[bdamm]

Right, but it’s probably done by auditing resources to treatment records. The actual patient needn’t be involved. And in countries like Canada you may end up with multiple operating agencies that are competing for efficiency, such as Coastal Health vs Providence, even though ultimately it’s the government footing the bill.

[Scoundreller]

Providence is under Vancouver Coastal health. The authorities aren’t competing with each other (well, not really) as they have their own geographic catchments.

[bdamm]

Right, but they're able to be audited against each other, even though they have separate geographic catchments. Significant discrepancies can be then analyzed.

Folks who view single-payer as a system without checks need to know how those checks do in fact occur.