Despite mixed opinions about the effectiveness of the system, 94% of Canadians say their health care system is a source of personal and collective pride in their country. So how much does Canada’s health care system differ from that of the United States.
In 2017, Canada spent about 10.4% of its GDP on health care. By comparison, the United States spent about 17.2% of its GDP. The Organization for Economic Cooperation and Development (OECD) estimates that Canada spent about $4500 per person in 2017. In the United States, that figure exceeds $10,200 per person. Out-of-pocket spending is also lower in Canada. On average, Canadians spent about $650 per person in 2016; Americans spent nearly $1,100.
In addition to having lower health care costs in Canada, the country also has better health outcomes than the U.S. But compared to other countries, Canada’s health care system has room to grow. Researchers looked at mortality rates that could have been prevented with proper access to health care in 11 countries. Canada ranked seventh on the list, while America ranked worst. We can see the same trends in infant mortality rates. Canada outperforms the U.S., but other countries, such as Sweden and Australia, have much lower infant mortality rates than Canada.
Canadians also live longer than Americans. Life expectancy in Canada is one of the highest of any country and nearly four years higher than in the United States. In addition, maternal mortality rates in Canada are almost four times lower than in the United States, and more Americans die of heart disease and stroke than Canadians.
So how does Canada manage to spend less money than the United States while having a more efficient health care system?
Canada’s Medicare program is designed to provide the same quality of care to all citizens regardless of people’s ability to pay and to reduce administrative costs. There is some variation in what services are covered depending on the province, but most basic services are equally available to all residents.
Prescription drugs are not covered, nor are dental care, mental health services, or optometry. Therefore, most Canadians also buy private health insurance through their employers to pay out-of-pocket costs. However, they cannot use this private insurance to purchase government-covered services. In 2015, private insurance costs accounted for about 30% of health care spending in Canada.
Although most health care is publicly funded, most hospitals and doctors’ offices are privately owned. Doctors who own their own private practices are considered contractors who bill the government insurance fund for their services. The government is not their boss.
Despite affordability, the system has some problems Waiting times in Canada are longer than in the U.S. In a 2016 survey, 53% of Canadians said they couldn’t get an appointment the same or next day they were sick and needed medical advice. The United States fared slightly better, with 42% dissatisfied. Of the 11 countries surveyed, Canada performed worst in this category. 30% of Canadians said they waited two months or longer to see a specialist, compared with 6% in the United States.
Nearly one in five Canadians waited four months or longer for elective surgery, compared with only 4% of respondents in the United States. About 60% of Canadians have difficulty accessing medical care in the evenings, weekends and holidays. This wait can lead to an excessive workload in the emergency department.
Half of Canadians say they have waited two hours or more when they desperately need help. Not all medical care is covered in Canada, resulting in significant personal costs, such as prescription drugs.
There are social programs that help Canadians pay for medications, but benefits vary by province. For example, Ontario provides prescription drug coverage for young people under the age of 24 who don’t have private insurance.
The province also has a drug program for people over the age of 65. That said, Canada spends about the same amount as the United Kingdom on drugs, despite the fact that the latter has twice the population. Canadians spent about $670 per capita on drugs in 2015, while the U.S. spent $1,000.
One in 10 Canadians didn’t get a prescription or chose to skip a dose because of the cost. This is much better than in the United States, where nearly one in five people chose not to buy drugs because of cost.
