How Canada's Universal Health-Care System Works

Summary

The video script explores Canada's single-payer healthcare system, often compared to the 'Medicare for All' proposals in the U.S. Despite lower healthcare spending and universal coverage, Canada faces challenges like long wait times and gaps in coverage, such as for prescription drugs. The script contrasts the Canadian system's efficiency and equity with the U.S.'s higher costs and varying access, highlighting the ongoing debate about the best approach to healthcare.

Takeaways

• 🌐 Canada's health care system is often compared to the U.S., with universal coverage and lower drug prices but also longer waiting times.
• 💊 Canada's health care expenditure is significantly lower than the U.S., at 10.4% of GDP compared to 17.2% in the U.S.
• 🏥 Despite lower spending, Canada has comparable or better health outcomes, including a higher life expectancy and lower maternal mortality rates.
• 💼 The Canadian system is a publicly funded model with private delivery, aiming for equity and low administrative costs.
• 🏢 Most hospitals and doctor's offices in Canada are privately owned but operate within the government-funded framework.
• 💲 Out-of-pocket costs for Canadians are lower than in the U.S., with an average of $650 USD per person compared to around $1,100 in the U.S.
• 🤔 There's a debate on the effectiveness of Canada's health care, with some pointing to long wait times and others highlighting its equitable nature.
• 💊 Prescription drugs are not covered under Canada's Medicare, leading to significant out-of-pocket costs for many patients.
• 🏥 Canadians face longer wait times for appointments and specialist consultations compared to the U.S.
• 👍 Canadians are generally proud of their health care system, viewing it as a source of personal and collective pride, despite recognizing the need for reform.

Q & A

What is the term used to describe Canada's health care system?

Canada's health care system is often referred to as a single-payer system, similar to the 'Medicare for All' concept, and is unofficially known as 'Medicare'.

How does the health care expenditure as a percentage of GDP compare between Canada and the United States?

In 2017, Canada spent approximately 10.4 percent of its GDP on health care, whereas the United States spent an estimated 17.2 percent of its GDP on health care.

What was the estimated per capita health care spending in Canada and the United States in 2017 according to the OECD?

The OECD estimated that Canada spent around 4,500 USD per person in 2017, while the United States was expected to have spent at least double that amount, at ten thousand dollars per person.

What is the average out-of-pocket spending per person in Canada and the United States?

In 2016, the average out-of-pocket spending per person in Canada was around 650 USD, whereas in the United States, it was around eleven hundred dollars.

How does Canada's health care spending compare to the average of all 36 OECD countries?

Canada spends more than the average of all 36 OECD countries, which is around 3,800 dollars per person and 8.8 percent of GDP.

What are some health outcomes where Canada outperforms the United States?

Canada has better health outcomes than the U.S. in terms of life expectancy, which is nearly four years higher, lower maternal mortality rates, and fewer deaths from heart disease and stroke.

How does Canada manage to spend less on health care while having a more effective system?

Canada's health care system is a publicly funded model with private delivery, ensuring equity and low administrative costs. It covers medically necessary care with no out-of-pocket costs, leading to overall lower spending.

What are some services not covered by Canada's Medicare?

Prescription drugs, dental care, mental health services, and optometry are not covered by Medicare unless they are deemed medically necessary.

Why do most Canadians also have private health insurance?

Most Canadians have private health insurance to supplement out-of-pocket expenses for services not covered by Medicare, such as prescription drugs, dental care, and mental health services.

What is the issue with wait times in Canada's health care system?

Wait times in Canada's health care system are longer than in the United States, with a significant number of Canadians reporting difficulties in getting appointments or seeing specialists in a timely manner.

How do Canadians view their health care system despite its challenges?

Despite the challenges, 94 percent of Canadians consider their health care system an important source of personal and collective pride, and 45 percent rate the overall quality of medical care as excellent or very good.

Outlines

00:00

🌎 Comparison of Canadian and American Healthcare Systems

The paragraph discusses the Canadian healthcare system, often compared to the American system, particularly in the context of the 'Medicare for All' debate. Canada's single-payer system, unofficially known as 'Medicare,' provides universal coverage with lower drug prices but is criticized for long waiting times and bureaucratic red tape. The U.S. spends a significantly higher percentage of its GDP on healthcare compared to Canada, yet Canada achieves universal coverage and comparable or better health outcomes at a lower cost. The Canadian system is publicly funded with private delivery, aiming for equity and low administrative costs. Despite some shortcomings, such as not covering prescription drugs and having longer wait times, Canadians generally have a positive view of their healthcare system, which is seen as more equitable and efficient than that of the U.S.

05:00

💊 Challenges and Public Perception of Canadian Healthcare

This paragraph delves into the challenges faced by Canada's healthcare system, such as longer wait times for appointments and specialist consultations compared to the U.S. It also addresses the lack of coverage for prescription drugs, which can lead to significant out-of-pocket expenses for patients. Despite these issues, Canadians take pride in their healthcare system, with 94% considering it a source of personal and collective pride. While there is recognition of the need for reform, the majority of Canadians rate the quality of medical care as excellent or very good. The paragraph highlights the Canadian value of equality in healthcare, with a societal preference for a system that treats everyone the same, regardless of their ability to pay.

Keywords

💡Health Care

Health care refers to the organized provision of medical services to individuals or communities through various health professionals and allied health fields. In the video, health care is the central theme, with a focus on comparing the systems in the United States and Canada, highlighting differences in coverage, cost, and efficiency.

💡Single Payer System

A single payer system is a type of universal health care where one public authority is the primary source of health coverage. The script discusses Canada's single payer system, often referred to as 'Medicare,' and contrasts it with the 'Medicare for All' proposals in the U.S., emphasizing the universal coverage it provides.

💡Medicare for All

Medicare for All is a proposal for a public health insurance option available to all U.S. residents, eliminating the need for private insurance. The video script mentions this as a point of political discourse, with Democrats promoting it as an equitable system, similar to Canada's health care.

💡Universal Coverage

Universal coverage means that all residents of a country have access to health care services, regardless of their ability to pay. The script explains that Canada's health care system ensures universal coverage for essential medical needs, unlike the U.S. system.

💡Drug Prices

Drug prices refer to the cost of pharmaceuticals. The video script notes that Canada has relatively cheaper drug prices compared to the United States, which is a point of comparison in the discussion of health care systems.

💡Waiting Times

Waiting times refer to the duration patients must wait to receive medical care or consultations. The script reports that Canada has longer waiting times compared to the U.S., which is a common critique of the Canadian health care system.

💡Administrative Costs

Administrative costs are the expenses associated with managing a health care system. The video script suggests that Canada's publicly funded model was created to keep these costs low, contrasting with the U.S. where such costs are higher.

💡Equity

Equity in health care refers to the fair and just provision of health services, regardless of a person's economic status. The script discusses how Canada's health care system aims to ensure equity among its citizens, providing the same level of care to everyone.

💡Private Delivery

Private delivery in the context of health care means that services are provided by privately owned entities, such as hospitals and clinics, even though they are funded publicly. The script explains that in Canada, most hospitals and doctor's offices are privately owned but operate under a publicly funded system.

💡Out-of-Pocket Costs

Out-of-pocket costs are expenses for health care services not covered by insurance and paid for by the patient. The video script compares the lower out-of-pocket costs in Canada to the higher costs in the U.S., showing the impact of different health care systems on individual financial burdens.

💡Maternal Mortality Rate

Maternal mortality rate is the number of women who die from pregnancy-related causes during pregnancy or within a given time after delivery. The script uses this as a measure of health care system effectiveness, noting that Canada's rate is significantly lower than that of the United States.

Highlights

Canada's health care system, often compared to the 'Medicare for All' plans in the U.S., has universal coverage and is colloquially known as Medicare.

The U.S. spends a significantly higher percentage of its GDP on health care compared to Canada, with 17.2% versus 10.4% in 2017.

Canada's per capita health care expenditure is estimated at $4,500 USD in 2017, whereas the U.S. is expected to be at least double that amount.

Out-of-pocket spending is considerably lower in Canada, with an average of $650 USD per person in 2016 compared to $1,100 in the U.S.

Despite lower spending, Canada's health care system ensures universal coverage for essential medical needs, unlike the U.S.

Canada has comparable or better health outcomes than the U.S., including lower rates of preventable deaths, infant mortality, and maternal mortality.

Canadians live longer on average than Americans, with a life expectancy nearly four years higher.

Canadian Medicare is a publicly funded model with private delivery, aiming for equity and low administrative costs.

All Canadians receive coverage through Medicare, which is managed locally by each of the 12 provinces under federal supervision.

Most medically necessary care in Canada is covered with no out-of-pocket costs, although there are exceptions such as prescription drugs, dental, mental health, and optometry.

Many Canadians purchase private health insurance to supplement out-of-pocket expenses not covered by Medicare.

Private insurance in Canada cannot be used to purchase care already covered by the government plan, avoiding a two-tier medicine system.

In 2015, private funding accounted for about 30% of health care spending in Canada, with most hospitals and doctor's offices privately owned but not operated by the government.

Long wait times for appointments and specialist consultations are a notable issue within Canada's health care system.

Canada's system has challenges with access to medical care outside of regular business hours, leading to overuse of emergency rooms.

Not all medical care is covered in Canada, resulting in significant out-of-pocket costs for prescription drugs and other non-essential services.

Canadians express pride in their health care system, with 94% considering it an important source of personal and collective pride.

Despite the system's issues, 45% of Canadians rate the overall quality of medical care in the country as excellent or very good.

Transcripts

When you hear people talk about health care in

America there is one country that seems to get a

good amount of attention.

It's a single payer health care system.

Kind of like the "Medicare for All" plans that

some well-known Democrats have been promoting.

In fact, the system's unofficial name is also

Medicare. It has universal coverage.

It has relatively cheaper drug prices than the

United States and it also has reports of long

waiting times and endless reams of red tape.

You've probably guessed which country we're

talking about: Canada.

Canada's health care system is playing a larger

role in America's political discourse, as the

2020 presidential elections heat up.

Progressives on the left love pointing to Canada

as an equitable and efficient health care system.

Conservatives, on the other hand, use Canada as

an example when warning about the dangers of

socialized medicine and unchecked bureaucracy.

So how different, really, is Canada's health care

system from what's going on in the United States.

In 2017, it's estimated that Canada spent around

10.4 percent of its GDP on health care.

By comparison the United States is estimated to

have spent about 17.2

percent of its GDP that year.

The OECD estimates that Canada spent around 4,500

USD per person in 2017.

In the United States, though, the figure is

expected to be at least double that at ten

thousand dollars per person.

Out-of-pocket spending is also lower in Canada.

On average Canadians spent around 650 USD per

person in 2016.

The average for Americans was around

eleven hundred dollars that year.

Canada still spends more than the average of all

36 OECD countries, which comes in around 3,800

dollars per person and 8.8 percent

of GDP.

Despite spending less than the United States,

Canada's medicare system ensures citizens have

universal coverage for medical needs that are

deemed essential something the U.S.

hasn't accomplished.

Canada also has comparable or better health

outcomes than the U.S.

even though it spends less money.

But, compared to other countries, Canada's health

care system has room for improvement.

Researchers looked at the rate of deaths that

could have been prevented with proper access to

care across 11 countries.

Canada ranked seventh on the list while America

was last.

We can see the same trends in infant mortality

rates.

Canada outperforms the U.S.

but other countries like Sweden and Australia

have much lower infant mortality rates than

Canada.

Canadians also live longer than Americans.

Canada's average life expectancy is among the

highest of all the countries and is nearly four

years higher than the U.S..

Additionally, Canada's maternal mortality rate is

almost four times lower than that of the United

States and more Americans die of heart disease

and stroke than Canadians.

So how does Canada manage to spend less money

than the United States while having a more

effective health care system?

Canadian medicare is a publicly funded model with

private delivery.

The system was established in order to ensure

equity among citizens regardless of people's

ability to pay.

It was also created in order to keep

administrative costs low.

"There's no private plan can take cognizance of

the family's ability to pay.

Only a government can levy taxes on that basis."

All Canadians receive their coverage through

Medicare which is run at the local level by each

of the 12 provinces under federal supervision.

"So basically the health ministry in the capital

in Ottawa determines what procedures are going to

be covered.

What we're going to pay for it.

What pills we're going to cover on our list.

These are decisions that are made separately by

insurance companies, basically, in the United

States."

That's T.R.

Reid author of the book "The Healing of America."

He traveled the world exploring different health

care systems and how well they work in Canada.

"Everybody has the same treatment.

They would drive them nuts if George got better

health care than Sam did.

That's that's not acceptable in Canada."

There's some variation on what is covered based on

province but most medically necessary care is

covered with no out-of-pocket costs.

There are some universal exceptions.

Prescription drugs are not considered essential

under medicare.

Dental, mental health, and optometry are also not

covered unless they are considered medically

necessary.

Because Medicare does not cover everything.

Most Canadians also buy private health insurance

through their employers to supplement out of

pocket expenses.

They cannot however use that private insurance to

purchase care that is covered under the

government plan.

"If there's any treatment or procedure or surgery

that the system covers under its rules, then you

can't buy it privately.

This is because - you know how in America we hate

this notion of socialized medicine, whatever it

seems that's really bad...

in Canada the bad thing is what they call two

tier medicine.

That is, they don't want rich people getting

better care for all that would be terrible that

would violate their basic gallantry and values.

In America we kind of take it for granted that a

rich kid is going to get better treatment than a

poor kid, that's kind of standard. In

Canada, that would be taboo. That's

a sin."

In 2015, private funding such as household

out-of-pocket costs and private insurance

spending accounted for about 30 percent of health

care spending in Canada.

Despite the majority of health care being

publicly funded, most hospitals and doctor's

offices are privately owned and operated.

Doctors who own their own private practices are

considered contractors who bill the government

insurance fund for their services.

The government is not their boss.

"The doctors are not allowed to practice outside

of the system.

They can either practice completely in the

government medicare system or completely out of

it. And there are very few places Canada where a

doctor can make a living without taking the

Medicare patients, and therefore for most people

that's the only choice."

Despite having universal coverage the system still

has some problems.

Wait times are longer in Canada than the United

States. In a 2016 survey 53 percent of Canadians

said they were not able to get an appointment on

the same or next day when they were sick or

needed attention.

The United States performed slightly better at 42

percent. Out of all of the 11 countries surveyed,

Canada performed the worst in that category.

Thirty percent of Canadians said they waited two

months or longer to see a specialist compared to

6 percent in the United States.

Nearly one in five Canadians waited four months or

more for elective surgery while only 4 percent of

American respondents said the same.

About 60 percent of Canadians find it difficult

to access medical care in the evenings, on

weekends or during holidays without going to a

hospital. These long wait times can lead to the

overuse of the emergency room, where half of

Canadians said they've waited two hours or more

to be seen.

"It's a good system but it doesn't work that well

in Canada, interestingly.

In its own home country, there are long waiting

lines. You know, there are constant stories about

care being denied or people just had to wait

months just to see the doctor.

And I believe that's because the Canadians are too

cheap about it.

They just don't spend enough on health care to

have a lively system.

Some provinces like Saskatchewan where this

started, have shorter waiting times for both

acute and elective treatment than most of the

United States.

So there are parts of Canada where it works."

Not all medical care is covered in Canada which

leads people to have significant out-of-pocket

costs.

Medicare does not classify prescription drugs as

essential which means they are not covered for

many patients.

There are some social programs to help Canadians

pay for drugs, but the benefits vary by province.

For example, Ontario provides prescription drug

coverage for anyone under 24 years old who does

not have private insurance.

The province also has a drug program for people

65 and older.

Canadian pharmaceutical costs are also not as

controlled as other countries.

Canada spends approximately the same amount as

the UK on pharmaceuticals despite having only

half the population.

There are also no out-of-pocket caps on spending.

In 2015, Canadians spent around $670 U.S.

dollars per capita on retail prescription drugs

compared to the United States per capita costs of

roughly 1000 dollars in 2016.

One in 10 Canadians did not fill a prescription

or chose to skip a dose due to cost.

This is still significantly better than the

United States where nearly one in five people

chose not to buy medication because of cost.

Despite the problems Canadians are proud of their

health care system but they do recognize it needs

reform.

94 percent of Canadians surveyed said it was an

important source of both personal and collective

pride. But nearly one in four Canadians were

concerned about whether they would be able to pay

for all of the care they might need if they ever

became seriously ill.

Despite that concern 45 percent of Canadians

rated the overall quality of medical care in

Canada as excellent or very good and nearly three

quarters said the same of their personal care in

the past year.

"The citizens are crazy about It.

It's egalitarian and treats everybody the same.

That's the most important societal value in

Canada is treating everybody equally.

The other thing they like about it is they know

it's better than the U.S.

system. They have better outcomes, they have

better recovery rates from disease, they have

longer life expectancy and they pay less and man

they love being better than the U.S..

That matters to Canadians."