Running Head: Healthcare Systems Comparative Analysis 1

Healthcare Systems Comparative Analysis

Breanan Cromeans
Department of Nursing, University of South Alabama
NU-610-807
Healthcare Systems Comparative Analysis 2

Healthcare Systems Comparative Analysis

A healthcare system is an organization consisting of people, institutions, and resources

that provide healthcare to a certain population. While healthcare systems can greatly differ in the

way they are organized or function, their goals are merely the same. The primary goal of a

healthcare system is to promote the health and maintenance of a population. Canada and the

United States both have an advanced and successful healthcare system, making them easy to

compare. In this paper, the United States and Canada’s healthcare system will be analyzed by

access and affordability, healthcare economics, population health measures, insurance rate

coverages, and healthcare utilization.

Access and Affordability

The United States effectively provides healthcare to its citizens by putting the emphasis

of cost on the individual receiving the care. The cost of healthcare in the United States relies

primarily on insurance coverages and individual out of pocket payments. Insurance is primarily

provided through an individual’s employers or through privately owned insurance companies.

Individuals with health insurance will pay a monthly or yearly premium as well as co-pays or

deductibles whenever accessing healthcare in the United States. If an individual does not have

insurance, then they will be responsible for the full price of service through a payment plan with

the facility or in cash before the service is provided. The cost of healthcare without insurance can

be very costly, therefore many Americans rely on private insurance companies to aid in their

healthcare payments. In 2022, 92.1 percent of people, or 304.0 million, had health insurance in

the United States for this reason (Keisler-Starkey, 2023).

Canada provides free healthcare access to its citizens. While the healthcare system in

Canada is labeled as free, there are certain conditions where citizens will be required to pay for
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equipment or services such as eye exams, prescription drugs, dental care or equipment like

wheelchairs, or crutches (Advisorsavvy, 2023). Many citizens in Canada have private insurance

to cover the cost of healthcare necessities that are not included within the free healthcare. Private

health insurance is held by about two thirds of the population (Marchildon et al., 2020). In

Canada, the principal source of financing for the healthcare system is taxation by the provincial,

territorial and federal governments (Marchildon et al., 2020). While Canada’s healthcare is

presumed as free the citizens are paying taxes to aid in the funding of their healthcare system just

like the United States.

Accessibility to healthcare is another important aspect that should be compared between

the United States and Canada. Access to health care based on need rather than ability to pay was

the founding principle of the Canadian health-care system (Martin et al., 2018). A primary care

provider is a health professional that a person sees or talks to when they need care or advice

about their health. This can include a family doctor, physician assistant, or nurse practitioner. In

2021, about 86% of Canadians had a regular health care provider, about14% of Canadians did

not which is about 4.7 million people. (Government, 2023). Canada has a slightly higher

physician to population than America at 2.7 physicians to 1,000 Canadians (Quick Facts n.d.)

In 2021, 7.3% of U.S. counties did not have a primary care physician at all and the

national ratio of primary care physicians to patients was 2.6 per 1,000 population (State of the

Primary, 2023). America is currently facing a shortage of primary care physicians making

accessibility to healthcare extremely difficult. On top of the already expensive healthcare,

lacking physicians creates a large problem for Americans seeking healthcare. Twenty-eight

percent of U.S. adults were forced to skip or delay medical care in 2022 because they could not

afford to pay for it (Fleck & Richter, 2023).

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Population Health

Population health is an important factor to analyze when comparing healthcare systems.

Population health is the health status and outcomes of a group of people. Chronic disease

prevalence and outcomes, patient safety outcomes, mortality rates, and life expectancy are all

factors discussed within a population’s health.

It is estimated that at least 129 million people in the United States have a chronic disease

or illness. The most common chronic health conditions in the U.S. are dyslipidemia,

hypertension, and osteoarthritis which can all be related to obesity. Obesity is the leading cause

of chronic diseases in the U.S. (Cost of Chronic Disease n.d.). The prevalence of chronic

illnesses is high in Canada as well. According to the National Institutes of Health, at least one in

every three Canadians live with at least one chronic illness or major disease (Roberts et al.,

2015).

The United States has tremendously improved its patient safety outcomes in the recent

years. In 2021 there was a 17% reduction in hospital-acquired conditions such as falls, pressure

ulcers and hospital related infections, stemming in almost 50,000 fewer patient deaths and $12

billion in healthcare savings (Berger, 2023). Canada has a slightly higher rate of incidence with 6

out of every 100 hospital stays having at least one harmful event occurring (Government of

Canada, 2023).

Mortality rates are calculated to understand the significance of healthcare interventions in

managing chronic illnesses. Cancer was the leading cause of death in Canada in 2021,

accounting for 26.6% of all deaths, followed by heart disease at 17.7% (Ahmed, 2023). The

leading causes of death in the United States in 2021 was also heart disease (20%) and cancer

(17%). The United States life expectancy in 2023, was 78.5 years while Canada’s life expectancy
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for the same year was higher at 82.2 years (World Health Organization, 2023). This may be

because Canadians are more likely to seek medical treatment and prevention than Americans due

to the free healthcare.

The average life expectancy in the United States is 78.9 for whites, 75.3 for Blacks, and

73.1 for the Native American population. The most prevalent indicators of U.S. mortality are

socioeconomic status and underlying health characteristics (Barrett, 2024) Socioeconomic are

presumed to be one of the causes in the discrepancies between life expectancy between the races

in the United, this is because people of the middle and upper classes have the monetary means to

seek out medical care. The lower classes rely on medical care provided through government

owned insurance companies like Medicaid. Medicaid has strict policies on what healthcare

facilities and physicians may be used. The racial differences in Canada are very similar to that of

the United States. The differing social background, educational background, access to healthcare,

and racism are all factors that influence the life expectancy of different races in both America

and Canada.

Economics

Healthcare economics is another important topic that must be compared between two

health systems. Healthcare economics allows a person to understand the roles individuals, such

as physicians, insurers, government agencies, and more, play in determining healthcare cost. It is

not hard to believe that the United States spends more on healthcare than any other country. In

the U.S., health spending per person equaled $12,914, with a GDP of 18.3%. Canada had a GDP

of 11.68% and a total cost of $6,086 per Canadian (Healthcare Spending, 2024). The United

States spent over 3 billion dollars on healthcare related expenses in 2021, compared to only 2

billion dollars spent in Canada (Healthcare Spending, 2024).

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The United States is considered the “cash cow” for global pharmaceutical revenues

because the U.S. generates nearly half of the revenue on its on. This is because there are no

governmental bodies regulating the price of prescription drugs. Brand name drug prices can be

set by the supplier itself and typically they set it at the highest margin. Namely branded, patent

protected drugs reach very high prices, often multiple times higher than in other comparable

countries (Mikulic, 2024). Generics copies of these brand name drugs is one-way Americans can

save money on prescription drugs, but there is still not a “cap” on pricing for these drugs either.

Most insurance companies in America also provide a prescription drug coverage plan as well.

Once a deductible is met on some prescription drug coverages a person must only pay a “co-pay”

or sometimes nothing at all for their prescription medications.

In Canada, governing bodies negotiate with pharmaceutical suppliers to either eliminate

the expensive medication or place a cap on pricing. Canada’s free healthcare does not provide

medication coverages though so many Canadians are forced to seek out private insurance to help

with these expenses. Drugs administered in Canadian hospitals are provided at no cost to the

patient, outside of the hospital setting, provincial and territorial governments are responsible for

the administration of their own publicly funded drug plans (Government of Canada, 2024)

The United States spends large amounts of money on healthcare compared to other

countries. There are several factors that contribute to this overspending on healthcare. The U.S.

has one of the largest costs for insurance companies. The U.S. also pays their healthcare

providers and nurses much higher wages than other countries. The citizens of the United States

also have higher rates of health issues such as heart disease, obesity, diabetes, and stroke which

are all complex health issues that lead to an increase in healthcare costs (Cost of Chronic
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Diseases, 2024). When the United States begins to place more emphasis on preventative care

instead of interventional measures, a decrease in healthcare expenses is likely to follow

Immigrant Health

The United States is home to nearly 48 million immigrants, of these immigrants, 24

million are uninsured. Many immigrants in the United States lack insurance because of

educational and language barriers, fear of deportation, and unawareness of insurance coverage

availabilities. Immigrants of the United States are less likely to seek out medical care therefore

healthcare expenditures on U.S. immigrants are much lower than native born citizens (Key Facts

on Health, 2024). Documented immigrants of the United States tend to have more access to

insurance coverages through their employers, since uninsured immigrants are more than likely

going to seek jobs who do not offer healthcare coverages. Recent research finds that, because

immigrants, especially undocumented immigrants, have lower health care use despite funding

billions of dollars in insurance premiums and taxes, help offset the costs of care acquired by

U.S.-born citizens (Key Facts on Health, 2024).

Conclusion

In conclusion, the United States and Canada both have well developed and successful

healthcare systems. Understanding a country’s population health, healthcare economics, and

access and affordability of healthcare is important to understanding its healthcare system as a

whole. By analyzing healthcare systems, profitable changes can be implemented to allow for

better healthcare coverages for citizens as well as lower healthcare expenditures for a country’s

government and its citizens.

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References
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%202.7%20physicians%20per,(2017%20or%20nearest%20year).
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