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I AM FIRST going to make sure that you understand what the Canadian single-payer system is all about, and I will preface my remarks by reminding you that it took us about 30 years to get to where we are now. The principles on which the current system is based have not changed much, but our system is not static and continues to evolve. The other important point is that it is a provincially based health care delivery system, so there are differences from province to province, and when you say "single payer," it means different things at different times and places.
The salient principles are that it is universal, (ie, it applies to all Canadians); it is accessible; it is comprehensive (meaning that it covers all medical services, and recently that has come under a little bit of examination; the list of what is included under insurable services is
Langer B. The Canadian Single-Payer System: A Primer on How It Works and How It Affects Surgical Research. Arch Surg. 1995;130(9):935–937. doi:10.1001/archsurg.1995.01430090021008
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