POLS 403 Essay
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Essay: Question #7
Essay: Question #7
University of Northern British Columbia
POLS 403: Social & Health Policy & Admin Jason Morris
June 6, 2023
Essay: Question #7
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To say a perfect healthcare system exists is along the same lines of saying there is no uncurable disease in the world. It is simply a monster that is undefeatable. Each healthcare system has its downfalls, debt and those who disagree. The Canadian and United States healthcare systems differ predominantly on choices made based on history and values. Canada follows a more reform liberalist viewpoint with freedom being valued to achieve goals with equalization of chances to succeed compared to the neighboring country the United States who values freedom of choices above all following classical liberalism (Morris, 2022). Canada chose in 1984 to pass the Canada Health Act which provided “free” healthcare to all Canadian citizens (Martin et al., 2018). The United States in 2010 passed the Affordable Care Act (ACA) with the goal that all citizens would have at least the most basic healthcare coverage, although the goal has yet to be reached (HealthCare.gov, 2023). Both of these government acts that were passed had significant push back from the people as Canadians saw the private sector for the physicians taking a hit and a portion of the United States population saw it as a movement for control by the
government. Three ways that Canada and the United States differ are single payer vs network of payees, types of public healthcare programs, and the most shocking cost per capita each country spends. Canada uses the single payer method for healthcare, each person is taxed based on their income a percentage that directly goes towards healthcare. There is no choice in the matter. Although, in return when medical services are being sought out there is no point of care charges to be incurred hence where Canada gets the representation of “free” healthcare. However, this is a false statement as each dollar made by a Canadian a portion is going towards our healthcare system. The federal government is our healthcare system by funding each province for medical services in which the provincial government can distribute as they see accordingly based on
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Essay: Question #7
need. There are private insurance companies that exist in Canada that are optional to cover additional needs such as prescription medications or aspects of health that the government does not focus on. Overall, the single payer for healthcare comes from the public healthcare of the government in Canada. The United States however is a combination of both public and private sector, with private being the more dominant of the two (Tunstall, n.d.). The government funds niche programs for specific populations but not as a whole for the country. The private sector on the other hand carries out all other aspects of healthcare coverage with what seems to be endless choices. Most Americans who have coverage receive this through employment in which their place of work has a subsidized plan that “
contract with a network of health service providers, such as doctors, hospitals, clinics and other health care providers such as pharmacies, labs, x-ray centers and medical equipment vendors, to provide services to their clients” (Tunstall, n.d.). Those who do not receive coverage from place of work will go on to pay individual private insurance that include exponential premiums, deductibles, and co-payments. That is if one can afford it. As you can see Canada has a more streamline effect of cost of healthcare that taxes go directly to the federal government in which they fund the provinces to provide care, meaning a Canadian citizen will never see a medical bill. Compared to the United States where many choices are needed to be made and a network created before coverage for healthcare is considered. Both Canada and the United States have publicly funded healthcare programs. Canada having Medicare, the healthcare system as a whole. Along with other programs that focus on mainly health promotion, chronic disease prevention, infectious disease prevention and control and health security that are provided to the entirety of the country from taxes (Government of Canada, 2023). The Unites States’ public programs are slightly more confusing. There is
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Medicare, Medicaid, and Children’s Health Insurance Program (CHIP). The term “Medicare” is used both in Canadian and United States healthcare systems but, do not make the mistake of assuming they have the same definition. Medicare in Canada is the healthcare system, in the United States it is a mainly publicly funded four part “
national social insurance program administered by the federal government, accessed primarily by seniors aged 65 and older, and by
some people living with a disability” (Tunstall, n.d.). That being said mainly publicly funded, there are aspects that require the individual to pay monthly premiums. Medicaid “is a state-based
insurance program accessed by some poor and near-poor” (Tunstall, n.d.), however it is state-
based, the level of participation from the state is voluntary and partially funded by the individual states. CHIP “insures children up to age 19 from families with incomes too high to qualify for Medicaid” (Tunstall, n.d.) meaning that to qualify for this program you have to be around 300% of the federal poverty level. As you can see the differences between the public healthcare programs between Canada and the Unites States is that Canada has an encompassing spectrum of
health services that benefit the entirety of the population compared to the Unites States who focuses strictly on the vulnerable populations. Cost is always a topic of debate especially when they are projected to be out of reach placing the country into significant debt. Both Canada and the United States are members of the Organisation for Economic Co-operation and Development (OECD) which is comprised of 38 countries with the purpose of stimulating economic progress, policy development and develop reports on expenditures. Based on a study done in 2020 from the OECD, the average spending in
Canadian currency per capita was $5,502 from all members. Canada ranked to be above average sitting at $7,507 per capita, and the United States won the race by a long shot at $15,275 per capita. Now one would think how it is possible for the United States to be spending more than
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Essay: Question #7
double compared to Canada with having a mainly private sector healthcare system? The network of payees used in the United States creates a wasteful space for administrative costs that are associated with the organizing of insurance, “spending about 8% of its healthcare dollar” (Boyle & Velasquez, 2022). The healthcare professionals make a higher income compared to Canada. Similarly, to Canada with dollar amounts varying with each province, the United States does not have any set price for healthcare which allows providers to charge as much as possible. Most significant, in the U.S. hospitals are profit centers “accounting for 31% of the nation’s healthcare
costs” (Jha et al., 2018). Based on all the reasons listed it is clear that the infrastructure of the healthcare systems break down costs very differently while Canada and the United States are both in debt, the U.S is spending more than double per capita on healthcare. There is no perfect healthcare system and while long wait times may seem favourable over hefty bills that is not the case for every individual. Reform for any country in regard to healthcare would not go over smoothly as that is the “normal” for the citizens. While Canada may seem ideal and as people say “free”, it is not once investigation is done. The United States may seem daunting with the several thousand-dollar bill after an emergency room visit but to change that would be impeding on personal freedom a value that is of utmost importance. Canada and the United States healthcare systems may be similar in many ways of combination of
public and private sector but for a majority they differ in regard to historical choices and values. Canada following reform liberalism, choosing government involvement for achievement of goals, healthcare for all and the United States with classical liberalism upholding freedom of choice without government involvement. References
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Boyle, M., & Velasquez, V. (2022). 6 Reasons Healthcare Is So Expensive in the U.S.. Investopedia. Retrieved from: https://www.investopedia.com/articles/personal-
finance/080615/6-reasons-healthcare-so-expensive-us.asp
Government of Canada. (2023). Programs and policy development – Public Health Agency of Canada. Retrieved from: https://www.canada.ca/en/public-health/programs.html
HealthCare.gov. (2023). Affordable Care Act (ACA). Retrieved from: https://www.healthcare.gov/glossary/affordable-care-act/#:~:text=The%20comprehensive
%20health%20care%20reform,%2C%20or%20%E2%80%9CObamacare
%E2%80%9D).&text=A%20measure%20of%20income%20issued,and%20Human
%20Services%20(HHS
). Jha, AK., Papanicolas I. &
,
Woskie. (2018). Health Care Spending in the United States and Other High-Income Countries.
JAMA.
319(10):1024–1039. doi:10.1001/jama.2018.1150
Martin, D., Miller, A. P., Quesnel-Vallée, A., Caron, N. R., Vissandjée, B., & Marchildon, G.
P. (2018). Canada's universal health-care system: achieving its potential.
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(10131), 1718–1735. https://doi.org/10.1016/S0140-6736(18)30181-8
Morris, J. (2022). Social & Health Policy & Admin. University of Northern British Columbia.
Nunn, R., Parsons, J., & Shambaugh, J. (2020). A dozen facts about the economics of the US healthcare system. Brookings. Retrieved from: https://www.brookings.edu/research/a-dozen-
facts-about-the-economics-of-the-u-s-health-care-system/
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Essay: Question #7
Organisation for Economic Co-operation and Development (OECD). (2023). Retrieved from:
https://www.oecd.org/about/
Peter G. Peterson Foundation. (2022). Healthcare Costs Are a Major Driver of the National Debt and Here’s the Biggest Reason Why. Retrieved from: https://www.pgpf.org/blog/2022/10/healthcare-costs-are-a-major-driver-of-the-national-debt-
and-heres-the-biggest-reason-why#:~:text=Under%20current%20law%2C%20the
%20nation's,such%20as%20Medicare%20and%20Medicaid
. Tunstall, L. (n.d). Backgrounder: Making Sense of the U.S. Health Care System: A Primer. Evidence Network. Retrieved from: https://evidencenetwork.ca/backgrounder-making-sense-of-
the-u-s-health-care-system-a-primer-2/#:~:text=The%20U.S.%20health%20care%20system
%20is%20not%20a%20universally%20accessible,insurance%20plans%20through%20their
%20employers
.