs from both public (government) and private insurance. A small percentage of Canadians have only public healthcare insurance.
For those who have a combination of government and private coverage, there may still be remaining out-of-pocket expenses depending on insurance limits and other costs, such as premiums and deductibles. Public programs in Canada pay for only 42% of total prescription drug expenditures, private insurance plans (usually these are a combination of employer and employee premiums) pay for 35%, and patients pay a whopping 23% out-of-pocket.1
The federal government funds the bulk of our healthcare systems through transfer payments to the provinces and territories (P & T) from tax contributions made by Canadians, including taxes on income, property, profit, sales, and more. However, the funds go into general revenue for the P & T, rather than to healthcare exclusively.2
Thus, it’s hard to track how much of your tax dollars go into healthcare. Researchers sought to answer this by calculating the amount households, including individuals, contribute to the country’s total healthcare spending (these do not include dependents and children since they are not taxpayers). According to the Canadian Institute of Health Information, governments directed approximately $172B of Canadian tax dollars toward public healthcare costs in 2019.
Researchers divided Canadian families into ten income groups. Families with the lowest average yearly total incomes of $14,168 will pay an average of $471 for public health insurance in 2020. Families with an average income of $65,522 will pay $6,627. The top-earning Canadian families, on the other hand, with an average income of $281,988 will contribute $39,731.
This methodology assumes that that the amount of tax going toward healthcare insurance is equal to tax revenues spent on healthcare by the government, which researchers estimated to be 28.8% for 2020/21.
Wait Times
In 2019, the national wait time average for treatment after a specialist appointment was 10.8 weeks, which is a slight improvement of 0.2 weeks shorter than in 2018. However, the average wait time for receiving medically necessary surgeries and procedures after a referral from a general practitioner was 21 weeks, an increase of two weeks compared to 2018.3
Quebec has the shortest wait times for specialists, with an average of seven weeks, while Prince Edward Island (PEI) suffers from the longest, at about 29 weeks. Ontario has the shortest wait time from consultation with a specialist to receiving treatment, at eight weeks, while PEI has the longest wait time of 20.5 weeks. 80-93% of Ontarians needing surgery in the digestive system and thoracic surgery for gastroesophageal reflux disease received timely care by performance benchmarks.4
Access to diagnostic testing also has its barriers, which is crucial for people with digestive diseases and disorders. Individuals waited around 4.8 weeks for a computed tomography scan, 9.3 weeks for a magnetic resonance imaging scan, and 3.4 weeks for an ultrasound.
Governments across Canada have prioritized healthcare services to combat COVID-19, postponing elective surgeries in the early months of the pandemic, leading to backlogs of more than 100,000 by May 2020.5 It is too early to determine the consequences these delays will have on our healthcare systems.
First published in the Inside Tract® newsletter issue 215 – 2020
1. Brandt J et al. Prescription drug coverage in Canada: a review of the economic, policy and political considerations for universal pharmacare. Journal of Pharmaceutical Policy and Practice. (2018)11:28.
2. Barua B et al. The Price of Public Healthcare Insurance, 2020. Fraser Institute. August 2020.
3. Bachhus B et al. Waiting Your Turn Wait Times for Health Care in Canada, 2019 Report. Fraser Institute. December 2019.
4. System Performance. Health Quality Ontario page. Available at: https://www.hqontario.ca/System-Performance/Wait-Times-for-Surgeries-and-Procedures/Wait-Times-for-Other-Surgeries-and-Procedures/Time-from-Decision-to-Having-Surgery-or-Procedure. Accessed 2020-08-20.
5. CADTH. Resumption of Elective Health Services Amid COVID-19. CADTH Briefing Note. May 2020.
Photos: © konephoto | bigstockphoto.com, © ValdekS | bigstockphoto.com
FAQs
The health system is funded mainly by provincial or territorial general tax revenue with some federal transfers and is free at the point of delivery for citizens. There is no cost-sharing for inpatient or outpatient care and prescription drug prices vary but are still inexpensive.
How do Canadians pay for health care? ›
Canada has a universal health care system funded through taxes. This means that any Canadian citizen or permanent resident can apply for public health insurance. Each province and territory has a different health plan that covers different services and products.
Do US citizens have to pay for healthcare in Canada? ›
Health care in Canada is provided through Provincial Health Ministries for taxpaying citizens and Permanent Residents and their families. It is not “free” to visiting US tourists so they need to buy travel insurance coverage for their Canadian visit in the same that Canadians do when they go south for the winter!
How much does healthcare cost per month in Canada? ›
How much does health insurance in Canada cost? Private health insurance in Canada costs about $756 annually or about $63 per month, according to the latest figures gathered by the Canadian Institute for Health Information (CIHI).
Does US health insurance work in Canada? ›
Canada provides world-class hospitals and top-ranked health care in the event of a medical emergency. However, U.S. government health insurance plans do not pay for hospital costs, medical expenses or prescription drugs for visitors to Canada.
Do all Canadians get free healthcare? ›
Can You be Denied Healthcare in Canada? Canadian citizens and permanent residents are entitled to free public healthcare, while tourists and visitors are not. However, anyone in Canada can seek private healthcare.
Can I use Medicare in Canada? ›
In most situations, Medicare won't pay for health care or supplies you get outside the U.S. The term “outside the U.S.” means anywhere other than the 50 states of the U.S., the District of Columbia, Puerto Rico, the U.S. Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands.
Can I go to the ER in Canada without insurance? ›
For uninsured residents and non-residents, hospital outpatient fees are applicable for each and every emergency visit, outpatient clinic visit (ambulatory care, Childbirth Centre, day surgery, rehabilitation, orthopedic services, etc).
What happens if an American gets sick in Canada? ›
If during your visit to Canada you get sick or injured, the Canadian government won't pay for any hospitalization or emergency medical services for visitors. Also, if you don't have proper medical insurance coverage, you will be liable to pay for any medical service out of your own pocket.
Can a US citizen see a doctor in Canada? ›
Can an American visit a Canadian doctor when visiting Canada for treatment purposes if they don't have health insurance? They can, yes, if they can find one to take them. But they'll need to pay cash or credit (typically in advance) for whatever they want done.
Canada fares better than the United States with regard to coverage, cost, and health outcomes. While overall access is better in Canada, patients are sometimes required to endure longer wait times than in the United States.
Is it worth getting health insurance in Canada? ›
If you're one of the many Canadians who don't receive health benefits through work, we're here to say that yes, health insurance is worth paying for. And it's very likely that you'll use it. It will save you money AND help keep you healthy.
Can a tourist get health insurance in Canada? ›
When Visitors to Canada coverage is purchased prior to arrival in Canada, coverage becomes effective on the day you arrive. The plan is also available for purchase within 30 days of arrival, and coverage commences 72 hours following the date of application.
Can US citizens go to Canada for free healthcare? ›
Do tourists get free healthcare in Canada? No. However, it is possible for non-residents to get emergency healthcare coverage while in Canada (but it won't cover non-emergency expenses). This is highly recommended no matter whether you're visiting the country for one week or multiple months.
Does my US insurance cover me in Canada? ›
An American car insurance policy works the same way in Canada as it does in the U.S. Your comprehensive car insurance coverage and auto collision coverage, for example, still apply to damage to your vehicle if you're in an accident while driving in Canada.
Can Americans pay for healthcare in Canada? ›
Foreigners will receive emergency care, but non-urgent medical treatment won't be covered. To make sure you won't have to pay for all of your medical expenses, you should sign up for an international health insurance plan.
How much do Canadians pay in taxes for free health care? ›
Article content. Contrary to the myth that Canadian health care is “free,” families pay anywhere from $726 to $41,916 annually for it through their taxes, according to a new study by the Fraser Institute.
How much does Canada pay per person for healthcare? ›
In 2022, overall health expenditure in Canada is predicted to be 331 billion Canadian dollars or 8,563 Canadian dollars per person.
How do doctors get paid in Canada if healthcare is free? ›
Doctors are self-employed, which means they can determine their own hours and work location, and they are responsible for paying their employees, for office space and other overhead expenses. Doctors earn money by billing their provincial government for the services they provide to patients.
Do Canadians pay less for healthcare than Americans? ›
Health expenditures in the United States average out at $12,914 per person, nearly double the $6,500 spent per person in Canada.
