The United States is one of very few industrialized nations that does not provide some type of universal, publicly-funded health care system, and this fact has long been a bone of contention between those on the left and the right. It is often pointed out that the United States pays far more per capita on health care than other nations while failing to cover roughly 43 million Americans; in addition, according to a 2005 Harvard study, about half of all personal bankruptcies are caused by medical expenses. Talk of reform, particularly leading up to the 2008 election, has grown exponentially, and as Canada and the UK are the nations usually invoked as models for any health reform in the United States, a brief look at these systems is in order.
Canada’s Single-Payer System Overview
The Canadian health care system, known as a single-payer model, is different from the American system mainly in the way it is funded. Rather than basing the largest portion of the system around private insurance, as in the US, the Canadian government acts as a “single payer,” collecting money through taxes, negotiating with health care providers to come to an agreement on costs, and then disbursing the fees from a central public fund. There is no charge to the patient for most necessary medical care, though there is a small fee for some pharmaceuticals. Doctors and hospitals can be publicly or privately owned, as in the US, and private insurance may be purchased by those wishing to do so, but in general most citizens utilize the public system, and according to a May 2001 paper by Strategic Policy and Research, less than a quarter of Canadians think the health care system should be completely reformed (as opposed to 33% in the US).
Advantages and Drawbacks
The single-payer system seems to have many significant advantages: Per capita spending on health care, for example, is much lower than it is in the United States, and the coverage is universal, whereas in the US health care is not guaranteed, except to those under the federal poverty level or to those over 65. Life expectancy is also much higher in Canada than in the United States; the Canadian average of 79 years comes in just below 80 years in the top-rated nation, Japan (life expectancy in the US is among the lowest in industrialized nations, only 76.7 years). Disadvantages of the Canadian system include fewer physicians per 1,000 population than the G7 average (though not substantially fewer than in the US), fewer scanners and MRI machines, slightly longer wait times for some procedures, and a comparable infant mortality and cancer mortality rate to the low-rated United States (although Canada’s heart disease mortality rate is significantly better).
The United Kingdom’s National Health Service Overview
Signed into law in 1948, the NHS differs from both the Canadian and American systems. First of all, most health care providers are considered government employees, and are paid a government salary, collected through taxes. As in Canada, most necessary care is free of charge, though there is a small fee for prescriptions if the patient is employed; students, the elderly, and the unemployed generally have these fees waived, and in Wales, there is no charge for any approved drug. Private insurance is an option for those who wish to utilize it, and some employers offer private insurance as part of their hiring packages, but the great majority of Britons use the NHS exclusively, and only 14% of the population would want to see the system changed completely.
Advantages and Drawbacks
As in Canada, the system is advantageous in that it covers everyone, and for substantially less cost than in the United States (where in 1998 the cost per capita was $4,178, as opposed to Canada’s $2,312 and the UK’s $1,461). Life expectancy in the UK is marginally better than in the US, at 77.2 years, and their infant mortality rate is lower than either Canada or the United States. On the other hand, the rates of heart disease and cancer mortality are slightly worse, and the UK has fewer scanners and MRI machines than Canada, plus fewer physicians per 1,000 population.
Jenny Ashford - Jenny Ashford is a writer and graphic artist from central Florida. Her main area of interest in her Suite 101 articles is science, with a ...
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