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Health care in Canada is delivered through a publicly funded health care system, which is mostly free at the point of use and has most services provided by private entities.〔Public vs. private health care ''CBC'', December 1, 2006.〕 It is guided by the provisions of the Canada Health Act of 1984.〔(【引用サイトリンク】title=Overview of the Canada Health Act )〕 The government assures the quality of care through federal standards. The government does not participate in day-to-day care or collect any information about an individual's health, which remains confidential between a person and his or her physician.〔(【引用サイトリンク】title=Five things Canadians get wrong about the health system )〕 Canada's provincially based Medicare systems are cost-effective partly because of their administrative simplicity. In each province, each doctor handles the insurance claim against the provincial insurer. There is no need for the person who accesses health care to be involved in billing and reclaim. Private health expenditure accounts for 30% of health care financing.〔(【引用サイトリンク】url=https://secure.cihi.ca/free_products/FundRep_EN.pdf )〕 The Canada Health Act does not cover prescription drugs, home care or long-term care, prescription glasses or dental care, which means most Canadians pay out-of-pocket for these services or rely on private insurance.〔 Provinces provide partial coverage for some of these items for vulnerable populations (children, those living in poverty and seniors).〔 Limited coverage is provided for mental health care. Competitive practices such as advertising are kept to a minimum, thus maximizing the percentage of revenues that go directly towards care. In general, costs are paid through funding from income taxes. In British Columbia, taxation-based funding is supplemented by a fixed monthly premium which is waived or reduced for those on low incomes.〔(【引用サイトリンク】title=Ministry of Health - Redirect )〕 There are no deductibles on basic health care and co-pays are extremely low or non-existent (supplemental insurance such as Fair Pharmacare may have deductibles, depending on income). In general, user fees are not permitted by the Canada Health Act, though some physicans get around this by charging annual fees for services which include non-essential health options, or items which are not covered by the public plan, such as doctors notes, prescription refills over the phone.〔 A health card is issued by the Provincial Ministry of Health to each individual who enrolls for the program and everyone receives the same level of care.〔(【引用サイトリンク】title=Provincial/Territorial Role in Health )〕 There is no need for a variety of plans because virtually all essential basic care is covered, including maternity. Infertility costs are not covered fully in any province other than Quebec, though they are now partially covered in some other provinces. In some provinces, private supplemental plans are available for those who desire private rooms if they are hospitalized. Cosmetic surgery and some forms of elective surgery are not considered essential care and are generally not covered. These can be paid out-of-pocket or through private insurers. Health coverage is not affected by loss or change of jobs, health care cannot be denied due to unpaid premiums (in BC), and there are no lifetime limits or exclusions for pre-existing conditions. The Canada Health Act deems that essential physician and hospital care be covered by the publicly funded system, but each province has some license to determine what is considered essential, and where, how and who should provide the services. The result is that there is a wide variance in what is covered across the country by the public health system, particularly in more controversial areas, such as midwifery or autism treatments.〔 Canada is the only country with a universal healthcare system that does not include coverage of prescription medication.〔(【引用サイトリンク】title=Canadian medicare needs an Rx )〕〔(【引用サイトリンク】title=Why, in a sea of pink, are so many cancer patients in the red? )〕 Pharmaceutical medications are covered by public funds in some provinces for the elderly or indigent,〔CIHI p.91〕 or through employment-based private insurance or paid for out-of-pocket. Most drug prices are negotiated with suppliers by each provincial government to control costs but more recently, the Council of the Federation announced an initiative for select provinces to work together to create a larger buying block for more leverage to control costs.〔(【引用サイトリンク】title=Canada's Premiers - The pan-Canadian Pharmaceutical Alliance )〕 More than 60 percent of prescription medications are paid for privately in Canada.〔 Family physicians (often known as general practitioners or GPs in Canada) are chosen by individuals. If a patient wishes to see a specialist or is counseled to see a specialist, a referral can be made by a GP. Preventive care and early detection are considered important and yearly checkups are encouraged. 2012 saw a record year for number of doctors with 75,142. The gross average salary was $328,000. Out of the gross amount, doctors pay for taxes, rent, staff salaries and equipment. Recent reports indicate that Canada may be heading toward an excess of doctors,〔http://fullcomment.nationalpost.com/2013/10/08/barer-evans-what-doctor-shortage/〕 though communities in rural, remote and northern regions, and some specialities, may still experience a shortage.〔(【引用サイトリンク】title=More health specialists not the answer to health system woes )〕〔http://fullcomment.nationalpost.com/2013/02/22/maria-mathews-calling-all-country-doctors/〕 ==Public opinion== Canadians strongly support the health system's public rather than for-profit private basis, and a 2009 poll by Nanos Research found 86.2% of Canadians surveyed supported or strongly supported "public solutions to make our public health care stronger." A Strategic Counsel survey found 91% of Canadians prefer their healthcare system instead of a U.S. style system. A 2009 Harris/Decima poll found 82% of Canadians preferred their healthcare system to the one in the United States. A 2003 Gallup poll found 25% of Americans are either "very" or "somewhat" satisfied with "the availability of affordable healthcare in the nation", versus 50% of those in the UK and 57% of Canadians. Those "very dissatisfied" made up 44% of Americans, 25% of respondents of Britons, and 17% of Canadians. Regarding quality, 48% of Americans, 52% of Canadians, and 42% of Britons say they are satisfied.〔(【引用サイトリンク】title=Healthcare System Ratings: U.S., Great Britain, Canada )〕 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Health care in Canada」の詳細全文を読む スポンサード リンク
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