Japan has a ‘go to any specialist nearby and be seen’ system. Very few GP’s, and a multitude of specialists for their own area of expertise.

I had my pick of three ortholaryngologists today (all of them less than ideal according to reviews, but they were there).

I think in most countries people don't have to ask their PCP for permission to see the proper specialist. I don't have much other basis for comparison because I don't think I've ever met any PCP more than once anyway.

The Canadian system absolutely requires a referral from your GP to see a specialist. And even in the US, when you do have insurance that allows you to see a specialist without a referral, there are some specialists who won’t see you without a referral anyway, I assume because they don’t want to deal with random people off the street.

>The Canadian system absolutely requires a referral from your GP to see a specialist

I presume that's only when you want your expenses covered. If you pay with your own money/private insurance you can see whoever you want, no?

There are some rules hobbling the private system in Canada that don’t exist in every country with universal healthcare. As I understand it, if a doctor participates in the public system they’re limited in their ability to accept private-pay patients. Happy to take correction here from Canadians who know better.