Introduction
The healthcare system in a country determines the quality of care that the citizens of that country get whenever they seek medical services. Because healthcare is one of a country’s most important services, the government works hard to create policies that ensure citizens receive high-quality care at the lowest possible cost. Due to the existing inequalities between the various social classes within a country, the government tends to implement mechanisms that ensure that all citizens have access to quality healthcare services. With the different leadership models or systems maintained by countries, the mode of funding healthcare services differs, influencing the care quality that individuals from different walks of life can access based on their financial status. Different government policies guiding healthcare provision in different countries are presumed to have led to the development of varied healthcare models with different impacts. This paper will compare and contrast the Canadian Medicaid healthcare system with the American private market and pluralist healthcare system.
Comparison of Costs
The cost of healthcare varies in different countries based on the model used to fund and reimburse the healthcare system. Healthcare costs refer to the money used to effectively run healthcare facilities, including paying for physician services and acquiring drugs. Since the model of care differs in Canada and the United States, the cost of care needs to be assessed from different perspectives (Chown et al., 2019). The different perspectives entail the insurance system, government spending on sustaining the healthcare system, the costs of care services such as surgery, and the examination of the system that is costlier than the other.
Insurance System
The federal government of Canada is one of the countries across the world that has been able to implement a universal healthcare system where the government is the only player in insurance coverage. The Medicaid system implemented in Canada has enabled all citizens to access healthcare services, which are paid for using the taxes collected by the government. According to the universal healthcare plan maintained in the country, families in Canada are required to pay an average of CAD 4000 every year for private or supplement health insurance (CIHI, 2022). The use of the Medicaid system makes it a public-funded healthcare model where taxes from the ten provinces and three territorial regions are used to fund the system. The collective nature of funding makes healthcare in the country standardized and easy to access for all citizens.
Contrary to the universal healthcare system maintained in Canada, the United States maintains a privately owned healthcare system where a free market is maintained for the issuance of medical coverage. Such an aspect means that healthcare facilities and hospitals in the United States are profit-based, and individuals get services based on their ability to pay (Chown et al., 2019). As a result, most Americans use private insurance and other state and federally-funded healthcare programs to access healthcare. The lack of a universal healthcare system in the United States has created numerous healthcare providers and payers, making it beneficial only to the individuals who can purchase privately sold covers. The process has led to inequality in the healthcare system, where the quality of care is determined by the individual’s ability to pay for the various services provided.
Government Spending on the Healthcare System
The publicly funded healthcare method in Canada makes the government spend more on the system, which is paid through the country’s budget. Incorporating healthcare as part of government projects in Canada has made it easy for the state to provide funds at the right time, ensuring continuous operations of the healthcare system. Research on healthcare spending in Canada shows that the services experienced a 4% growth in expenditure every year before the development of the pandemic (CIHI, 2022). According to reports on healthcare spending in the country, Canada is expected to spend at least $331 billion on healthcare in 2022 (CIHI, 2022). Such spending is attributed to repressing 12.2 % of the country’s gross domestic product (CIHI, 2022). This aspect shows that Canada spends so much, ensuring its citizens can access free healthcare.
In the United States, individuals or private insurance providers pay for most healthcare services. The combination of private expenditures on healthcare services is considered to account for 85% of the total expenditures made in healthcare (Peterson, 2022). Based on such statistics, it is evident that the United States federal government pays for 15% of the total healthcare costs accrued in the country (Peterson, 2022). An analysis of the government’s spending on healthcare in the United States shows that the government spends an estimated $12318 per person on healthcare. It is estimated that the United States will spend $997 billion on healthcare services in 2022 (Peterson, 2022). Such an amount is higher than the Canadian government’s spending on universal healthcare.
Costs of Surgery and Medication
The United States is considered to have higher prices for all healthcare services than most developed countries in the world. Studies show that most American citizens believe that the costs of prescription drugs in the country are unaffordable. According to drug cost research in the United States, the country spent more than $1000 per individual on prescribed medication. A comparison of medical and surgical services costs shows the U.S. to be 85% higher than the average cost experienced in any other OECD country (Peterson, 2022). The medication costs in the United States are higher than in other developed countries such as Germany, Canada, Japan, Switzerland, Belgium, the United Kingdom, and Sweden.
Regarding surgery costs, the prices vary since the medical facilities are privately owned and change differently based on the quality of services provided and the type of surgery undertaken. Statistics show that the average cost per surgery varies between $4,000 and $170,000 for individuals without insurance coverage (Peterson, 2022). Such prices are extremely high compared to those in other OECD countries.
Aspects Making the United States’ Healthcare Expensive
The healthcare system in the United States is considered highly complex due to the privatization of the sector and many players in the market. Due to the nature of the healthcare sector’s market, the costs of both medication and surgery are market-driven. In addition, medication costs are unregulated, making drug and surgery expenditures expensive. Such aspects make the salaries of healthcare providers in the United States higher than those of other western countries (Chown et al., 2019). The existence of multiple care systems makes this sector highly complex, with the different players being able to charge for their services independently, without any influence from the government. Different care plans, from government-sponsored programs to the Medicaid and Medicare systems, create room for developing different charges made for healthcare services.
In addition, the nature of the healthcare sector as being profit-centered significantly contributes to the high costs of healthcare since the service providers are not regulated. Defensive medicine raises healthcare costs because hospitals must perform tests that can be used as a defense in lawsuits if patients raise legal issues (Quirk, 2019). Furthermore, because the healthcare industry is a free market with many players, price fluctuations are common, making it difficult to control the prices of medicines and surgeries in the country. Due to the nature of the healthcare system in the country, it is challenging to control the prices of the services.
Comparison of Quality
The quality of healthcare services in Canada, and the United States differ based on the effectiveness of medical care and the healthcare outcomes of patients in each country. Quality measures are tools used to quantify healthcare processes, outcomes, perceptions, and organizational structure or systems. Quality measures are used to examine how the health system can achieve its goals of providing quality and affordable care to its citizens.
Important Measures of Quality
Effective care delivery, costs, financing barriers, patient safety, equitability, patient-centeredness, and timely care are all measures used to quantify the quality of care. Effective care delivery is considered to be the ability of the healthcare system to offer healthcare in the most effective way (Jarvis et al., 2020). For a health care system to be effective, the system should be able to guarantee patients the safety of the products and services provided. In most countries, patient-centered care is considered a significant aspect of healthcare provision as it gives patients the authority to participate in the healthcare process (Chown et al., 2019). Lastly, a quality healthcare system should be able to provide healthcare services promptly to prevent deaths resulting from delays in the delivery of care. The number of patient complaints is another factor determining the quality of care provided (Quirk, 2019). Such complaints are influenced by patient perceptions of the healthcare system’s services. In addition, healthcare outcomes can be used to assess the quality of healthcare systems. This aspect can be attained through examining factors such as patient stay in hospitals, recurrence of healthcare conditions, and the patient review of the services provided.
Similarities and Differences Between the U.S. and Canada’s Healthcare Systems
According to the nature of healthcare services provided in Canada and the United States, both systems have the necessary resources and technology available to ensure that the countries provide high-quality services. Generally, both countries are ranked among the states with the highest quality of care worldwide. A critical analysis of the various quality measures in the two countries shows that Canada has a more effective healthcare system than the United States (Quirk, 2019). Regarding costs, countries such as Canada and Germany are considered to provide healthcare services at a much lower rate, where more services are provided at a cheaper rate than in the United States. Such aspects are attributed to the fact that the two countries have government-sponsored insurance that covers their citizens, unlike in the United States, where the system is privatized, and market forces determine the charges. Using such a system makes it challenging for the government to change the prices of products or services.
The nature of the system maintained in the United States gives the country a negative reputation as cases of patient deaths, increased hospital stays, and discriminatory care exist, lowering the quality of care. Privatization gives capitalists the power to control the prices of critical resources such as medication, influencing citizens’ quality of life. These aspects put the lives of the citizens at stake, as only those in the highest social classes can access quality healthcare, while the poor cannot get medical attention (Chown et al., 2019). The process has made the American system discriminatory while promoting inequality between the rich and the poor (Jarvis et al., 2020). Privatization is considered to lead to the development of players in the healthcare system, where some facilities are considered better than others, increasing the cases of varied medical charges for the same healthcare conditions.
The healthcare system’s focus is different in the United States compared to other countries such as Canada and Germany. The American healthcare system is profit-focused, where the quality of care is determined by the ability of an individual to obtain insurance coverage or pay for the services provided. These features differ in Canada and Germany, where the focus is on delivery to ensure that all citizens can access healthcare (Jarvis et al., 2020). Additionally, healthcare in the U.S. is discriminatory, as it favors only the rich. In other countries such as Canada, equitability is attained as all citizens can access quality healthcare services, irrespective of whether they are poor or rich (Quirk, 2019). These factors have greatly influenced the costs of surgery and medication, as there is no regulation on prices or physician fees, which makes the cost of care expensive in the United States. In Canada and other countries such as Germany, the government regulates the price of drugs and medical services, making the services cheaper.
Ways of Improving the Quality of the American Healthcare System
Quality healthcare systems should be able to provide medical services equitably to all citizens of a country, irrespective of their social class or employment status. The American healthcare sector can be improved through the development of policies that would make the cost of healthcare lower. In addition, the quality of care can be attained through the regulation of the system, ensuring that the government has the power to set prices for critical aspects such as drugs and the costs. Exercising some control on quality of healthcare of general and minor healthcare conditions (Quirk, 2019). Regulating the costs of the healthcare process would ensure that the development of a standard quality of medication is attained, making it easy for people with lower incomes to afford even surgical services. Through these mechanisms, the government could enhance the utilization of various healthcare resources (Jarvis et al., 2020). Increasing accessibility would increase the health status of a country, which plays a critical role in determining the quality of the services provided within the country’s system.
Comparison of Access
For a system to be considered quality, it must provide healthcare insurance. The government should ensure that insurance coverage is available to citizens and that healthcare services are readily available and easily accessible to all citizens. In this case, the nature of services should be easily acceptable to all citizens regarding the quality of services provided, equality in care and attendance, and patient prioritization (Chown et al., 2019). This aspect means that the healthcare system should be patient-centered, and the service providers should not be profit-oriented. Through such a mechanism, it would be easy to attain standard service provision among the rich and the poor. Implementing these practices would give the patients a positive attitude toward the system and give positive feedback as they could access care such as any other citizen (Quirk, 2019). These factors are considered the main reason healthcare quality in countries such as Germany and Canada is considered better than in the United States.
Lessons the U.S. can take from Countries such as Canada and Germany
The American government should take significant lessons from the healthcare systems in other countries on how to improve the quality of healthcare. The United States should learn that policy adjustment is needed for America to attain equality in healthcare provisions. The healthcare system is considered a critical and sensitive factor in a country and should not be left in the hands of capitalists. Such aspects have made the costs of care in the United States to be high as the different hospitals have the authority to set their prices for the various services they provide (Quirk, 2019). Cutting costs should be given a higher priority as it is the main factor that is making healthcare inaccessible in the United States.
Healthcare is a basic need and should be highly regulated to prevent the exploitation of some members of society. In addition, the U.S. should learn that there is a need to develop a universal system to ensure that the accessibility and availability of healthcare services are not determined by peoples’ differences (Quirk, 2019). Factors such as poverty, income and discrimination should never be a crucial determination in healthcare quality disparities that exist in the United States. The country should learn to have decentralized control over its healthcare system while still achieving universal coverage, as Canada does (Jarvis et al., 2020). In this case, the government can develop a common pool for healthcare funding and be the only payer to regulate and redistribute medication costs, making the services available and accessible to all citizens. In addition, it should examine how other countries have benefited from universal coverage and use the knowledge to enhance its system.
Conclusion
Comparing the healthcare systems of the United States and Canada shows significant differences in how the systems are operated. Such comparisons show how the government plays a critical role in promoting the quality of life that its citizens maintain. The differences between the management of the healthcare systems in both counties show that healthcare is a critical aspect of human life. Additionally, it describes how healthcare issues should be taken seriously to ensure that equity is attained in the distribution of critical services. Accessing healthcare in the United States is costly compared to countries such as Canada and Germany, making it ineffective in attaining equity and promoting healthy behavior. Privatizing the sector is considered the main reason why the country is considered to lag in terms of healthcare quality despite having one of the most stable economies in the world. Due to this reason, the country needs to readjust its healthcare policy to ensure that healthcare services are cheaper, more accessible, and more equitable. The country could control various activities through mechanisms such as setting healthcare products and service prices.
References
Chown, J., Dranove, D., Garthwaite, C. & Keener, J. (2019). The opportunities and limitations of monopsony power in healthcare: Evidence from the United States and Canada. National Bureau of Economic Research.
CIHI. (2022). Health spending. CIHI.
Jarvis, T., Scott, F., El-Jardali, F., & Alvarez, E. (2020). Defining and classifying public health systems: A critical interpretive synthesis. Health Research Policy and Systems, 18(1).
Peterson, P. G. (2022). How does the U.S. healthcare system compare to other countries? Peter G. Peterson Foundation.
Quirk, P. J. (Ed.). (2019). The United States and Canada: How two democracies differ and why it matters. Oxford University Press.