Key points
- Canada runs national health insurance: one public insurer per province or territory, funded from taxes — the single-payer model.
- Medically necessary hospital and physician services are free at the point of use, under the Canada Health Act of 1984.
- Most care is delivered by private providers, paid by the public plan — single-payer is about financing, not delivery.
- Outpatient prescription drugs, dental care and vision care are mostly not covered by the public plans.
- Life expectancy at birth was 81.7 years in 2023, and health spending was 11.3% of GDP in 2024 (OECD Health at a Glance 2025).
Direct answer: Canada runs national health insurance — the single-payer model. Each province and territory has one public insurer, funded from taxes, which pays for medically necessary hospital and physician services. Those services are free at the point of use, under the Canada Health Act of 1984. Most care is delivered by private providers, paid by the public plan: single-payer is about who pays, not who delivers. Life expectancy at birth was 81.7 years in 2023, and health spending was 11.3% of GDP in 2024 (OECD Health at a Glance 2025).
At a glance
| Item | Detail |
|---|---|
| Model | National health insurance — single-payer |
| Who pays | One public insurer per province or territory, from taxes |
| Who delivers | Mostly private providers, paid by the public plan |
| What is free at the point of use | Medically necessary hospital and physician services |
| Life expectancy at birth | 81.7 years (2023, OECD Health at a Glance 2025) |
| Health spending | 11.3% of GDP (2024, OECD Health at a Glance 2025) |
| Source for the model and coverage | KFF Health Policy 101 — international comparison |
Figures are a snapshot checked 7 November 2026, not a live feed. No country is ranked as best.
How the system works
Canada’s system is called Medicare, and it is a federal framework with provincial delivery. The Canada Health Act of 1984 sets the national standards — public administration, comprehensiveness, universality, portability and accessibility — and the federal government contributes funding. Each province and territory then runs its own public insurance plan, which is the single payer for the services the Act covers: medically necessary hospital services and physician services. A resident of Ontario is covered by Ontario’s plan; moving to another province means the new province’s plan takes over, with coverage portable across the move.
The first point of contact is the family physician, in private practice, who bills the public plan. Hospitals are mostly private non-profit institutions, funded by the public plan. The government writes the cheques but does not, for the most part, run the clinics and hospitals. That is the key distinction of the single-payer model: it is about financing, not delivery. Read the single-payer guide for the model in full.
Who pays, and what people pay
The public plans are funded from general taxation — federal and provincial. There is no bill for a hospital stay or a visit to the family doctor. But the public plans cover a narrower set of services than the name “Medicare” suggests. Outpatient prescription drugs, dental care, vision care, physiotherapy and home care are mostly not covered by the public plans. Most working Canadians get that coverage through employer-sponsored private insurance, and others buy it themselves or pay out of pocket. The gap between what is covered and what is not is the most common surprise for people comparing Canada with the United Kingdom.
What is free, and what is not
Free at the point of use: medically necessary hospital services and physician services. Not covered by the public plans, in most provinces: outpatient prescription drugs, dental care, vision care, and much of home and long-term care. Some provinces cover more than others — prescription drug coverage for older people and people on low incomes, for example, varies by province — so the boundary is not the same across the country.
How it compares
Canada spends 11.3% of GDP on health — above the OECD average of 9.3% — and its life expectancy of 81.7 years sits above the OECD average of 81.1 years (OECD Health at a Glance 2025). Its distinguishing feature in this set is the narrowness of the public package combined with the breadth of the principle: universal coverage for hospital and physician care, with a large private top-up for everything else. Compare countries side by side in the Health System Comparison tool, or read the other profiles in the country index.
Frequently asked questions
Is Canadian healthcare free?
Medically necessary hospital and physician services are free at the point of use. But outpatient prescription drugs, dental care, vision care and many other services are mostly paid for privately or through employer insurance.
Who runs Canadian healthcare — the federal government or the provinces?
The provinces and territories run it. The federal government sets national standards through the Canada Health Act and contributes funding; each province and territory runs its own public insurance plan.
Can Canadians choose their own doctor?
Yes. Most care is delivered by private providers, including family physicians in private practice, who bill the public plan. Patients choose their family doctor, who is the first point of contact.