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Is health care in Canada really free? Where the money comes from and what you still pay

You do not pay at the doctor's office, but public care is funded by taxes, and drugs, dental and vision are largely out of pocket. CIHI data, BC's premium history and a household cost estimate.

Updated 2026-10-13

Short answer

In Canada you show your health card and do not pay at the door for a doctor visit or a hospital stay. But "free" is not accurate. Those costs are already paid through the taxes you pay all year, and a large share of other items, such as prescription drugs, dental, vision, physiotherapy and home care, is still paid by individuals or private insurance.

What the country spends

CIHI projects total health spending in Canada at about $399 billion in 2025, or $9,626 per person and 12.7% of GDP.[1] Governments pay about 71%. The remaining 29% is paid by individuals and private insurers, mainly for prescription drugs, dental, vision, physiotherapy and home care.

In CIHI's 2022 data, the private share was 28.8%, above the OECD average of 25.3%.[2]

BC's MSP premiums: from monthly charge to elimination

BC residents used to pay monthly MSP premiums. In 2017 the rate was $75 a month per adult. It was cut in half in 2018,[3] and premiums were eliminated on January 1, 2020.[4]

Since then, funding comes mainly from the province's general tax revenue and from the Employer Health Tax, which started in 2019. BC employers with total payroll under $1 million are exempt, and those with payroll above $1.5 million pay 1.95% of payroll.[5]

What a typical household pays

No bill shows this number, so it can only be estimated. In a 2025 study, the market-oriented think tank Fraser Institute assumed that 23.8% of all tax revenue goes to health care. On that basis, a family of two adults and two children pays about $19,000 a year in taxes toward public health care. A median-income family pays about $8,292, and the lowest-income 10% of families about $702.[6]

Household typeEstimated yearly taxes going to health care
Family of two adults and two childrenAbout $19,000
Median-income familyAbout $8,292
Lowest-income 10% of familiesAbout $702
These are a think tank's estimates built on assumptions, not a government bill, and other organizations may calculate differently. Check the original Fraser Institute report for the details.[6]

What you still pay for

  • Prescription drugs (BC's Fair PharmaCare gives income-based help)
  • Dental and vision care
  • Physiotherapy
  • Home care

These items, along with other private spending, make up the roughly 29% private share described above.[1] Many people cover part of it through employer benefit plans.

A more accurate way to put it

You do not pay at the time of care because the money was already collected through taxes. Drugs, dental and vision are paid separately. When comparing health systems between countries, it helps to look at these two parts separately.

Sources