HEALTH CARE REFORM

Health Care Reform



Health Care Reform

The calls for health care reform are as loud as they are persistent. A variety of stakeholders both inside and outside the health care industry regularly voice their concerns about issues such as Medicare, managed care, health insurance, coverage for the uninsured, and the role of tax policy in health care.

While federal policymakers have so far failed to enact sweeping legislation addressing the nation's health care system, significant changes affecting health care financing, insurance, and service delivery have occurred. (Doctors Balk at Cancer Ad, 2007)

Government and public health and public policy analysts often make a comparison of the Canadian and American health care systems because the two countries at one time had very similar health care systems until the Canadians began reforming their system in the 1960s and 1970s. The U.S. spends much more on health care than Canada, both on a per-capita basis and as a percentage of GDP. In 2006, per-capita spending for health care in Canada was US$3,678; in the U.S., US$6,714. The U.S. spent 15.3% of GDP on health care in that year; Canada spent 10.0%. In 2006, 70% of health care spending in Canada was financed by government, versus 46% in the United States. (Eggen, 2009) Total government spending per capita in the U.S. on health care was 23% higher than Canadian government spending, and U.S. government expenditure on health care was just under 83% of total Canadian spending (public and private).

Studies have come to different conclusions about the result of this disparity in spending. A 2007 review of all studies comparing health outcomes in Canada and the US in a Canadian peer-reviewed medical journal found that "health outcomes may be superior in patients cared for in Canada versus the United States, but differences are not consistent." Life expectancy is longer in Canada, and its infant mortality rate is lower than that of the U.S., but there is debate about the underlying causes of these differences.

One commonly-cited comparison, the 2000 World Health Organization's ratings of "overall health service performance", (Kraus, 2006)which used a "composite measure of achievement in the level of health, the distribution of health, the level of responsiveness and fairness of financial contribution", ranked Canada 30th and the U.S. 37th among 191 member nations. Kraus, 2006) This study rated the US "responsiveness", or quality of service for individuals receiving treatment, as 1st, compared with ...