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Comparative Analysis of Health Outcomes and Spending: Canada vs. U.S.

This comprehensive analysis explores key health metrics and spending differences between Canada and the U.S. It highlights annual death rates per 100,000 individuals, particularly focusing on homeless populations in Toronto, Boston, and New York. While Toronto's homeless death rates are elevated, they remain lower compared to U.S. cities. Additionally, it examines the administrative costs and public spending in Canada’s National Health Insurance Program versus U.S. healthcare. Evidence suggests slightly better quality of care in Canada, particularly for patients with similar conditions.

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Comparative Analysis of Health Outcomes and Spending: Canada vs. U.S.

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  1. International Comparisons

  2. 3500 • 3000 • 2500 • 2000 • 3048 • 1500 • Annual Deaths Per 100,000 • 2227 • Men Age 45-64 • 1000 • 1680 • 500 • 730 • 0 • Toronto • Homeless • Boston • Homeless • New York • Homeless • Non-Homeless • Toronto Homeless in TorontoDeath Rate Elevated, But Lower than In U.S. Source: JAMA 2000; 283:2152

  3. U.K. • $1,450 • Japan • $1,780 • Sweden • $1,820 • France • $2,120 • Canada • $2,250 • Germany • $2,400 • U.S. • $2,740 • $1,530 • $0 • $1,000 • $2,000 • $3,000 • $4,000 • $5,000 • $ Per Capita • Total Spending • U.S. Public • U.S. Private U.S. Public Spending Per Capita for Healthis Greater than Total Spending in Other Nations Note: Public includes benefit costs for govt. employees & tax subsidy for private insuranceSource: NEJM 1999; 340:109; Health Aff 2000; 19(3):150

  4. Canada’s National Health Insurance Program

  5. Why are Canada’s system administrative costs lower? • No need to determine who is eligible for what • Canada’s overall administrative % close to Medicare (before Medicare + Choice), less than Medicaid • No marketing of insurance • No billing or collecting insurance premiums

  6. Number of Insurance Products

  7. Private insurers’ High Overhead

  8. Why are hospital administrative costs less in Canada? • Global budgets • Operating budget • Capital investment budget • Negotiated with Province • No bills. • No need to track and bill for individual services and goods

  9. Why are physicians’ administrative costs lower in Canada? • Single payer • One place to send bills • One set of rules

  10. Quality of Care Slightly Better in Canada Than U.S. A Meta-Analysis of Patients Treated for Same Illnesses (U.S. Studies Included Mostly Insured Patients) Source: Guyatt et al, Open Medicine, April 19, 2007

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