Physicians’ Perspective The Truth about American and Canadian Health Care by Dr. Rick Bayer
In the July 2006 American Journal of Public Health, Harvard Medical School researchers published the fact that, in spite of spending nearly twice as much per person for healthcare, Americans are less healthy than Canadians and have less access to healthcare.
The authors studied more than 8,000 American and Canadian citizens. Americans have higher rates of nearly every chronic (long-duration) illness including diabetes, arthritis, chronic lung disease, and high blood pressure. American rates of obesity and sedentary lifestyle were higher too. The good news? Americans are less likely to smoke tobacco.
Compared to Americans; Canadians have better access to most types of medical care, were more likely to have a regular doctor, and were less likely to have an unmet health need. In the US, cost is the largest barrier to care. Americans are twice as likely as Canadians to go without a needed medicine due to cost. Overall, Americans are far more likely to go without needed care due to cost. But, uninsured Americans are particularly vulnerable with over 30% having an unmet health need due to cost. The bottom line is average Canadians have similar health outcomes to insured Americans while the rate of uninsured Americans increases regularly.
Lead author Dr. Karen Lasser, primary care doctor at Cambridge Health Alliance and Instructor of Medicine at Harvard commented: “Most of what we hear about the Canadian health care system is negative; in particular, the long waiting times for medical procedures. But we found that waiting times affect few patients, only 3.5% of Canadians vs. 0.7% of people in the US. No one ever talks about the fact that low-income and minority patients fare better in Canada. Based on our findings, if I had to choose between the two systems for my patients, I would choose the Canadian system hands down.”
“These findings raise serious questions about what we’re getting for the $2.1 trillion we’re spending on health care this year,” said Dr. David Himmelstein, Associate Professor of Medicine at Harvard and study co-author. “We pay almost twice what Canada does for care, more than $6,000 for every American, yet Canadians are healthier, and live 2 to 3 years longer.”
Dr. Steffie Woolhandler, also an Associate Professor of Medicine at Harvard and study co-author, commented: “Our study, together with a recent study showing that people in England are far healthier than Americans, is a terrible indictment of the US healthcare system. Universal coverage under a national health insurance system is key to improving health. It’s striking that both whites and non-whites do better in Canada. A single-payer national health insurance system would avoid thousands of needless deaths and hundreds of thousands of medical bankruptcies each year. In 1971, Congress almost passed national health insurance. Since then, at least 630,000 Americans have died because they failed to act. How much longer must we wait?”
To summarize, Americans on average are less healthy and less able to access healthcare than Canadians. It’s well documented by statistics and well articulated by leading academic professors that universal healthcare coverage reduces inequalities.
What can Americans do? Americans must encourage discussion of universal healthcare among peers and politicians so that universal healthcare again becomes a mainstream political topic. Data from similar Western-type representative democracies show universal healthcare improves health with less cost than what Americans currently spend. Rather than lack of knowledge, America suffers lack of political will. If Canadians can provide universal healthcare and demonstrate improved healthcare outcomes, why can’t we Americans do the same?
Richard “Rick” Bayer, MD, FACP is board-certified in internal medicine, a Fellow in the American College of Physicians (FACP), practiced, and lives in Oregon. He is member of Physicians for a National Health Program www.pnhp.org