Canadian and American healthcare systems are contrasted

Examining different countries' healthcare systems is a widespread practice among healthcare practitioners in wealthy nations. The comparison offers a foundation for exchanging cutting-edge concepts to improve the health of people living in the associated countries and expertise in the field of global healthcare. Even so, there are significant variations in healthcare results across the majority of nations, which raises the possibility that different healthcare policies have been applied. Canada and the United States are two instances of two states that have different healthcare systems in terms of a number of factors, including socialized medicine, healthcare spending, life expectancy, and health insurance. The objective of this study is to compare and contrast the healthcare systems of Canada and the United States.
Comparing Expenditure
One of the ways to quantify healthcare for both Canada and the US is to compare the spending habits of both countries. Comparing the expenditure on health is vital because capital in all forms is the primary resource of a healthcare system which determines health outcomes of the citizens. According to a 2015 report by the Commonwealth Fund which compared health spending among thirteen countries, healthcare took up 17.1 % of the GDP in the US compared to 10.7 % of the GDP in Canada in 2013 (Squires and Anderson). The critics of the American healthcare system, most of whom are American politicians, congressmen, and health policymakers, think the GDP share of healthcare is too high and is a drag on the overall prosperity of the nation. For example, the 2016 Democratic candidate for President, Bernie Sanders, campaigned on a promise to adopt the Canadian healthcare system that is single payer and progressive (Graham). The need to question whether Americans get value for their money arises when one compares expenditure through per capita income. According to figures by Squires and Anderson, the cost of healthcare was $ 9086 per capita for the US while Canada spent $ 4569 per head in 2013. Admittedly, the two countries have different purchasing powers which could be a factor in the disparity. However, the almost double cost of healthcare for the US compared to Canada becomes alarming when figures and statistics compare the health outcomes and life expectancy rates. One of the reasons for the high spending in the US is the adoption of healthcare policies and measures that aim to improve healthcare. However, a comparison of the historical growth of healthcare for the US and Canada shows that Americans do not get marginal value for their investments in healthcare, and instead, the health policies increase cost with minimal benefits for the citizens. For instance, in the 1960s, both the US and Canada had an almost similar healthcare system. The similarity is evident in figures which show Canada spent 5.5 % of the GDP per capita on health while the US used 5.2 % of the GDP per capita. However, by 1990, the spending was at 12.9 % and 9.2 % for the US and Canada respectively (Squires and Anderson). The figures show a sharp increase in healthcare spending in the US with low health expectations. This study submits that the healthcare systems adopted by the US over the years are responsible for the high cost of healthcare. Instead of entirely socializing healthcare to a single payer system, the US fragmented the healthcare so that there was a dominant private sector dominating the majority of the public sector of the healthcare. Private companies are focused on making money with little regard for the general welfare of the nation and the citizens. Still, the partially socialized section of the US healthcare system proves too expensive for the low income earning segment of the population because of the high cost of insurance. On the other hand, the insinuation is that Canada has a fully socialized healthcare system. For example, Canada provides all citizens with universal healthcare where the public funds the health services. In comparison, 20 % of non-elderly Americans do not have health insurance ("Comparing The U.S. And Canadian Health Care Systems").

Health Outcomes

One would expect the spending trends to reflect respectively on the health outcomes of the US and Canada. However, a further comparison indicates that Canada gets more benefits with injecting less money into the system while the spending of the US keeps rising with time without a reflection of favorable health outcomes. Canada has a life expectancy of 80.9 % compared to the US at 78.6 % (Krell). Furthermore, the rates of infant mortality, diabetes, and cardiovascular diseases are high in the US compared to Canada. This study submits that the wholesome healthcare delivery of Canada is majorly responsible for the favorable health outcomes. Unlike in the US, a Canadian can regularly cater for health without much worry about financing and therefore, the citizens carry out more preventive visits to health centers. On the contrary, most Americans do not have a medical plan for when they are ill leave alone insurance or a healthcare system that enables regular health check-ups. As in the healthcare spending, the US depicts a trend of low growth concerning life expectancy. For instance, both Canada and the US had an appropriate median survival age in 1990 (Krell). The similarity depicts a period of congruence between the survival of Canadians and Americans. After input of health measures and resources, both countries raised the median survival rate between 1990 and 2013. However, the Canada grew at a higher rate compared to the US such that by 2015, the median survival rate for the US and Canada was 40.6 years and 50.9 years respectively (Krell). The ten-year gap in survival rate cannot be accounted for in healthcare disparities, and thus other entities think that other factors are responsible. According to the National Bureau of Economic Research, the US has a higher mortality rate among the younger population as a result of accidents and homicides. Further, heart-related conditions cause high mortality in the US due to differences in lifestyles in the two countries. For instance, only 19 % of Canadian women are obese compared to 33 % of women in the US ("Comparing The U.S. And Canadian Health Care Systems"). Therefore, the disparities in health outcomes, life expectancy, and mortality rate are not solely attributed to the healthcare system but also the culture in America.

Health Insurance

Thus far, it is clear that the healthcare systems of Canada and the US are utterly different, if not opposed to each other. However, the above analysis shows the areas of comparison that people use to either praise the Canadian system or critic the America system. Still, it is essential to know the principal differences to understand the reason for the difference in health outcomes. The methods of processing health insurance are alarmingly different. First, Canada has a single-payer health insurance method where taxes that cater for the essential healthcare for all citizens finance the healthcare system (Ellis, Chen, and Luscombe). For instance, the public covers healthcare in Canada and hence it is a single-payer healthcare system. The cost of the healthcare system in the US is covered by multiple outlets namely; public taxes, the private sector, qualified individuals and employers. Thus a single individual in the US can have numerous health covers from both the public and private sector, hence the name multi-payer system of healthcare. Secondly, while the government is the primary insurer of all citizens in Canada, the employer is mostly responsible for people’s health insurance (Ellis, Chen, and Luscombe). Even the employer’s insurance cover is not mandatory as opposed to the government’s protection being a mandatory requirement in Canada. The mentioned differences suggest variance in the methods of processing insurance. For instance, if every citizen in Canada is entitled to health insurance, it follows that at birth, one automatically gets cover for hospital visits under various programs depending on age. The processes and routines for getting medical cover are limited and instead offered on one stop at birth. However, the American citizen must seek health insurance from any of the more than 1200 health insurance providers (Ellis, Chen, and Luscombe). Still, even before choosing an insurance company, being employed or not determines the likelihood of getting a decent medical cover. It follows that for the average American, the process of getting insurance begins at the job market. After securing a job, an individual can bargain for a health coverage under the employer’s medical cover allowances. If the employer’s cover is not enough, especially for people with families, the individual must seek private health insurance from one of the numerous health insurance companies in America. Therefore, the one Canadian health plan ultimately proves more efficient than the many health plans that cause more stress than relief for US citizens.

The payment mode for health cover automatically changes with a country’s insurance plan. The US citizens use several insurance payment methods depending on the structure of an individual's coverage. For example, a sizeable number of people buy health services directly from the providers through the private good market insurance (Ellis, Chen, and Luscombe). The traditional method of paying for a service is also used by insured people in both countries when buying non-prescription drugs and undergoing routine care such as dental check-ups. Some US citizens pay for health insurance through the conventional means of paying premiums to a health insurance program that contracts and pays health providers on behalf of the people. Conventional insurance mostly covers secondary health care. The majority of Americans pay for coverage through a sponsor who directly or indirectly collects revenue from consumers. The sponsor then pays the healthcare providers under a contractual agreement. Canadian healthcare system uses the sponsored insurance, only that the government is the sponsor (Ellis, Chen, and Luscombe).

Socialized Medicine

Socialized medicine is another point of consideration when comparing and contrasting the Canadian and American healthcare systems. Given the negative association of the word socialism and the concept of social living in America, the socialized system of healthcare has been politized over the years in the US with some quotas, especially the right wingers, vehemently opposing any reforms inclined to socialized medicine (Cummings). However, liberals in the healthcare sector front the argument that socialized medicine denotes a system of universal healthcare. For Canada, the health sector has successfully implemented socialized medicine as the government is the sole sponsor of health cover without regard to social class. In the US, socialized medicine is limited to hospital and primary medical care for all citizens with the government being the regulator and subsidizer of health through funds from taxation. Medicare and Medicaid of 1965 were the first programs of government intervention that regulated the healthcare system in favor of the consumers.

President Lyndon Johnson enacted the two systems with the aim of protecting senior citizens and people who live under the poverty line (Cummings). The fact that the system was created to cover specific groups of people brought about a controversy with people questioning the criteria for choosing who to insure. The main limitation of health coverage under Medicare and Medicaid is that an individual must consent to the network of hospitals and health providers that the insurances company has contracted. The Medicare and Medicaid programs are different from the socialized medicine of Canada in that the government contracts health services on behalf of the consumer instead of living the consumer to negotiate for coverage. Furthermore, the government has healthcare resources for public use, and the people do not struggle to afford healthcare. It is likely that the Canadian government is overwhelmed in times of emergencies and catastrophes because of being the sole provider of a working healthcare system. Critics of the single-payer system also intimate that patients wait for long periods before getting medical care due to lack of available options as is the American case.

Obamacare versus the Canadian Medical Service Plan

After rigorous campaigns and calls to abolish Medicare and Medicaid on the grounds of favoritism and a thin cover for all, the Obama administration sought to address the problem with the introduction of the Patient Protection and Affordable Care Act or Obamacare in 2010 (Cummings). The analysis of Obamacare is essential to this study because critics of Obama’s Affordable Care Act think that the government attempted to replicate the Canadian single-payer system and implement it in stages until the entire healthcare system is completely socialized. However, after careful analysis, this study submits that Obamacare is also different from Canada’s Medical Service Plan and it, in fact, does not intend to make the US healthcare system single payer. The Affordable Care Act enhanced healthcare by expanding the eligibility of Medicaid and reforming Medicare to improve efficiency. Also, the act established policies with minimum standards for health insurance contracts and abolished the refusal of coverage due to pre-existing conditions (Cummings).

Even with the mentioned changes, Obamacare is still different from the Canadian healthcare system in several ways. First, the Obamacare does not repeal the complex structure of healthcare but adds other layers while amending existing legislation (Maioni). For instance, under Obamacare, the majority of citizens continue to procure health services through insurance providers only that the administration enacted laws to provide the health insurers. Obamacare solved the problem that Medicare and Medicaid could not solve by introducing health exchanges for American citizens without health insurance (Maioni). Therefore, unlike the Canadian system where a medical card caters for all medical expenses paid by public funds for all people, Obamacare still depends on the multiples payers in the US. Secondly, the Canadian Medical Service Plan provides universal coverage for all under one care of the state. Under Canada's comprehensive care, the devolved units of provinces and districts must publicly finance and deliver health cover for every legal resident (Maioni). On the other hand, the Obamacare increased coverage but did not make or lay the groundwork to make healthcare in the US universal. Still, Americans are responsible for purchasing insurance to access care. While the government of Canada pays for health care through public funds, the US government, under Obamacare, expanded the options for consumers so that even the lowest income earners are eligible for coverage under the Medicaid plan (Maioni). Thirdly, unlike Obamacare, the Canadian Medical Service Plan is a national health insurance system. The Canadian health system is such that an individual gets cover for a range of comprehensive services under the same plan. Also, the provinces and territories may have different health plans, but they all subscribe to the federal government’s principal health plan. Given that the Supreme Court curtailed any obligation of the federal government to expand Medicaid and implement Obamacare, the healthcare system may further deepen the rift between the federal and state government (Maioni).

The fourth difference between Obamacare and the Canadian system regards the most controversial issue that Americans use to critique the Affordable Care Act. While the health system in Canada provides equal access to medical services, Obamacare still fronts the notion that care depends on how much an individual can afford as opposed to the prevailing health needs (Maioni). Therefore, as Canadians citizens don’t have to worry about their social status to access medical services, the quality of care in the US even under Obamacare still depend on an individual’s income, age, and health. Furthermore, the multiplayer system in the US asks consumers to choose either bronze, silver, gold or platinum coverage. It is from all the complexity of healthcare structures that some citizens do not view the new act as affordable. Finally, Obamacare may make healthcare services efficient but does not address the problem of cost control (Maioni). The multiple payer systems have many administrative costs which become a financial burden to the consumer. The Canadian government budgets for hospitals and negotiates fees with health providers as a way of controlling cost.

Conclusion

Canada and the United States are examples of two nations that differ in healthcare through various aspects such as health insurance, life expectancy, healthcare spending and socialized medicine. Comparison of healthcare in the two countries indicates that Canada gets more benefits with injecting less money into the system while the expenditure of the US keeps rising with time without a reflection of favorable health outcomes. Socialized medicine is a significant point of consideration when comparing and contrasting the Canadian and American healthcare systems. Obamacare is the only healthcare system closest to the Canadian Medical Service Plan, but still has glaring differences that exhibit the structural complexity of the entire health system of the US.

Works cited

Cummings, Elizabeth. "Understanding The US Healthcare System." InterExchange, Inc. N.p., 2015. Web. [www.interexchange.org/articles/abroad/2015/08/10/understanding-us-healthcare system/].

"Comparing The U.S. And Canadian Health Care Systems." National Bureau of Economic Research. N.p., 2017. Web. [www.nber.org/aginghealth/fall07/w13429.html].

Ellis, Randall P., Tianxu Chen, and Calvin E. Luscombe. "Comparisons Of Health Insurance Systems In Developed Countries." Encyclopedia of Health Economics. N.p., 2014. Web. [www.bu.edu/law/files/2016/01/EllisPaper.pdf].

Graham, John R. "The Reality Of U.S. And Canadian Health-Care Spending." Fraser Institute. N.p., 2016. Web. [www.fraserinstitute.org/blogs/the-reality-of-us-and-canadian-health-care spending].

Krell, Kenneth. "Canadian Vs. U.S. Health Care." Physicians for a National Health Program. N.p., 2017. Web. [www.pnhp.org/news/2017/may/canadian-vs-us-health-care].

Maioni, Antonia. "Obamacare Vs. Canada: Five Key Differences." Physicians for a National Health Program. N.p., 2013. Web. [www.pnhp.org/news/2013/october/obamacare-vs-canada-five-key differences].

Squires, David, and Chloe Anderson. "U.S. Health Care From A Global Perspective." The Commonwealth Fund. N.p., 2015. Web. [www.commonwealthfund.org/publications/issue briefs/2015/oct/us-health-care-from-a-global-perspective].