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03-15-2012, 03:15 PM   #1
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Interesting look at Canada vs USA Health Care systems:

Comparison of the health care systems in Canada and the United States - Wikipedia, the free encyclopedia

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Comparison of the health care systems in Canada and the United States
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Health spending per capita, in U.S. dollars PPP-adjusted, with the U.S. and Canada compared amongst other first world nations.

Comparison of the health care systems in Canada and the United States are often made by government, public health and public policy analysts.[1][2][3][4] The two countries had similar health care systems before Canada reformed its system in the 1960s and 1970s. The United States spends much more money on health care than Canada, on both a per-capita basis and as a percentage of GDP.[5] In 2006, per-capita spending for health care in Canada was US$3,678; in the U.S., US$6,714. The U.S. spent 15.3% of GDP on health care in that year; Canada spent 10.0%.[5] In 2006, 70% of health care spending in Canada was financed by government, versus 46% in the United States. Total government spending per capita in the U.S. on health care was 23% higher than Canadian government spending, and U.S. government expenditure on health care was just under 83% of total Canadian spending (public and private) though these statistics don't take into account population differences.[6]

Studies have come to different conclusions about the result of this disparity in spending. A 2007 review of all studies comparing health outcomes in Canada and the US in a Canadian peer-reviewed medical journal found that "health outcomes may be superior in patients cared for in Canada versus the United States, but differences are not consistent."[7] Life expectancy is longer in Canada, and its infant mortality rate is lower than that of the U.S., but there is debate about the underlying causes of these differences.

The United States and Canada have different racial makeups as well as different obesity and alcoholism rates, which would likely cause the United States to have a shorter average life expectancy and higher infant mortality even with equal health care provided. The United States is comprised of 12.2% "Blacks" and 16.3% "Hispanics" (2010 Census), whereas Canada has only 2.5% African Canadians and 0.97% Hispanic Canadians (2006 Census). Blacks have higher mortality rates than any other racial or ethnic group for 8 of the top 10 causes of death.[8] The cancer incidence rate among African Americans is 10% higher than among European Americans.[9] U.S. Latinos have higher rates of death from diabetes, liver disease, and infectious diseases than do non-Latinos.[10] Adult African Americans and Latinos have approximately twice the risk as European Americans of developing diabetes.[9] The infant mortality rates for African Americans is twice that of whites.[11] Unfortunately, directly comparing infant mortality rates between countries is difficult, as countries have different definitions of what qualifies as an infant death. The death of an infant of an American visiting Canada is not counted as an infant death by Canada, however the successful delivery of an infant of a Canadian who is visiting the US is counted as a successful live birth by Canada, although the birth occurred outside of their country.[12]

Another issue with comparing the two healthcare systems is the baseline health of the patient's for which the systems must treat. Canada has only half the obesity rate that the United States healthcare system must deal with (14.3% vs 30.6%).[13] On average, obesity reduces life expectancy by 6-7 years.[14]...............
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In both Canada and the United States, access to health care can be a problem. Studies suggest that 40% of U.S. citizens do not have adequate health insurance, if any at all. In Canada, however, as many as 5% of Canadian citizens have not been able to find a regular doctor, with a further 9% having never looked for one. Yet, even if some cannot find a family doctor, every Canadian citizen is covered by the national health care system. The U.S. data is evidenced in a 2007 Consumer Reports study on the U.S. health care system which showed that the underinsured account for 24% of the U.S. population and live with skeletal health insurance that barely covers their medical needs and leaves them unprepared to pay for major medical expenses. When added to the population of uninsured (approximately 16% of the U.S. population), a total of 40% of Americans ages 18–64 have inadequate access to health care, according to the Consumer Reports study.[45] The Canadian data comes from the 2003 Canadian Community Health Survey,[46]
U.S. scores dead last again in healthcare study | Reuters

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(Reuters) - Americans spend twice as much as residents of other developed countries on healthcare, but get lower quality, less efficiency and have the least equitable system, according to a report released on Wednesday.

The United States ranked last when compared to six other countries -- Britain, Canada, Germany, Netherlands, Australia and New Zealand, the Commonwealth Fund report found.

"As an American it just bothers me that with all of our know-how, all of our wealth, that we are not assuring that people who need healthcare can get it," Commonwealth Fund president Karen Davis told reporters in a telephone briefing.

Previous reports by the nonprofit fund, which conducts research into healthcare performance and promotes changes in the U.S. system, have been heavily used by policymakers and politicians pressing for healthcare reform.

Davis said she hoped health reform legislation passed in March would lead to improvements.

The current report uses data from nationally representative patient and physician surveys in seven countries in 2007, 2008, and 2009. It is available here

In 2007, health spending was $7,290 per person in the United States, more than double that of any other country in the survey.

Australians spent $3,357, Canadians $3,895, Germans $3,588, the Netherlands $3,837 and Britons spent $2,992 per capita on health in 2007. New Zealand spent the least at $2,454.

This is a big rise from the Fund's last similar survey, in 2007, which found Americans spent $6,697 per capita on healthcare in 2005, or 16 percent of gross domestic product.

"We rank last on safety and do poorly on several dimensions of quality," Schoen told reporters. "We do particularly poorly on going without care because of cost. And we also do surprisingly poorly on access to primary care and after-hours care."


03-15-2012, 04:57 PM   #2
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Whatever the pros or cons of each system, I am glad with the system I have.

Out of full time work for 2 years with just some small 2-3 month contracts, no private health insurance. 3 weeks ago my wife (who doesn't work due to seizures) had an epileptic seizure and dislocated and broke her shoulder. Local hospital had to do a partial replacement (the ball joint had to be replaced).

1 week in hospital including two nights in intensive care $1000/night ?
ball joint unit $3000ish
operation $2-3000?
Nurse in 2 days a week for a week to change dressing $?
8 home visits by physiotherapist plus 8 or so more weeks out-patient visits $?

maybe $10000 in total?

my cost? $110 in parking fees, $150 for prescription medication, $37 for shoulder immobilizer, $45 for ambulance fee.

Yes, I have to pay something but at least I don't have to remortgage or sell my home.

It may not be perfect, but our system works for me.
03-15-2012, 05:20 PM   #3
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Thank you for posting this. I have always been wondered how the systems stacked up against each other.

QuoteOriginally posted by mtansley Quote
It may not be perfect, but our system works for me.
The US system seems to work for the people who have good insurance, but many other people get thrown under the bus. My parents and siblings have been plagued with a number of health issues (not their fault, they are not obese, so not smoke, and do not drink). They have been insured through all of this, but their out of pocket expenses over the past 10 years have been tens of thousands of dollars. They are fortunate they made wise financial decisions early in their lives and are very frugal, or they would be in a terrible financial situation. I saw your out of pocket expenses and sat here shaking my head (because $350 is nothing when it comes to medical expenses, sounds like the Canadian system is working).
03-15-2012, 05:27 PM   #4
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QuoteOriginally posted by kswier Quote
Thank you for posting this. I have always been wondered how the systems stacked up against each other.



The US system seems to work for the people who have good insurance, but many other people get thrown under the bus. My parents and siblings have been plagued with a number of health issues (not their fault, they are not obese, so not smoke, and do not drink). They have been insured through all of this, but their out of pocket expenses over the past 10 years have been tens of thousands of dollars. They are fortunate they made wise financial decisions early in their lives and are very frugal, or they would be in a terrible financial situation. I saw your out of pocket expenses and sat here shaking my head (because $350 is nothing when it comes to medical expenses, sounds like the Canadian system is working).
Yes, but many people only complain because it's the only system they have used and don't realize what is actually being paid out on their behalf.

I believe that the U.S. system is probably the best health care that can be purchased. That's the rub, if you can't afford it through private insurance or private wealth then a lot of it is probably not accessible. Ours may not be quite as good, (you can wait for hours in the emergency room for some things, though if it becomes more serious, you will be seen) but it is available to all.

3 years ago my wife had brain surgery as well to attempt to stop the seizures, it worked for two years and unfortunately the seizures seem to have returned though not in the same quantity. The nice thing about our system is that even though this would probably be considered a pre-exisiting problem, it's still covered. Even the neurosurgeon said that if the operation my wife had didn't work, then there are some other things to look at. All covered under our health insurance system. We are lucky.

03-15-2012, 05:45 PM   #5
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QuoteOriginally posted by mtansley Quote
.......I believe that the U.S. system is probably the best health care that can be purchased........
This would appear to be contradicted by the second quote from the original posting - at the very least it is at least debatable (and I am not here referring to health care for the "well off").

QuoteQuote:
......Americans spend twice as much as residents of other developed countries on healthcare, but get lower quality, less efficiency and have the least equitable system, according to a report released on Wednesday....
03-15-2012, 05:54 PM   #6
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QuoteOriginally posted by stevewig Quote
This would appear to be contradicted by the second quote from the original posting - at the very least it is at least debatable (and I am not here referring to health care for the "well off").
That's interesting. That blows away the opinion that some people have up here about the U.S. system.

Oh well, our system works as far as I'm concerned and it's what I'm used to. I just hope it continues until I no longer require it.
03-15-2012, 06:03 PM   #7
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QuoteOriginally posted by stevewig Quote
This would appear to be contradicted by the second quote from the original posting - at the very least it is at least debatable (and I am not here referring to health care for the "well off").
My understanding, which could be incorrect, is that the United States has the best (or one of the best) healthcare if you have money (i.e. best technology, etc). We pay a lot for it; much more than other countries. Thus not everybody had access to it. Therefore the 'health care system' is not as good (because the goodness of the US healthcare system is how well it takes care of all the people in the US, not just the affluent people).
03-15-2012, 06:35 PM   #8
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QuoteOriginally posted by kswier Quote
My understanding, which could be incorrect, is that the United States has the best (or one of the best) healthcare if you have money (i.e. best technology, etc).
That would be a really hard one to compare. If you had unlimited funds to spend on care in any industrialized country, I suspect you would be well treated. I'm not sure how one would find enough examples to compare.

However, in actual outcomes for people who are able to get care, our quality of results in comparison to other countries is quite mixed. http://www.urban.org/uploadedpdf/411947_ushealthcare_quality.pdf In addition, we have one of the highest rates of medical errors. It is not just that we have a lot of malpractice claims; we have a lot of malpractice by health care providers. It is also interesting that we do a lot of expensive heart surgery, but it does not really seem to reduce the number of cardiac deaths and increases the number of strokes.

03-15-2012, 07:23 PM   #9
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This topic comes up from time to time so I apologize for those that have read my post before.

I've lived in both the US and Canada, had kids in both countries and as such, have had direct experience with both health care systems.

I'm not a fan of US health care. I wasn't impressed with the level of care accessible via insurance. I(my company) paid $600 every 2 week for my family and it was very good care, but they still refused to pay for some of my newborns care.

Canadian healthcare isn't perfect either, and it isn't sustainable with the aging population. I should mention that the US is in the same boat but most Americans don't understand how much of their taxes go to health care. Ironic since it is supposedly non social.

Anyways, I see (hope) Canada moving towards some of the more successful health care models that exist in the world. As far of the US system, that society has decided that it's ideology is the only one that is correct, so it doesn't matter how bad it gets, it will survive.
03-15-2012, 07:25 PM   #10
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The comments below this article are stereotypical. U.S. scores dead last again in healthcare study | Reuters

Don't annoy us with your Socialist lies. The US has the best of everything, RAH RAH!

I just came back from California. It was a great trip, I loved most everything about it. But I saw many destitute people in LA and San Diego. It was depressing to me, because I wondered what happens to these people when they're ill? I know some of them are addicts and the authors of their own misfortune, but some are mentally ill through no fault of their own. In Canada these people can access the same health care as anyone else. That makes me proud of our system.

Of course there are lots of working people in the US with no health care too. And people who have health insurance, but still can't afford proper treatment when they become seriously ill. I hope one day Americans will see how misguided they've been.
03-16-2012, 04:07 AM   #11
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QuoteOriginally posted by GeneV Quote
In addition, we have one of the highest rates of medical errors. It is not just that we have a lot of malpractice claims; we have a lot of malpractice by health care providers.
Fascinating. I am wondering if doctors in other countries (the ones with lower rates of medical errors) work less than they do here. I have a friend who is completing his residency, and he works a ton of hours, and is trying to start a family at the same time. It almost seems as if working long hours is a right of passage. I imagine the fatigue caused by these long hours may contribute substantially to the error rate.
03-16-2012, 04:49 AM   #12
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Interesting the comments which attempt to attribute some of the US healthcare poor outcomes to racial factors. I don't believe for a minute that non-whites are inherently less healthy, and suspect it comes back around to the poor healthcare coverage in lower socio-economic groups (which disproportionately include minorities). So it's not an 'excusing' factor.
03-16-2012, 04:55 AM   #13
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Extract of a report from U.S. Department of Commerce International Trade Administration report:

QuoteQuote:
In the United States, government action has focused on creating the environment that
would best encourage further innovation and yield a constant flow of new and innovative
medicines to the market.
The goal has been to ensure that consumers would benefit both
from technological breakthroughs and the competition that further innovation generates.
The United States also relies on a strong generic pharmaceutical industry to create added
competitive pressure to lower drug prices. Recent action by the Administration and
Congress has accelerated the flow of generic medicines to the market for precisely that
reason.

By contrast, in the Organization for Economic Cooperation and Development (OECD)
countries studied in this report, governments have relied heavily on government fiat
rather than competition to set prices, lowering drug spending through price controls
applied to new and old drugs alike
. Such controls, when applied to new drugs, reduce
company compensation to levels closer to direct production costs, leaving less revenue
for R&D. As OECD countries individually seek to reduce spending on drugs through
price controls, their collective actions reduce R&D that would provide substantial health
benefits to all.
http://www.ita.doc.gov/td/chemicals/drugpricingstudy.pdf

The conclusion of the report is that all the other OECD countries have got it wrong, and should give pharmaceutical / healthcare companies more freedom in the prices they charge for their products. It is suggested that the rest of the world is benefiting from R&D funded by US consumers, but is not paying a fair share of the revenues that pay for this R&D.

That's right - high costs in America are our fault. What BS.

Last edited by ihasa; 03-16-2012 at 05:03 AM.
03-16-2012, 06:02 AM   #14
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QuoteOriginally posted by ihasa Quote
Extract of a report from U.S. Department of Commerce International Trade Administration report:

http://www.ita.doc.gov/td/chemicals/drugpricingstudy.pdf

The conclusion of the report is that all the other OECD countries have got it wrong, and should give pharmaceutical / healthcare companies more freedom in the prices they charge for their products. It is suggested that the rest of the world is benefiting from R&D funded by US consumers, but is not paying a fair share of the revenues that pay for this R&D.

That's right - high costs in America are our fault. What BS.
If you look at when that study was written (2003-2004) and for what purpose, you have your answer. The tone of the study, from the introduction all the way through, is that of a drug lobbyist white paper rather than a government analysis. The study was written at the time of the passage of the Medicare prescription drug plan to justify the failure to include any ability to negotiate drug prices. Remember that all branches of government were controlled by the same party, and that congressional leaders on this issue were awash in Pharma money, with some given 7 figure jobs after they killed any ability to negotiate. Congressmen needed an excuse not to be sent to jail.

There probably is some truth to the assertion that prices might have to go up a little bit elsewhere if the U.S. did not foot the bill for all of the profits drug companies could dream of. However, that increase, spread across the world, would probably not be huge. Like executive compensation, we are talking about how much it really takes to motivate innovation and work in the context of a system which is clearly allowing far more than necessary. Drug company R&D is about 12% of budget under most reports I've read.
03-16-2012, 06:12 AM   #15
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QuoteOriginally posted by kswier Quote
Fascinating. I am wondering if doctors in other countries (the ones with lower rates of medical errors) work less than they do here. I have a friend who is completing his residency, and he works a ton of hours, and is trying to start a family at the same time. It almost seems as if working long hours is a right of passage. I imagine the fatigue caused by these long hours may contribute substantially to the error rate.
I have wondered about that, too, but a large portion of the errors are not necessarily made by resident physicians or even doctors at any level. Types of Medical Mistakes - RightDiagnosis.com Nurses, orderlies, pharmacists and hospital workers of all kinds can make mistakes classified as "medical errors."
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