The United States of America and Canada are North American countries with unique health care systems with diverse similarities and differences. The nations above also have different infant mortality and cardiovascular disease death rates, populations with standard body mass indices prevalence, and life expectancy for females and males. Moreover, Canada and the United States of America have public and private insurance plans with varying benefits and limitations sensitive to country-specific federal and state laws. Additionally, the Canadian and United States’ healthcare systems have different cost structures, cost-saving strategies, access rules and regulations, and quality management frameworks. Finally, Canada and the United States of America spend varying percentages of their GDP on healthcare. Therefore, Canada and the United States have different healthcare systems with unique benefits, costs, quality control techniques, and access, and limitations.
Overview of the Canadian Healthcare System
Canada has a single-payer, universal, devolved healthcare system funded by the government primarily. The country’s provinces and territories (P/T) support primary healthcare services sought by Canadians in any clinical facilities, while private insurance providers cover non-public insured services. The Canadian Medicare system covers all permanent residents and Canadian citizens despite their income status, race, age, marital status, or geographic location. The universal healthcare system in Canada (Canadian Medicare) was instituted in 1966 and is documented under the Canada Health Act of 1984 ( Allin, Marchildon, & Peckham, 2020) . Characteristics of the Canadian Medicare system include public administration, coverage comprehensiveness, universality, inter-province portability, and accessibility. The Canadian Medicare is fully funded by the federal government, responsible for delivering and organizing the system above. Additionally, the federal government directly pays hospitals, physicians, drug programs, community-based care ventures, and nonhospital long-term care facilities.
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Overview of the United States Healthcare System
The United States of America has a mix of profit, not-for-profit, private, and publicly funded healthcare systems. The federal government subsidizes Medicare and Medicaid, which target the vulnerable in society, such as low-income populations, children below 18 years, pregnant women, and senior citizens. Additionally, the United States has the Veterans Health Administration plan covering retired or severely injured military members relieved from their duties early ( Commonwealth Fund, 2020) . The United States has an open-market system where citizens and permanent residents purchase affordable insurance premiums paid according to provider agreed rates. Further, private insurance providers sell their premiums on the open enrollment market.
Comparisons of the Canadian and United States Health Care Systems
Benefits
Canada’s Medicare system accords users benefits, such as free physician consultations, emergency care, and inpatient admission. Additionally, Canadian Medicare pays for inpatient drug prescriptions for users, immunization, diagnosis, and unpaid medications from physicians on outpatient drugs to purchase. Moreover, currently, Canada’s private insurance providers cater for non-Medicare healthcare services, such as dental, vision, chiropractic care, mental health, medical equipment, and midwifery ( Allin, Marchildon, & Peckham, 2020) . Further, some Canadian provinces provide subsidized hospice care per-needs assessments, provided the patient meets set requirements. Canadian P/T also fund long-term care in approved nursing facilities using a need–assessment basis. Finally, the Canadian federal and state government provides unpaid care to non-insured individuals who require emergency services, such as undocumented women in labor.
Similarly, the United States has several federal-funded healthcare programs, such as Medicare, Medicaid, Children’s Health Insurance Program, and Veterans Health Administration plan. Medicare is a federal-funded health insurance plan that pays for hospital services for senior citizens, persons with long-term disabilities, and end-of-life renal care patients. Medicare beneficiaries enjoy benefits, such as free hospital consultations, private medical care in federal and state-approved institutions, and inpatient and outpatient prescription drug coverage. Medicaid is also a federal-funded healthcare insurance plan that accords vulnerable populations, such as persons from low-income households, children below18 years, expectant mothers, and persons living with permanent disabilities, access to unpaid healthcare services within the country’s boundaries.
Further, the United States has the Children’s Health Insurance Program created in 1996 that accords children from low-income households that do not qualify for Medicaid because of slightly higher-than-allowed income unpaid care in any federal-approved facility ( Commonwealth Fund, 2020) . Finally, the United States Veterans Health Administration covers healthcare costs for military members discharged from duty because of severe injuries or end-of-service. Private insurance providers pay for the above services, except they cater for persons who do not qualify for Medicaid, Medicare, CHIP, and Veterans Health Administration plans.
Limitations
The Canadian Medicare system and the United States Medicare and Medicaid plans have similar limitations. For instance, Medicaid does not cover outpatient drug prescriptions in the United States, similar to Canada’s Medicare care exemption ( Allin, Marchildon, & Peckham, 2020) . Additionally, Medicaid and Canadian Medicare do not cover end-of-life services, routine check-ups, cosmetic surgery, and non-essentials, such as adult diapers, bandages, and chiropractic care. Further, the Canadian and United States’ Medicare do not cover eye check-ups, hearing aids, dental care, acupuncture, and prescription glasses.
Issues Faced in the Canadian and United States Healthcare Systems
Quality
The quality of care is lower in the United States compared to Canada. United States’ populations do not receive adequate patient education to prevent mortality rates, maintain normal BMIs, or avoid lifestyle diseases, such as cardiovascular failures. The quality of care in the United States is different from Canada’s based on outcomes, such as infant mortality rates, percentage of people with normal BMI, mortality rates for cardiovascular diseases, maternal mortality rates, and male and female life expectancies. For instance, according to the most recent reports, the life expectancy for women in the United States is 76 years and 84 years in Canada. Similarly, the life expectancy of males in Canada is 80 years and 76 years in the United States ( Statista.com, 2020) .
Moreover, infant and maternal mortality rates are caused by trigger factors, such as low birth weight, poor diet, inaccessible hospitals advanced by federal rules, and substance abuse during pregnancy. Substance abuse and inaccessible clinics for pregnant women are more prevalent in the United States than in Canada, which increases the susceptibility for infant and maternal mortality rates ( Lam, 2019) . Pregnant women do not qualify for substance abuse care or mental health treatment in the United States. If their conditions remain untreated for long periods, they may lack adequate blood causing maternal deaths or birth low-weight children who die during the infancy stages. Moreover, the United States’ culture promotes unhealthy dieting lifestyles compared to Canada, implying that more people have cardiovascular diseases propelled by obesity than Canadians.
However, Canada and the United States have various regulatory bodies that ensure healthcare facilities provide quality services. For instance, Canada has the Home Care Reporting System and Canadian Institute for Health Information that reports resource utilization, clinical functioning, and demographic data for hospitals. Additionally, Canada’s Patient Safety Institute creates standardized practices and tools to guide hospitals on required care levels. Moreover, the Canadian Agency for Drugs and Technology regulates medical equipment and drug qualities consumed by patients and stocked by hospitals ( Allin, Marchildon, & Peckham, 2020) . Other Canadian entities that control performance in the country’s healthcare system include the Canadian Cancer Registry, Accreditation Canada, and the Canadian Foundation for Healthcare Improvement. Similarly, the United States federal government controls quality in its healthcare facilities through institutions, such as the Agency for Healthcare Research and Quality that reports the country’s quality of care progress annually and the National Quality Strategy ( Commonwealth Fund, 2020) . Finally, the United States mandates the Centers for Medicaid and Medicare Services to inform their clinical functioning and resource allocation data for public consumption.
Access
Medical care access in the United States varies significantly from Canada’s because of different payment options for the regions. All Canadian citizens and permanent residents qualify for a fully-paid care consultation in public hospitals, implying that no one is exempted from seeking care because of funds. However, Canada’s Medicare does not accord citizens access to services, such as cosmetic surgery, dental and eye care, end-of-life home-based care, or chiropractic care ( Allin, Marchildon, & Peckham, 2020) . In contrast, the United States has a multi-payer system that denies persons who do not enroll for Medicare or Medicaid help when they visit hospitals for non-emergency care. However, the United States and Canada do not allow groups, such as undocumented illegal immigrants, persons residing illegally in the above countries post-visa expiration, and uninsured individuals who refuse to enroll for federal-sponsored plans and temporary residents any access to care ( Lam, 2019) . Nevertheless, the United States and Canada provide safety nets for the exempted populations above; they can only receive emergency care in any hospital.
Cost of Care
Finally, the United States and Canada have varying expenditures in their healthcare systems. For instance, according to a 2017 report, the Canadian federal government allocated 11.5 % of its GDP to subsidize and improve healthcare in its public sector ( Allin, Marchildon, & Peckham, 2020) . Additionally, in 2018, Canada spent $29.4 billion to better healthcare services and finance patient treatments ( Allin, Marchildon, & Peckham, 2020) . Moreover, the Canadian system does not allow patients to co-pay for clinical services unless they seek exempted care, such as vision, dental, or chiropractic care. In contrast, the United States spending on healthcare is almost twice that of Canada’s. In 2017, the United States used 28% of its GDP to cater for healthcare services and 45% of federal taxes to pay for the above expenditure. Moreover, the United States promotes copayment systems even for primary care ( Commonwealth Fund, 2020) . Finally, United States patients cannot access clinical help if they do not pay monthly premiums, even for federally subsidized plans. Therefore, the cost of care in the United States is highlighted than Canada’s. However, as indicated above, Canada has better care quality and more access than the United States, even though the country’s expenditure on healthcare is near half that of the United States.
References
Allin, S., Marchildon, G., & Peckham, A. (2020). International Health Care System Profiles:Canada . Commonwealth Fund. https://www.commonwealthfund.org/international-health-policy-center/countries/canada
Commonwealth Fund. (2020). International Health Care System Profiles: United States . https://www.commonwealthfund.org/international-health-policy-center/countries/united-states
Lam, G. (2019). U.S. health care from a global perspective, 2019 . Commonwealth Fund. https://www.commonwealthfund.org/publications/issue-briefs/2020/jan/us-health-care-global-perspective-2019
Statista.com. (2020). Life expectancy in North America 2019 . Statista. https://www.statista.com/statistics/274513/life-expectancy-in-north-america/
