This phrase is often used to describe a single-payer, nationalized or socialized health care system. Actually, Canada has a system consisting of national health insurance and twelve separate single-payer systems—the ten provinces plus two territories—each with a global budget. Most physicians are self-employed and reimbursed under a negotiated fee schedule. Patients choose their own physicians. About half of the hospitals are government-owned; the rest are nonprofits which are reimbursed in lump sums. The provinces approve investments in facilities and technologies.