U.S. vs. Canada Healthcare Systems: Key Differences

Introduction

The Canadian healthcare system is often considered a probable model or standard for the United States healthcare system, particularly in relation to healthcare reform initiatives. The Canadian healthcare system largely differs from the American one in that it is a single-payer and largely publicly funded system, whereas the U.S. healthcare system is multi-payer and largely privately funded. However, Canadians and Americans seem to agree that they would not want each other's healthcare system, though most Americans base their views on a limited understanding of how the Canadian healthcare system works, and Canadians are similarly unfamiliar with the U.S. system. Despite the structural differences between the two systems, there are notable similarities in their objectives. Moreover, the Canadian healthcare system offers important lessons through which the United States healthcare system can be improved or reformed.

U.S. and Canadian Healthcare Systems Overview

The United States healthcare system is a multi-payer, mostly private system, though it is seemingly culturally similar to the Canadian healthcare system ("Comparing the U.S. and Canadian Health Care Systems," n.d.). The American healthcare system is multi-payer because more Americans are encouraged to obtain health insurance, given that the country has not adopted universal coverage. The focus on health insurance in the U.S. is driven by the fact that the country has more than 37 million people without health insurance, while another 53 million are underinsured. This means that a large portion of the population is insufficiently covered in the event of a severe illness or disease. For U.S. citizens and residents, healthcare coverage depends on the health insurance provided either by two major public programs or by their employer (Bernard, n.d.). While Medicaid and Medicare provide health coverage for the poor and the elderly respectively, benefits and costs vary significantly between public and private employees. Given rising healthcare costs, many employers — both public and private — struggle to provide adequate coverage, as they are often unwilling or unable to bear the financial burden.

In contrast, the Canadian healthcare system is a single-payer, largely publicly funded system that provides universal access to care for the country's citizens. While offering universal access, Canada spends far less of its Gross Domestic Product on healthcare costs. The Canadian healthcare system is a carefully developed hybrid system that reflects political compromise through the adoption of a broad social program. Because Canada provides universal coverage, all Canadians — regardless of income, employment status, health condition, or age — have access to health insurance through the comprehensive provincial system. The Canadian system has essentially no monetary barriers to healthcare, meaning Canadians can visit any doctor and receive care without making out-of-pocket payments at the point of service. The country also prohibits private health insurance that would duplicate the services provided through the provincial healthcare plans. Furthermore, the Canadian healthcare system does not allow direct patient payments to healthcare providers, co-payments, or deductibles for any covered services.

Similarities Between the Systems

Despite their structural differences, the U.S. and Canadian healthcare systems share certain similarities. First, both systems face challenges with equality in access to healthcare services. While the United States has attempted to broaden coverage through the Affordable Care Act, achieving true equality in access has proved difficult. Similarly, Canada's universal coverage model still struggles to ensure equality in access and in health outcomes across its population. Second, in both healthcare systems, the single most significant determinant of population health is standard of living. In both countries, wealthier individuals tend to live longer and experience disability later in life compared to those with lower incomes. Third, both the U.S. and Canadian healthcare systems attempt to implement cost containment measures, which in turn generate certain shortages. Despite these measures, rising financial pressures on both systems continue to create resource constraints.

Conclusion

The U.S. and Canadian healthcare systems have various differences and similarities rooted in their structural distinctions. These systems differ primarily because the Canadian system is single-payer and mostly publicly funded while the American system is multi-payer and largely privately funded. Beyond structure, the two systems also diverge in healthcare coverage, costs, and outcomes. Based on this analysis, the Canadian healthcare system offers valuable insights that can help guide the improvement of the United States healthcare system.

References

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"Comparing the U.S. and Canadian Health Care Systems." (n.d.). The National Bureau of Economic Research. Retrieved January 19, 2015, from http://www.nber.org/bah/fall07/w13429.html

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