The Quebec health care system in the Canadian context: impact on medical practice

Despite their close kinship, the United States and Canada have evolved very different health care systems. Apart from the fundamental difference of voluntary versus compulsory insurance, the contrasts are most pronounced in the case of Quebec, whose approach to health care reform is the most radical of the Canadian provinces. Key features of the Quebec health care system include mechanisms for the planning and coordination of services and institutions, for the evaluation of health programs, and for regulation of the health professions, especially medicine. Freedom to choose a specialty and practice location is relatively tempered and constrained. Compensation is negotiated via physicians' unions. Physicians mostly practice on a fee-for-service basis and make claims to a single government authority which, in the process, acquires many data about physician practice.