Canada adopted a national health insurance scheme in 1971. It is administered regionally; each province runs a public insurance plan with the government contributing about 40% of the cost (mostly from taxes). Government regulations ensure that private insurers can only offer particular types of health care provision. Drug prices are low. Most hospitals and doctors operate privately. Hospitals are paid by allocated budgets and doctors receive fees per treatment. The system offers considerable choice, but there is little competition and the government has used rationing measures to limit health care expenditures. Access to health care and cost containment are good, but there are strains on the budget, increased by an aging population. In 1997, the National Forum on Health, created by the government three years earlier, released a report on ways to improve Canada's health system. It recommended several initiatives, including formation of a Health Transition Fund to support provincial and territorial health programs.
Major health planning is carried on by provincial governments, most of which offer substantial free care for patients suffering from tuberculosis (7 cases reported per 100,000 people in 1999), poliomyelitis, venereal diseases, and certain types of cancer. They also assume responsibility for mental health treatment. Municipalities are responsible for sanitation; communicable disease control; child, maternal, and school health care; public health nursing; health education; and vital statistics. In some cases, they supply hospital care and medical service to the poor. The federal government provides consultant and specialist services to the provinces, assists in the financing of provincial programs, provides services to veterans and Indians, exercises control over the standard and distribution of food and drugs, maintains quarantine measures, and is responsible for carrying out certain international health obligations. The federal Department of National Health and Welfare provides financial assistance for provincial health and hospital services through the National Health Program and for provincial hospital insurance programs through the Hospital Insurance and Diagnostic Services Act of 1957, under which the federal government shares the provinces' costs (since 1977, by means of tax transfers and cash payments). By 1973, this program had been established in all provinces and territories, covering more than 99% of the total population of Canada. Federal and provincial governments contribute toward construction costs of new hospitals. Total health care expenditures for 1995 were US $1,899 per capita. Public insurance pays about 80% of the Canadian population's health bills. The total expenditure on health is second only to the United States, with an estimated 9.3% of GDP going toward health as of 1999.
The Canadian death rate of 7.5 per 1,000 people in 1999, the maternal death rate (1998) of 6 per 100,000 live births, and the infant mortality rate (2000) of 5 per 1,000 live births are among the lowest in the world. In 1999, 6% of all births were low birth weight. Diseases of the heart and arteries account for nearly 40% of all deaths and cancer accounts for about 28%; the proportion of deaths from causes related to old age is rising. Tobacco consumption, which was 2.8 kg (6.2 lbs) a year per adult in 1984–86, was 2.3 kg (5.1 lbs) in 1995. Accidents are the leading cause of death in childhood and among young adult males and rank high for other population groups. In 2000, life expectancy at birth was estimated at 79 years. Canada had a birth rate in 1999 of 11.9 per 1,000. Between 1980 and 1993, 73% of married women (ages 15 to 49) were using contraception. In 1997, children up to one year of age were immunized as follows: diphtheria, pertussis, and tetanus, 93%; polio, 89%; and measles, 98%. The HIV prevalence was 0.30 per 100 adults in 1999. As of 1999, the number of people living with HIV/AIDS was estimated at 49,000 and deaths from AIDS that year were estimated at 400.
As of 1999, there were an estimated 2.1 physicians, 7.5 registered nurses, and 4.1 hospital beds per 1,000 people. Canada has a total of 57,052 physicians in 2000. In 1995, there were 15,636 dentists, 232,869 nurses, and 22,197 pharmacists. As of 1998, there was an oversupply of physicians in Canada.