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The Canadian healthcare system is characterised by the juxtaposition of a basket of goods and services with public financing (doctor’s visits and hospital care), and for which private financing is either prohibited or extremely limited and an ensemble of consummations that remain, in large part, private (dental, drugs, in-home care, mental health, transportation). Of the public portion, the need evaluated by healthcare professionals is judged to be more legitimate than the requests made (to the need in dollars) by the patients. This clearly results in a problem of waitlists and delays in getting access to care by specialists and for scheduled hospitalisation. This also results in a certain rigidity in the system when it is faced with changes in practices and the inclusion of new types of care in the public basket (such as the turn to outpatient treatment). The author describes the system’s principles, the tensions and public debate it has generated and attempts to compare it to the French system.