So each province taxes and administers their own system, which is policed by the feds?
Yes, that’s correct. Patients and doctors have no contact with the feds at all, and the “policing” is often more a matter of politics than anything else — if Quebec decides on a broad interpretation of a federal principle, Ottawa has a difficult time doing anything about it. The point I’m really trying to make here is that the very largest health care system in Canada (in the province of Ontario) covers 14 million people. The others are all smaller, they share no software systems in common, and nobody applies for anything through a federal web portal.