When you hear people talkabout health care in America there is one countrythat seems to get a good amount of attention.
It's a single payerhealth care system.
Kind of like the “Medicarefor All” plans that some well-known Democratshave been promoting.
In fact, the system'sunofficial name is also Medicare.
It hasuniversal coverage.
It has relatively cheaperdrug prices than the United States and it alsohas reports of long waiting times and endlessreams of red tape.
You've probably guessedwhich country we're talking about: Canada.
Canada's health care systemis playing a larger role in America's politicaldiscourse, as the 2020 presidential electionsheat up.
Progressives on the leftlove pointing to Canada as an equitable andefficient health care system.
Conservatives, on the otherhand, use Canada as an example when warningabout the dangers of socialized medicine andunchecked bureaucracy.
So how different, really, is Canada's health care system from what's going onin the United States.
In 2017, it's estimatedthat Canada spent around 10.
4 percent of itsGDP on health care.
By comparison the UnitedStates is estimated to have spent about 17.
2 percent of itsGDP that year.
The OECD estimates thatCanada spent around 4, 500 USD per person in 2017.
In the United States, though, the figure is expected to be at leastdouble that at ten thousand dollarsper person.
Out-of-pocket spending is alsolower in Canada.
On average Canadians spentaround 650 USD per person in 2016.
The average forAmericans was around eleven hundred dollarsthat year.
Canada still spends more thanthe average of all 36 OECD countries, whichcomes in around 3, 800 dollars per personand 8.
8 percent of GDP.
Despite spending less thanthe United States, Canada's medicare systemensures citizens have universal coverage for medicalneeds that are deemed essential somethingthe U.
Canada also has comparableor better health outcomes than the U.
even though itspends less money.
But, compared to othercountries, Canada's health care system hasroom for improvement.
Researchers looked at therate of deaths that could have been preventedwith proper access to care across 11 countries.
Canada ranked seventh onthe list while America was last.
We can see the sametrends in infant mortality rates.
Canada outperformsthe U.
but other countries likeSweden and Australia have much lower infantmortality rates than Canada.
Canadians also livelonger than Americans.
Canada's average life expectancyis among the highest of all the countriesand is nearly four years higher thanthe U.
Additionally, Canada's maternalmortality rate is almost four times lower thanthat of the United States and more Americansdie of heart disease and strokethan Canadians.
So how does Canada manageto spend less money than the United Stateswhile having a more effective healthcare system? Canadian medicare is apublicly funded model with private delivery.
The system was establishedin order to ensure equity among citizensregardless of people's ability to pay.
It was also createdin order to keep administrative costs low.
“There's no private plancan take cognizance of the family's abilityto pay.
Only a government can levytaxes on that basis.
” All Canadians receivetheir coverage through Medicare which is run atthe local level by each of the 12 provincesunder federal supervision.
“So basically the healthministry in the capital in Ottawa determines whatprocedures are going to be covered.
What we're going topay for it.
What pills we're going tocover on our list.
These are decisions thatare made separately by insurance companies, basically, in the United States.
” That's T.
Reid author of the book”The Healing of America.
” He traveled the worldexploring different health care systems and how wellthey work in Canada.
“Everybody has thesame treatment.
They would drive them nutsif George got better health care than Sam did.
That's that's notacceptable in Canada.
” There's some variation on whatis covered based on province but most medicallynecessary care is covered with noout-of-pocket costs.
There are someuniversal exceptions.
Prescription drugs arenot considered essential under medicare.
Dental, mental health, andoptometry are also not covered unless theyare considered medically necessary.
Because Medicare doesnot cover everything.
Most Canadians also buyprivate health insurance through their employers tosupplement out of pocket expenses.
They cannot however usethat private insurance to purchase care that iscovered under the government plan.
“If there's any treatmentor procedure or surgery that the system covers underits rules, then you can't buy it privately.
This is because – you knowhow in America we hate this notion of socializedmedicine, whatever it seems that'sreally bad.
in Canada the bad thingis what they call two tier medicine.
That is, they don'twant rich people getting better care for all thatwould be terrible that would violate their basicgallantry and values.
In America we kind of takeit for granted that a rich kid is going toget better treatment than a poor kid, that's kindof standard.
In Canada, that wouldbe taboo.
That's a sin.
” In 2015, private fundingsuch as household out-of-pocket costs andprivate insurance spending accounted for about30 percent of health care spending in Canada.
Despite the majority ofhealth care being publicly funded, mosthospitals and doctor's offices are privatelyowned and operated.
Doctors who own theirown private practices are considered contractors whobill the government insurance fund fortheir services.
The government isnot their boss.
“The doctors are notallowed to practice outside of the system.
They can either practicecompletely in the government medicare system orcompletely out of it.
And there are veryfew places Canada where a doctor can make aliving without taking the Medicare patients, and thereforefor most people that's the only choice.
” Despite having universal coveragethe system still has some problems.
Wait times are longer inCanada than the United States.
In a 2016 survey53 percent of Canadians said they were not ableto get an appointment on the same or next daywhen they were sick or needed attention.
The United States performedslightly better at 42 percent.
Out of all ofthe 11 countries surveyed, Canada performed the worstin that category.
Thirty percent of Canadianssaid they waited two months or longer to seea specialist compared to 6 percent inthe United States.
Nearly one in five Canadianswaited four months or more for elective surgery whileonly 4 percent of American respondents saidthe same.
About 60 percent ofCanadians find it difficult to access medical carein the evenings, on weekends or during holidayswithout going to a hospital.
These long wait timescan lead to the overuse of the emergencyroom, where half of Canadians said they've waitedtwo hours or more to be seen.
“It's a good system butit doesn't work that well in Canada, interestingly.
In its own home country, there are long waiting lines.
You know, thereare constant stories about care being denied or peoplejust had to wait months just tosee the doctor.
And I believe that's becausethe Canadians are too cheap about it.
They just don't spend enoughon health care to have a lively system.
Some provinces likeSaskatchewan where this started, have shorter waitingtimes for both acute and elective treatmentthan most of the United States.
So there are parts ofCanada where it works.
” Not all medical care iscovered in Canada which leads people tohave significant out-of-pocket costs.
Medicare does not classifyprescription drugs as essential which means theyare not covered for many patients.
There are some socialprograms to help Canadians pay for drugs, but thebenefits vary by province.
For example, Ontarioprovides prescription drug coverage for anyone under 24years old who does not haveprivate insurance.
The province also has adrug program for people 65 and older.
Canadian pharmaceutical costs arealso not as controlled asother countries.
Canada spends approximately thesame amount as the UK on pharmaceuticalsdespite having only half the population.
There are also noout-of-pocket caps on spending.
In 2015, Canadians spentaround $670 U.
dollars per capita onretail prescription drugs compared to the United Statesper capita costs of roughly 1000 dollarsin 2016.
One in 10 Canadians didnot fill a prescription or chose to skip adose due to cost.
This is still significantlybetter than the United States where nearlyone in five people chose not to buymedication because of cost.
Despite the problems Canadiansare proud of their health care system but theydo recognize it needs reform.
94 percent of Canadians surveyedsaid it was an important source of bothpersonal and collective pride.
But nearly onein four Canadians were concerned about whether they wouldbe able to pay for all of the care theymight need if they ever became seriously ill.
Despite that concern 45percent of Canadians rated the overall qualityof medical care in Canada as excellent or verygood and nearly three quarters said the same oftheir personal care in the past year.
“The citizens arecrazy about It.
It's egalitarian and treatseverybody the same.
That's the most importantsocietal value in Canada is treatingeverybody equally.
The other thing they likeabout it is they know it's better than the U.
They have betteroutcomes, they have better recovery rates fromdisease, they have longer life expectancy and theypay less and man they love being betterthan the U.
That mattersto Canadians.