Two-tier healthcare
In other, typically poorer countries, the public health system is underfunded and overstretched, offering opportunities for private companies to deliver better-quality, albeit more expensive coverage.
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.
[citation needed] The decentralized, universal, publicly-funded health system is called Canadian Medicare.
[1] 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.
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.
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).
In 2005, the Supreme Court of Canada ruled that in Quebec, such bans are unconstitutional if the waiting period for care is excessively long.
The Shouldice Hospital, however, has mandatory additional room charges not covered by public health insurance.
Healthcare in France is a system of private and public physicians, who largely draw their income from the government.
[4] Optional additional supplementary insurance funds are available for purchase for elective coverage, such as for plastic surgery or for extra amenities in hospital.
Public insurance guarantees universal coverage, with no expenditure from patients other than a fraction of prescription drug cost.
Historically, avoiding waiting lists was the main reason that patients opted out of NHS treatment and into private care.
[7] As a result of these improvements, long waiting times reduced, and the private healthcare sector now sells its surplus capacity to the NHS.
The equivalent NHS operations in Wales, Scotland and Northern Ireland do not often fund treatment outside of their own facilities.
Whether the NHS funds treatment in a private hospital is a decision for the local commissioning health authority based on formal service contracts.
The United States has a two-tier health system, but most of the population cannot gain access to the public provision tiers.
Healthcare provided directly by the government is limited to military and veteran families and to certain Native American tribes.
Since enacting the Patient Protection and Affordable Care Act in 2010, Medicaid has been substantially expanded, and federal subsidies are available for low- to middle-income individuals and families to purchase private health insurance.
