While Canadian patients are rumored to come to the United States for more prompt treatment, in fact very few do so. Canadian hospitals, most of which are private nonprofit institutions, negotiate a global budget with the provincial governments each year. Hospitals must receive approval from the provincial health plan for new capital projects such as the purchase of expensive new technology or the construction of new facilities. Canada achieved its lower cost position by constraining new technology, eliminating duplication of facilities and services, simplifying prepayment, and minimizing administrative overhead. In order to control costs, Canada is experimenting with Germany s system of expenditure caps for physician services.
Some employers offer such supplemental insurance as a perk.
There is free choice of General Practitioners. Most of the hospitals which had been primarily nonprofit institutions or run by the government were nationalized and arranged into administrative regions. Regional health authorities were created, whose members included lay people, local governmental representatives, physicians, and nurses. Funds collected by the national government are distributed to the regions based on population, standardized mortality rates, and utilization rates within each region. Traditionally, most specialists have offices in hospitals and as in Germany, General Practitioners do not provide care in hospitals.