Running head: COMPARISON OF AMERICAN AND CANADIAN HEALTH CARE

SYSTEMS
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A Comparison of the American Health Care System and the Canadian Health Care System

Victoria Lee

Channel Islands State University

The United States’ healthcare system is capable of providing adequate care that allows

for many individuals to receive treatment as long as they have health insurance. While the United

States healthcare system is technology-driven, the subsystems within try to allocate power to

give treatment to all types of individuals. The cost of healthcare in the United States is

substantially higher than other countries, such as Canada. Universal healthcare in Canada allows

for every individual to receive equal healthcare. The United States healthcare system also has

higher costs than other industrialized countries and unequal subsystems allow limited access to

basic care. Canada’s universal healthcare system is centrally controlled, is less expensive and

allows for equal access to healthcare for all types of individuals. The use of a private sector in

the United States’ healthcare system allows for higher prices and limited access. Comparing

insurance in the United States to Canada’s national health insurance shows how limited the

United States healthcare system is. While there is no such thing as a perfect healthcare system,

universal healthcare in Canada provides more benefits than the United States’ healthcare system.

Differences in the United States healthcare system and Canada’s healthcare system will reveal

limitations between both. No healthcare system is perfect, but Canada’s healthcare system is

more favorable towards its citizens than the United States. Private sectors are present in both

countries, but Canada restricts the involvement in healthcare. The imperfect market in the United

States allows for affiliations and profits. The different types of hospitals in the United States

makes healthcare complex and was the result of government policy. The comparison of the

United States’ healthcare system to Canada’s healthcare system shows how universal healthcare

is more beneficial than how the United States handles healthcare.

System

The United States’ healthcare system is financed in multiple ways. Direct payment from

individuals, healthcare insurance that many jobs provide, medicare, medicaid and other programs

all finance the United States healthcare system. Employer provided insurance varies from a

managed care plan, health maintenance organization, preferred provider organization, or point of

service plan. Canada’s healthcare system is financed by taxation from the provinces and

territories. Candian Medicare allows for each province and territory to have its own insurance

plan. Canada’s government regulates services such as medications, medical devices, and

technology (Tikkanen, 2020).

The United States’ subsystems aim to provide care to all types of people, but does not

guarantee healthcare for all of its citizens. The managed care subsystem aims to provide basic

treatment for individuals under the plan. The military subsystem provides medical care to active

military and some uniformed nonmilitary services and covers preventative care. Retired veterans

are also provided hospital, mental health, and long term care under the military subsystem.

Vulnerable populations is another subsystem that aims to provide healthcare, but many uninsured

individuals will use emergency services as a result of how this subsystem is handled. Integrated

delivery is a subsystem that provides services continuously. Long-term care services include

medical and nonmedical care for those who are chronically ill or disabled. Public health is the

last subsystem of the United States’ healthcare system that aims to provide basic and necessary

care. While the subsystems aim to provide different options for healthcare in the United States,

they are not centralized and have high costs when compared to Canada’s healthcare system. The

subsystems are not well organized with each other, which leads many individuals to have
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average care and limited access. The United States’ investment in technology and innovation

does not mean that there will be a higher quality of care. Technology has helped inflation in the

United States’ healthcare system.

The universal healthcare system in Canada allows “two-tiered-or multi-tiered-healthcare

systems that provide high quality care to citizens and authorized residents,” there are also

programs that help certain types of people pay for services that are excluded (Villegas, 2019).

The centrally controlled system is less complex and accessible all over Canada’s provinces.

Canada’s government directly finances health services and its jurisdictions fund physicians and

drug programs (Tikkanen, 2020). Out of pocket payments are used or private insurance is used

for services not covered under Canadian Medicare. While “Canada’s healthcare system is based

on the principle that healthcare should be financed according to ATP and should be utilized

based on need” (Edmonds, 2019) and services such as "dental services, physiotherapy,

psychologist visits, chiropractic care, and cosmetic or plastic surgery” are not covered (Tikkanen,

2020). The services that are not included put Canadian individuals at a disadvantage, the

programs that are aimed to help with these issues do not cover all types of individuals.

Limitations in both Canada and the United States are shown in their coverage of

immigrants. The United States’ subsystem of vulnerable populations may help immigrants, but it

is known that many that fall under this category often forego treatment because they are not

offered much financial assistance. Many immigrants in the United States utilize emergency room

visits as opposed to a primary care physician. While Canada similarly has policies that do not aid

immigrants with healthcare coverage. Certain plans help underprivileged populations, but most

of these are for citizens of Canada. Private insurance is one solution for immigrants, but many

can not afford this type of insurance. Recent immigration viewpoints in both the United States
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and Canada show that immigrants that do not contribute taxes are using the healthcare system

wastefully. Canadian immigrants similarly utilize the emergency room as a means of medical

treatment as opposed to primary care. Preventative diseases and conditions are alarmingly high

in immigrants in both the United States and Canada. Canada recognizes that the cost of

immigrants using the emergency room over services covered by Canadian Medicare costs much

more than being uninsured (Villegas, 2019).

Consumers in the United States on average pay $500 per outpatient visit, while inpatient

care such as a hospital visit was on average $11,700. Outpatient care in hospitals has grown

exponentially. Outpatient growth is due to different settings being available and non hospital

facilities being able to have outpatient services. Inpatient costs, social factors, and amount of

time and resources are also reasons why outpatient services are much more favorable than

inpatient services (Gee, 2019). While Canada has a universal healthcare system that allows for

every Canadian citizen to receive medical treatment, not all services are fully covered by their

Candaian Medicare. An average inpatient visit costs $7,000, while an outpatient visit varies from

$180-$280 depending on the service. Copayments are one of the issues Canadian citizens face in

their healthcare system. The regulation of the healthcare system prevents prices from being

exponentially high, such as medications and procedures in the United States. Private healthcare

is also present in Canada’s healthcare system, but comparing Canada to the United States we see

the benefits in Canada outweigh the system in the United States.

Primary healthcare providers in the United States include “family physicians and general

practitioners, general internists, general pediatricians, and geriatricians” (A., 2018). These

physicians focus on a range of services such as preventative care, diagnostic services, and

therapeutic services. Primary care physicians aim to provide care over a long period of time. The
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long term relationship between primary care physicians and patients can expect a higher level of

care. Physicians will have an understanding of their patient’s needs such as the knowledge that

they have a tolerance towards certain medications and their limitations on insurance and

copayments (Biglione, 2019). Primary care in Canada is similar to the way primary care is in the

United States. The main primary healthcare providers in Canada are family physicians and

general practitioners. Physicians in primary care are not multi disciplined and work in either solo

or small group practices (Hutchison, 2001). The use of primary care in both the United States

and Canada shows higher health levels, satisfaction, and lower costs when not using primary care

services. Preventative conditions such as breast cancer will more likely be recognized when

using a primary care provider.

The United States and Canada have similar healthcare systems in regards to the way

physicians function, but differ in cost. Canada’s universal healthcare system allows for equal

opportunity of access to healthcare, the United States does not provide equal access to

healthcare. Canadian Medicare provides programs like the United States that helps certain types

of people pay for healthcare payments. The United States’ healthcare system is limited and

complicated due to the decentralized nature of organization. Canada shows how a centralized

healthcare system is easier for its citizens and is more efficient. While no healthcare system is

perfect, the differences in Canada’s healthcare system show much more accessibility and

organization compared to the United States. The limitations of Canada’s healthcare system are

the services that are not included under Canadian Medicare, but the overall copayments are

lower than prices in the United States. Many industrialized countries have universal healthcare

systems that numerous Americans want.

A. (2018, July). The Number of Practicing Primary Care Physicians in the United States.
Retrieved November 27, 2020, from
https://www.ahrq.gov/research/findings/factsheets/primary/pcwork1/index.html

Biglione, B. (2019, November 9). Aspirin in the Treatment and Prevention of Migraine
Headaches: Possible Additional Clinical Options for Primary Healthcare Providers.
Retrieved November 27, 2020, from
https://www-sciencedirect-com.summit.csuci.edu/science/article/pii

Edmonds, S., & Hajizadeh, M. (2019, September). Assessing progressivity and catastrophic
effect of out-of-pocket payments for healthcare in Canada: 2010–2015. Retrieved
November 21, 2020, from
https://search-proquest-com.summit.csuci.edu/docview/2231161029?accountid=7284

Gee, E. (2019, June 26). The High Price of Hospital Care. Retrieved November 27, 2020, from
https://www.americanprogress.org/issues/healthcare/reports/2019/06/26/471464

Hutchison, B., & Abelson, J. (2001, May/June). Primary Care In Canada: So Much Innovation,
So Little Change: Health Affairs Journal. Retrieved November 25, 2020, from
https://www.healthaffairs.org/doi/full/10.1377/hlthaff.20.3.116

Tikkanen, R. (2020, June 05). Canada. Retrieved November 20, 2020, from
https://www.commonwealthfund.org/international-health-policy-center/countries/canada

Villegas, P. E., & Blower, J. (2019). "Part of being canadian is having access to healthcare":
Framing the boundaries of healthcare deservingness for non-citizens through the interim
federal health benefits program. Canadian Journal of Communication, 44(1), 69-88.
doi:http://dx.doi.org.summit.csuci.edu/10.22230/cjc.2019V44n1a3280