Did you not see your countryman up there talking about “uniform negotiated fee schedules” and such? It’s easy to get tripped up here by Canadians, and I mean no snark either.
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The uniform fee schedule doesn’t mean that it’s an insurance system. It means that it’s a set fee-for-service, paid by the provincial medicare commission to the doctor.
Here’s why it’s not insurance, compared to the US model, which is insurance.
US: Tee goes to a doctor or a hospital. They provide Tee with medical services. Tee owes them that money. Tee is covered by insurance. Tee’s insurance company pays the medical bills on Tee’s behalf, to the extent those bills are covered by Tee’s insurance policy. Things that aren’t covered, Tee has to pay himself (e.g. - one of the doctors who had involvement in Tee’s care isn’t in his insurance company’s approved network).
As you say:
Canada: Piper goes to a doctor or a hospital. They provide Piper with medical services. Piper does not owe them any money. Piper is a resident of the province and covered by medicare. The provincial medicare commission owes the doctor or hospital for Piper’s care. The provincial medicare commission has a set fee schedule for all medical charges and procedures. The provincial medicare commission pays the doctor and hospital in full for the the medical charges and procedures. Piper is not on the hook for any of the charges.
It’s not an insurance system in Canada. I pay no premiums, I’m not liable personally for the cost of the care, and I have no contractual relationship with the provincial medicare commission. The provincial medicare commission is liable directly to the doctor and hospital and pays directly, not on behalf of me. It’s a government service, paid out of general tax revenue, not an insurance system.