The U.S. and Canadian health care systems are highly criticized. Statistics show that many U.S. residents go to Canada for treatment.
No Individual Insurance: Canadian critics tend to oppose “two-tier” medicine, but in fact, the U.S. has a tiered system. And despite the hype on both sides of Congress, “Obamacare” maintains the same complex structure, while adding another layer by introducing health-care “exchanges” for uninsured Americans. But most Americans will still have access to health care through various employer-provided or employer-paid health plans; about 50 million seniors and people with disabilities through federal Medicare; another 60 million with the lowest income through state federal Medicaid mechanisms.
Not universal: In Canada, health care is based on a simple scheme: every legal resident is covered by publicly funded provincial or territorial plans. The individual mandate, derived from Republican precedent in Massachusetts, is strikingly different from Canada’s universality principle. Although Obama’s reforms expand coverage, the individual mandate relies on the fundamental principle of insurance – health care depends on the type of coverage – and it forces Americans to purchase insurance in order to access health care. Americans now have more affordable insurance options and subsidies to cover their costs, and those on the lowest incomes are eligible for public insurance through Medicaid expansion. Yet even though online enrollment for the program began Tuesday, only half of the roughly 40 million who applied will get help.
Unequal access: Many say Canada has some problems with waiting times and timeliness of care, but all that pales in comparison to how difficult it is to access Medicaid in the United States. But the new law only reinforces the notion that access to health care will depend not on your needs, but on how much you can afford. As for health insurance, the amount of payments will depend on your age, health status, income, and whether you choose bronze, silver, gold, or platinum coverage. In Canada, on the other hand, access to health care is not turned into a competition.
No cap on spending: The harshest critics of Obama’s reforms argue that it does nothing to address the fundamental problem of controlling spending. In financial terms, the new law only includes a review of Medicare insurance and an expansion of accountable care organizations. But it does not address the problem of general inefficiencies in health care delivery and financing. Governments in Canada know that health care is a big financial responsibility, and they are taking steps to curb rising costs – negotiating with providers, overall budgets for hospitals – that America is not doing. Obama’s reforms are a huge step in reshaping American health care. But like other major reforms of the past, they have entrenched the private nature of the system, and the introduction of Canadian-style health care or public insurance is probably unlikely to be achieved. Bottom line: the Canadian health care system is many times better than the system in the United States.”
