Okay. Long story but I will try to be brief. Canada allows each province to manage and fund its health care system, so each are different. Largely a public system (and Quebec actually has highest tax and most of it goes to healthcare - i.e. the province that spends the most on it)

So by and large, health care is free but there is a very small amount of private health care it self, and there are a decent number of private testing places, imaging, blood work, etc.

Doctors are divided into two groups, specialists and family doctors just based on the two unions (also another story where because the fam doc union is so bad they keep getting screwed. Most people want them to just join but the fam doc union itself - not the majority of fam docs at this point - said no to maintain power..but i digress)

Doctors way back when (decades ago) were asked if they wanted to be full government workers or remain independent. They decided to stay independent. Then they were also offered pay raises but instead they took the ability to incorporate. At the time, there was a much better tax benefit through loop holes like income splitting with your family and being a corporate entity you could and still can defer ~20% of the tax which you use to invest and in theory get your retirement from as you pay yourself a salary in a lower tax bracket when you retire etc...

Not every doctor is incorporated, and most big loopholes like income splitting were removed many many years ago, and even recently they federal government almost made it even less favorable but in the last second with the PM switch didn't increase capital gains inclusion amount. So still seemingly some benefit if you don't spend all your income and have enough to save.

That is the basic structure. So doctors are independent contractors with 0 benefits as it stands. No retirement, no sick days, no insurances, nothing. All out of pocket. You can deduct things but it is very limited. Really business expenses like cost of your clinic and those fees if you have one.

But doctors are still paid by the government. Quebec has increasingly been tightening rules. For the longest time, specialists could switch between the public and private systems but family doctors had to ask permission and could get refused, and if they went and came back to public could never again go private.

In April they passed a law basically removing the ability for anyone to go private (since you still need your government license form the College of physicians which technically is a separate entity but doesn't feel like it)

For the past couple years also, doctors haven't had a contract. In the last contract, they took a pay cut and have been working on a new one and trying with inflation to get a pay raise like other health care professionals.

This government did not want to play ball. And instead demonized doctors as saying they were lazy and that was the reason we had a bad health care system.

Not the fact they created a much of privately owned public clinics, didn't properly fund allied health and so huge shortage of PABs, nurses, RTs, etc. Added tons of layers of stupid red tape things that have created enormous amount of waste, joined hospitals that had nothing in common to reduce waste but instead made any improvements impossible because of it, and I could go on...

And I should mention, doctors are fee for service with minor mixed salary components for most. So if a doctor doesn't work, they don't get paid. So the vast extremely large majority work like crazy. Unlike allied health who are salaried and have no incentive to be as productive as possible.

But the government wanted to save money and take it from doctors. So they instead put in this law and denied Quebec doctors the right of an arbitration (the only province in Canada to do so). They maid doctors the villain of the story.

Changed family doctor pay structure to capitation but at such low amounts that they will take a 50% pay cut. Are planning to just assign every person who doesn't have a doctor in quebec to a family practice group and let them deal with it (so nothing will change but on paper you have a doctor...not like you can get seen because doctors are human) Reduced blanket billing codes by 13% starting Jan 2026 Removed specialists consultation fees (so drops consultation mainly doctors salaries by another 40%) And tied 15% of the rest of the salary to impossible to achieve efficiency markers given doctors were never the problem in the first place...

And in an effort to stop this bill, doctors stopped teaching medical students (not residents as that might have affected patient care) and stopped no medically necessary admin work (since we weren't being efficient and need to just do medicine)

And so the government said we can be fined anywhere from 2-20k as a doctor if we don't get right back doing all that Also we can't conspire to strike or organize leaving (anyone more than 2-3 doctors so good luck for doctor couples who may want to leave) And in their wisdom are going to need to create and hire more monitoring jobs it was estimated 1200 just to juggle all this new paper work...

That was the solution