The Provincial governments have their hands on the valves...they decide on how many medical school placements are to be made available...they decide on how many specialist residency training positions are going to be made available...they decide how many medical doctors get licensed.

Since MDs see patients , assess them, investigate them...ordering tests and investigations ...treat and operate on them  at a cost to the Ministries of health ....the way to hold costs down is to suppress the number of doctors, make it more difficult for them to investigate the patients that they have ( an MRI done the next day in the superior health care systems takes months for in Ontario) , make the patients wait for specialist consultations and then wait even longer for surgery....even better , treat them badly , cut their fees and claw back their earnings.

 OECD: Canada has 2.7 doctors per 1000;  France 3.4 : 1000 ; Switzerland 4.3 & Austria 5.2 per 1000.

They are world class, we're not.