Up North and over the border. Canada. Land of maple syrup, breathtaking scenery, wilderness, French speakers, terrific metro centers, and a mysterious health system. I say “mysterious” because most Americans really have no idea of how it works, and that goes for those who support and lament the Canadian system. I’ve heard people say its “terrible” but they haven’t a clue about it, while others say “that’s the way we should do it here,” and they haven’t a clue either about how the Canadian system works.

When many people fail to understand is that universal healthcare and a national system are 2 very different beasts. And while all industrialized nations, aside from the U.S., have some type of healthcare system that covers all residents in one way or another, they all differ. What they have in common is that no one goes bankrupt trying to pay medical bills, as is common here in the U.S.

But getting back to Canada, before one reviles or applauds their system, at minimum, it is important just to know what you are applauding or reviling. There is a short article in the NY Times which dishes a little bit on how the Canadian system actually works, and hopefully dispels some of the myths and misconceptions.

For example, Canadian physicians are not government employees.  They retain a great deal of control over when, how and where they work. Instead of being paid salaries, most of them bill provincial governments on a fee-for-service basis. Canadian hospitals are also autonomous institutions that are generally, but not necessarily, governed by local health authorities.

The article also discusses, albeit briefly, how the growing private insurance industry opposed publicly funded medical care for all but the poorest Canadians, but ultimately, they did not prevail.