Editing Two-tier healthcare (section)

==Canada==
{{Main|Healthcare in Canada}}
In Canada, patients have freedom with regard to which doctors and facilities they use. Under Canada's single-payer system, all Canadian citizens have the right to access healthcare services governed by provincial and territorial authorities. Within a person's province of residence, where they pay taxes, they are able to access any doctor they choose for most basic and essential healthcare services free of charge. Both referrals to specialists and hospital visits are covered.{{fact|date=January 2023}}

The decentralized, universal, publicly-funded health system is called Canadian Medicare. The federal government distributes funds to the provinces for healthcare, providing that the provinces have designed their systems to meet certain criteria, which they all do at present. Most people receiving care in Canada do not pay for their care apart from prescriptions and certain procedures that are not covered, such as visits to dentists, optometrists, and some others. The healthcare system is financed primarily through tax revenue. Canadians can choose to purchase health insurance to cover some or all of the healthcare services that are not covered by the government. Medical providers are generally paid fixed fees depending on the type of visit. The average doctor is paid $258,049 a year for the care provided.<ref>according to indeed.com (an employment website)</ref> In situations where a doctor is being paid by their respective provincial healthcare system, the law bans the medical provider from charging patients to supplement their income from Medicare.{{fact|date=January 2023}}

Canada technically does not have a two-tiered healthcare system. However, some services in Canada are covered not by government provided healthcare, but instead by the private sector (dentistry, laser eye surgery, most cosmetic plastic surgeries), while most basic essential services are provided by the public healthcare systems, which are primarily administered by the country's 13 provinces and territories. Each province and territory has their own insurance plan receiving federal funding on a per-capita basis. About 70% of Canada's healthcare spending is via the public system. The other 30% comes from private funding, divided approximately equally between out-of-pocket funding and private insurance, which may be complementary (meeting costs not covered by the public system such as the cost of prescription medicines, dental treatments, and copayments) or supplementary (adding more choice of provider or providing faster access to care).<ref>{{Citation
 |publisher  = Canadian Institute for Health Information
 |title      = Exploring the 70/30 Split: How Canada's Health Care System Is Financed
 |year       = 2005
 |url        = http://secure.cihi.ca/cihiweb/products/FundRep_EN.pdf
 |access-date = 2009-05-27
}}{{Dead link|date=July 2018 |bot=InternetArchiveBot |fix-attempted=no }}</ref> Financial disincentives are in place to make private medicine for services that are covered by Medicare less economical.{{fact|date=January 2023}}

Six of Canada's ten provinces used to ban private insurance for publicly insured services to inhibit queue jumping and so preserve fairness in the health care system. In 2005, the [[Supreme Court of Canada]] ruled that in Quebec, such bans are unconstitutional if the waiting period for care is excessively long. However, this ruling only applies within the Province of Quebec. A second court challenge to determine whether the prohibition of private parallel health care violates the patients' right to life, liberty, and security under Section 7 of the Canadian Charter of Rights and Freedoms was defeated by the [[Supreme Court of British Columbia]] in 2020.<ref>{{Cite news|date=10 September 2020|title=Private Vancouver clinic loses constitutional challenge of public health-care rules|work=CBC News|url=https://www.cbc.ca/news/canada/british-columbia/cambie-surgeries-case-trial-decision-bc-supreme-court-2020-1.5718589|access-date=2020-09-10}}</ref>

Some private hospitals operating at the time the national healthcare plan was being instituted (for example, the [[Shouldice Hernia Centre]] in [[Thornhill, Ontario]]) continue to operate, but they may not bill additional charges for medical procedures. The Shouldice Hospital, however, has mandatory additional room charges not covered by public health insurance. That effectively places it in the "upper tier" of a two-tier system. Welfare recipients, for example, cannot be referred there, as they would not be able to afford the extra costs.{{fact|date=January 2023}}

Clinics are usually private operations but may not bill additional charges. Private healthcare may also be supplied, both in uncovered fields and to foreigners.{{fact|date=January 2023}}