In a nutshell -
You or your employer pay the monthly fee - which is set on a sliding income scale. When you go to your doctor - of your choice - & s/he bills the provincial health plan.
There's a basic plan, which is universal, and a variety of forms of extended coverage which vary from one place of employment to another.
The user fees for the basic plan are set by the provincial governments under the Canada Health Act. The act sets the conditions the provincial health insurance plans have to meet to receive cash from the federal govt.
The crucial variation from province to province is how they set the fee for those on no or low income. In this province, BC, there was an approx. (Can.) $20 monthly fee under the Social Credit government which was abolished when the NDP came in.
Note: The overwhelming majority of the population is anatagonistic to the privitization of health care and view the US system with fear and loathing.
Except for the doctors.
They are the greatest *enemies* of public health care in this country.
--luftmensch