Introduction
Healthcare systems in different countries are wildly different from one another. Over time, every nation has developed its special sauce of legislation, service delivery mechanisms, and finance structures to best utilize its limited resources. Many different strategies are used, even among high-income countries that can afford to invest more in health care. Access to care, patient satisfaction, and population health are all impacted by these decisions (Menear et al., 2019). This comparison is especially important now when global health threats like the COVID-19 pandemic put health care and public health institutions to an unprecedented test (Menear et al., 2019). Infection and illness prevention and control efforts have had wildly varying degrees of success. This paper compares the healthcare systems of the United States of America and Canada to learn more about the factors that contribute to high-performing systems in both countries. We use recent data to make our comparisons. The report also provides an analysis and description of the healthcare systems in each country, as well as a look into the issues and challenges those healthcare systems face and the steps being taken to address them.
Structure and Organization of the United States of America Healthcare System
The healthcare system in the United States (US) is one of the most intricate in the world, with a web of connections between medical professionals, insurance companies, and those who seek treatment. The healthcare system in the United States is always developing and changing. The United States healthcare system is best described as a hybrid since it combines publicly funded programs like Medicare and Medicaid with privately funded market coverage (Buntin, 2021). Healthcare is mostly financed and delivered through individual out-of-pocket spending and commercial insurance. Buntin (2021) estimates that in 2019 roughly half of Americans had access to private insurance through their employers (group insurance), 6% had access to private protection through health insurance marketplaces (nongroup insurance), 20% relied on Medicaid, 14% relied on Medicare, and 1% had access to other public types of insurance, leaving 9% of Americans without health insurance.
Structure and Organization of Canada’s Healthcare System
The Canadian Constitution lays forth the basic framework for the structure of the Canadian health care system, including the division of power between the federal and provincial/territorial levels of government. Health care in Canada is supported by the federal government. Most medical care received in a hospital or from a family doctor’s office is paid for by the government (Government of Canada 2019). As reported by NCBI, it is against the law in Canada for private coverage to pay for services that are already paid for by public insurance. According to the Canadian government (2019), the Canadian healthcare system is a “single-payer” system. The Canada Health Act of 1984 is largely credited with creating Canada’s current healthcare system. Insurance is provided by the government, however, hospitals and doctors are not directly employed by the government.
However, in Canada, providers work for private companies rather than the government (Ross University 2021). Independent physicians are nonetheless subject to the regulations set forth by their respective insurance companies. Canadians have the option of purchasing private health insurance to cover the costs of some medical procedures. Government health care plans do not pay for cosmetic procedures or dental care. Some coverage variations exist across the Canadian provinces, which are roughly analogous to the American states. Patient payment at the time of service is a fundamental distinction between healthcare in Canada and the US (Regis Collage, 2018). The Government of Canada website also notes that while most Canadians pay for healthcare through taxes, wealthier earnings are subject to a higher tax rate. This has the practical effect of increasing healthcare costs for high earnings relative to low earners. Canada’s lower per capita costs can be attributed, in part, to the government’s stronger hand at the bargaining table. The Canadian government, for instance, can bargain for lower prescription prices with manufacturers than private insurance ever could.
Health Issues and Challenges Faced by the United States of America
The United States has made strides in healthcare and customer service experience during the past decade. However, according to a recent survey, only 7% of Americans are happy with the healthcare system as it stands right now (Smith-Bindman et al., 2019). Six in ten Americans of varying political persuasions agree that the healthcare system either needs adjustments or a complete overhaul.
The Soaring Price of Medical Treatment The soaring price of medical treatment is arguably the biggest problem in the health care system today. An overwhelming majority of Americans (over 45%) find it challenging to pay for health care, and over 40% are currently carrying medical debt (Regis College, 2018). As a result of the high price of medical treatment, many individuals are putting off going to the doctor even when they are ill, and they are also skipping their annual checkups to save money.
Health equity issues have been raised for a long time due to the obvious differences in health outcomes between groups. Income and healthcare costs are not the only factors contributing to these inequalities. Instead, Smith-Bindman et al. (2019) found that environmental influences have a significant bearing on human health and well-being. Furthermore, persistent racial and social inequalities have contributed to poor health for centuries in some communities.
One of the most critical problems in health care was brought to light by the pandemic: the acute scarcity of medical professionals. According to Buntin, (2021), this scarcity is due to multiple factors; an increasing need for healthcare caused by an aging population. a regional paucity of doctors and nurses, causing a limited crisis in access to medical care; and burnout, which happens when doctors and nurses take on too much, are under too much stress, or work too many hours.
Solutions
Health equity measures, including those for lowering the cost of care, require coordination between government agencies on all levels and the organizations providing direct patient care. To increase healthcare access in underprivileged populations, environmental variables can be tackled through housing, transportation, and engagement with healthcare charities and churches (Regis Collage, 2018). A variety of services are available for patients to choose from that can be established by healthcare administrators. Reducing healthcare costs requires participation and action from providers, payers, and governmental bodies at all levels. There is a current push to implement pricing caps for services and insurance that are both all-encompassing and reasonable (Buntin, 2021). Many of these costs can be mitigated by the implementation of industry-wide improvements, like enhanced Medicare quality-of-care reporting, as well as through the automation of repetitive processes and the establishment of payer-provider communications platforms.
Providers are coming up with innovative ways to make up for the shortfall. To achieve this goal, it may be necessary to rethink recruitment strategies and prioritize long-term workforce planning. To design a competitive remuneration package, health system leaders may need to consider salary, compensated time off, and fringe benefits (Buntin, 2021). Overwork, medical mistakes, and burnout can be avoided if departments are properly staffed. Providing more possibilities for learning and promotion is another possibility for boosting morale in the workplace.
Health Issues and Challenges Faced by Canada
The universal health care system in Canada is under attack from three fronts: rising costs, a population that is getting older, and rapid technological advancements. Costs have been maintained low without sacrificing quality or fairness in this much-acclaimed program. Its success, however, highlights the limitations of medical care, showing that the remaining health problems will not be solved by simply increasing access to conventional services (Ross University, 2021). Coordination of an ever-expanding system becomes more challenging as a broader definition of health necessitates a larger role for health in other policy domains and a growing number of valid participants. Different policy alternatives include doing nothing, business as usual, managed care, workforce regulation, and overhauling the entire system. Disagreement and struggle are inseparable from transformation (Ross University, 2021). Because they rely on public funding, most hospitals are constrained by strict spending limits.
Most primary care doctors practice independently and accept patients on a fee-for-service basis. Canada’s health care system is highly regulated, and the government may restrict access to some services to reduce spending and wait times. Lack of system-wide cohesion and coordination is another issue plaguing Canada’s healthcare system. Improvements in the health care system’s efficiency have governments preoccupied with issues including expanding access to care that is not covered by Medicare, reducing wait times for specialists and elective surgery, and better coordinating the many different parts of the system. As a result of factors such as burnout and attrition, Canada’s hospitals, clinics, and primary care resources are understaffed.
Solution
All actors (the federal government, state and local governments, regional health authorities, health care delivery groups, individual clinicians, and patients) have a role to play in enhancing the quality of health care. To that end, rather than focusing on what doctors or patients may do individually, we narrow our attention here to a subset of evidence-based interventions at the system level. Care would be enhanced in all six of the aforementioned dimensions if these steps were taken.
Differences between the Health Care Systems
Aside from insurance, there are significant distinctions between medical treatment in the United States and Canada. Canada has a higher concentration of family doctors than the United States. According to the NCBI, over half of Canada’s practicing physicians are family physicians. According to Marchildon et al., (2021), just approximately a third of physicians in the United States practice general medicine. For non-emergency care, Canadians often need a recommendation from their primary care physician before visiting a specialist. Specialists in Canada are penalized financially if they treat a patient who does not have a primary care physician’s recommendation.
Wait times for specialists in Canada tend to be greater than in the United States in part because of this referral need. While Canadians do not have to wait for treatment in the event of an emergency, the NCBI reports that the average wait time in Canada for procedures like knee or eye replacement is several weeks higher than in the United States. When comparing healthcare systems, the United States and Canada both provide their residents with a variety of options. All Canadians are required to have health insurance, but the country keeps prices down by limiting access to specialists. The patient often pays more in the United States, despite the lower wait times.
Determination
Canada’s healthcare system may be imperfect, but it’s miles ahead of the U.S. system. For disease prevention and an enhanced quality of life, the USA of America should model its healthcare system after Canada’s. The United States requires either a universal health insurance system, like Canada’s, or a pluralistic system that includes both the government and private organizations to ensure that all citizens have access to quality healthcare. Canada’s universal health care system is tax-funded, making it an ideal model for the United States to adopt. This means that every legal resident or citizen of Canada is eligible to sign up for the country’s universal health care system. Health care plans in Canada’s various provinces and territories vary widely in the services and supplies they cover. The increasing number of people in the United States underscores the importance of a solid public healthcare infrastructure funded by the federal government. Diseases can be avoided and quality of life enhanced with the aid of good medical treatment. Health and financial security are both guaranteed by universal coverage. It encourages people to make use of healthcare services, and it aids in the fight against poverty. It also encourages people to use preventative measures and cutting-edge treatments.
References
Buntin, M. B. (2021). Confronting Challenges in the US Health Care System. JAMA, 325(14), 1399. https://doi.org/10.1001/jama.2021.1471
Government of Canada. (2019, September 17). Canada’s Health Care System. Government of Canada. https://www.canada.ca/en/health-canada/services/health-care-system/reports-publications/health-care-system/canada.html
Government of Canada. (2023). Canada’s health care system. Canada.ca. https://www.canada.ca/en/health-canada/services/canada-health-care-system.html
ISPOR. (2023). ISPOR – US Healthcare System Overview-Backgound. Www.ispor.org. https://www.ispor.org/heor-resources/more-heor-resources/us-healthcare-system-overview/us-healthcare-system-overview-background-page-1#:~:text=The%20US%20healthcare%20system%20does
Marchildon, G. P., Allin, S., & Merkur, S. (2021). Health Systems in Transition Third Edition. University of Toronto Press.
Menear, M., Blanchette, M. A., Demers-Payette, O., & Roy, D. (2019). A framework for value-creating learning health systems. Health research policy and systems, 17(1), 1-13. https://doi.org/10.1186/s12961-019-0477-3
Regis Collage. (2018, March 9). 5 Current Issues in Health Care and What Administrators Can Do | Regis. Regis College Online. https://online.regiscollege.edu/blog/current-issues-in-healthcare/#:~:text=The%20High%20Cost%20of%20Health
Ross University. (2021, May 11). US vs. Canadian Healthcare: What is The Difference? Ross University School of Medicine. https://medical.rossu.edu/about/blog/us-vs-canadian-healthcare#:~:text=Healthcare%20in%20Canada%20vs%20US%20comes%20down%20to%20different%20choices
Smith-Bindman, R., Kwan, M. L., Marlow, E. C., Theis, M. K., Bolch, W., Cheng, S. Y., … & Miglioretti, D. L. (2019). Trends in the use of medical imaging in US health care systems and Ontario, Canada, 2000-2016. Jama, 322(9), 843-856.
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