The Canadian health care system: a Canadian physician's perspective

Article Abstract:

There is growing interest in the Canadian system of health care delivery because Canada is perceived to have one of the premier health care delivery systems that is universally available, government funded and under cost control. The Canadian model also has avoided direct government control unlike Great Britain. With United States health costs now exceeding 11 percent of the GNP and expected to continue on the rise, the Canadian system is increasingly being explored. In the US the cost of construction of a new automobile includes an expense of approximately $700 to pay for workers' health insurance. By comparison, a similar car made in Canada includes only $223 of medical expense. Before changing its system, the United States should be aware of problems with the Canadian model that are beginning to surface. Previous analysis has indicated that by changing to the Canadian system, 8.2 percent or $29.2 billion dollars could be saved. In part this would be achieved by centralization, and by instituting financial controls over the adoption of technology and physician fees. Each Canadian province has evolved as nearly the sole payer for most health care bills. With continuing pressure of the Canadian public to increase the use of dramatic technologic advances, it is unlikely that global spending caps will prove adequate and flexible enough to dissipate these forces. To some degree the public has become the victim of these policies while being shielded from knowledge of these economic conflicts. The establishment of governmental authorities as a monolithic purchaser of health services results in the physician absorbing the cost of increased use of medical facilities. The governmental authorities are now attempting to increase their control over which services can be rendered by a physician to a patient. It is unlikely that the Canadian system can be transplanted intact to the United States; it must be altered to match the different social fabric of a new country. It is sensible for Americans to look at the Canadian system, but the risks inherent in a government-controlled monopoly are real and such a system cannot be expected to control costs for long. (Consumer Summary produced by Reliance Medical Information, Inc.)

Finance, Socialized medicine, column

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How does Canada do it? A comparison of expenditures for physician's services in the United States and Canada

Article Abstract:

The cost per person of medical care in the United States is 1.72 times that in Canada, and medical care costs represent 11.5 percent of the gross national product in the US in contrast to 9 percent in Canada. Nevertheless, there seem to be few differences in mortality. Furthermore, over 14 percent of Americans have no health insurance, while all Canadians are supplied with comprehensive health insurance. An investigation into the reasons for these disparities revealed several notable differences. The entire difference may be accounted for by higher fees; in fact, the actual quantity of physicians' services per capita is greater in Canada. Although fees in the US are often double or triple those for the same procedure in Canada, the physicians' incomes are only about a third greater in the United States. Billing and record-keeping costs are greater in the United States. In addition, general amenities in the physician's office are often greater in the US. This is likely due both to the fact that Americans are, in general, used to a somewhat higher level of general amenities, and also to the fact that US physicians are less likely to compete on the basis of price than on the basis of amenities provided to the patient. Offices are likely to be more spacious, and in a better part of town, in the United States. The workload for some specialties in Canada may be as high as twice that of physicians in the US. The results seem to indicate that higher fees for medical care in the US result primarily from a higher overhead and a lower workload for physicians in the US. (Consumer Summary produced by Reliance Medical Information, Inc.)

Medical economics, Economic aspects, Health services administration

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Acute bacterial sinusitis

Article Abstract:

On the basis of national population surveys and insurance reimbursement claims, sinusitis is one of the most common health problems in the United States. Acute bacterial sinusitis is suspected in the presence of facial pain and pressure, purulent nasal drainage, and symptoms lasting longer than seven days that do not respond to over-the-counter nasal decongestants and acetaminophen.

United States, Science & research, Care and treatment, Research, Communicable diseases

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