Healthcare reform is a subject of discussion in many countries. Ensuring public health care access & insurance has proven challenging in developed and developing countries. Regardless of where you are from, accessing the best health care is the ultimate aim. But when it comes to places where you can get better Medicare, two countries often come to mind: the States. and Canada. However, which of these two countries offers a better proposition?
Differences Between These Two Care Systems
The U.S. and Canadian medical systems have much in common and variations. The World Health Organization report shows that both countries are ranked relatively high in healthcare quality. Several statistics distinguish how these systems are structured. Below we will go through the fundamental variations between the Medicare programs in two neighbouring regions.
Government Involvement
The government is closely involved in healthcare in both countries. But what differentiates the authority involvement in health insurance of each country?
In Canada, the government plays an important role in managing its system for promoting and maintaining public health. The Canadian authorities actively participate in various critical aspects related to the population’s overall well-being, such as:
- Medicare: Funded through taxes and provides universal coverage of medical needs.
- Provincial and Territorial Governments: Provinces & territories administer healthcare systems such as setting reimbursement policies, coverage, and managing deliveries..
- Health Canada: Federal department responsible for national health regulation & policy.
- Canada Health Act: Province must abide by the accessibility guarantee set by the Canada Health Act to receive federal funding for healthcare.
The U.S. government’s involvement in healthcare is a mix of private & public systems. It plays a vital role in general well-being by ensuring other regulations & programs are in place. However, the authority does not offer comprehensive coverage for all citizens. Some critical areas where the American government is involved in its healthcare system include:
- Medicaid: A federal-stage program that provides health coverage to low-income families and individuals.
- Medicare: Health insurance for individuals 65 and older.
- State Children’s Health Insurance Program: It’s a children’s health insurance program administered by the United State Department of Health & Human Services, providing funds for families.
Coverage and Access
In Canada and the States, healthcare is primarily funded through health insurance, but there are notable differences in coverage and access to healthcare between these two countries.
In Canada, the government pays for Medicare with tax funds. As such, as a citizen of Canada, you get universal healthcare coverage. Also, as a legal resident, the government is liable for the cost of emergency room treatment. Although the wait time to get access to specialised care can be a concern.
Healthcare coverage is not guaranteed to all residents in the United States. According to studies, about 7% of its population must be insured or get adequate health insurance. As a result, many Americans rely on employer-sponsored health insurance to get the health insurance coverage they need. Accessing healthcare can be a challenging prospect for many Americans, especially those who are underinsured or uninsured. Although according to the EMTALA Act, residents here are ensured access to emergency services regardless of their ability to pay or be insured. But accessing non-emergency care is more complicated.
Cost and Administrative Overheads
Generally, healthcare can be expensive irrespective of your region. But with various levels of management sponsorship, the cost is subsidised. As a result, healthcare costs are quite different in the United States & Canada. For example, Canada’s public funding system makes it such that the cost of drug prices is lower compared to the U.S. Also, Canada has fewer doctors per capita compared to the USA. On average, there are 2.2 doctors per 1000 individuals in Canada.
In contrast, the U.S. incurs a higher administrative cost, accounting for 31% of healthcare expenditures, while Canada’s share stands at 16.7%. Furthermore, medical practitioners in the States earn higher incomes compared to Canada. Drugs are more expensive in the USA due to prohibiting systems like Medicaid or Medicare from negotiating drug prices, unlike Canada’s centralised buying by provincial authorities.
Type of Care Covered by Health Insurance
The extent of healthcare services covered remains a primary concern for individuals in both countries, irrespective of the funding source for their healthcare insurance. How these systems are supported in each country determines the type of access to health care services an individual gets.
For example, the universal healthcare system provides coverage to all Canadian residents. The restrictions include surgical and dental benefits coverage, medical practitioners, and hospital services. Moreover, provinces can give insurance for additional services tailored to individual needs, including coverage for home care, prescriptions, long-term care, dental care, mental health services, and other related benefits.
In contrast, healthcare coverage in the United States is predominantly facilitated through private insurance, leading to a considerable disparity in coverage determined by the agreed-upon benefits and policies. This variance results in various possibilities depending on the type of benefits and policies individuals have chosen. But with the introduction of the Affordable Care Act and Patient Protection in 2010, individuals no longer need to secure a minimum essential coverage. It’s also mandatory that insurers cover significant health benefits.
Primary Health Care Delivered
General practitioners (GPs) or primary care providers play a crucial role in both the U.S. and Canada. However, there is also a pressing need for essential medical providers in both countries. But there is a need for vital medical providers in the U.S. & Canada. And even with the few medical providers available for primary care, many are employed by small private institutions or self-employed. In Canada, about half of the practising physicians are general practitioners. These individuals act as the gatekeepers for health care services. Also, patients are not responsible for the cost of the physician services provided the health care plan covers the services.
But in the States, their primary care physician accounts for about one-third of all medicine specialists. Unlike in Canada, primary care physicians don’t have a formal gatekeeping function. Rather patients have the freedom to choose a doctor. And in the U.S., physicians’ pay is negotiated through fees with a private insurer, set fees, and capitation through a private insurer. Nevertheless, patients are still responsible for certain portions of the payment, unlike those who qualify for a waiver, reduced fees, or those who are uninsured.
Strengths and Weaknesses of the U.S. and Canadian Health Care System
The healthcare system in the States. & Canada could be better. There is still room for improvements and innovations. However, perspectives on the strengths & weaknesses differ based on individual experiences & opinions.
| Strengths | Weaknesses | |
|---|---|---|
| The States | Access to advanced medical technology Research and innovation Flexibility Quality specialised care | Lacks universal coverage High price Fragmented system |
| Canada | Universal access to essential care Lower administrative costs Emphasis on preventive care Cost control | Long wait times Limited access to specific treatments Underfunding and resources allocations |
Both healthcare systems have their strengths and weaknesses.
Conclusion
To sum up, this article is a simplified overview of the healthcare system in the U.S. & Canada. The healthcare industry is very complex and can vary based on different criteria. Assuming the healthcare system in the U.S. is better than Canada or vice versa opens up doors to several dialogues. But both countries have federal agencies dedicated to balancing industry innovation & protection through competition.
