This is correct. Canada's single payer system means doctors can't work in both the public and private systems. They have to choose one over the other.

There has been plenty of efforts put into allowing private clinics outside of the public system, but they have all been shutdown.

It should also be noted that this arrangement in Canada is not typical of other countries with universal healthcare. There's more than one way to skin this particular cat; Canada just gets unduly much attention in the debate because of its proximity, and the "Canadians waiting in endless lines come to US for treatment" conservative meme.

On the other hand, one thing that is usually ignored about Canadian healthcare when it's discussed in US, is the fact that it's run by provinces. Feds are involved, and most federal money that goes to healthcare comes with strings attached wrt how the resulting healthcare system should look; but ultimately the decision of how (and whether) to run healthcare is down to provinces.

https://en.wikipedia.org/wiki/Canada_Health_Act#History:_Fed...

Furthermore, that system didn't come up all at once - a single province tried it first, and it had proven popular enough that other provinces gradually adopted it. Once it was sufficiently widespread, the federal government stepped in.

Given that federalism in US is more developed than in Canada, I don't understand why this isn't the approach advocated by most adherents here. If Saskatchewan could organize healthcare all by itself back in the day, surely so can California, New York etc.

All good points.

However, I’d take issue with federalism being more developed in the US than Canada. In my experience, the federal gov’t wields much more power in Canada than the US.

However, your point stands that nothing is stopping the states from creating their own system. In fact, a few like CA and VT have proposed such arrangements, but they always fell through once the cost was apparent.

> However, I’d take issue with federalism being more developed in the US than Canada. In my experience, the federal gov’t wields much more power in Canada than the US.

Federalism being more developed means exactly that - that regions have more power relative to the center. The stronger the central government is, the less federalism, and the more country is a unitary state rather than a federation.

At least in Quebec and I know in other provinces, you have private medical clinics for medical consultations.

When it comes to surgeries, then they refer you to the public services.