In the United States and Canada, people often assess their health care satisfaction by comparing their respective health care systems with one another. Factors include the cost of health care, accessibility, and the quality of care available.
In this article, we will walk you through the fundamental differences in the health care systems of Canada and the US. We have distinguished their systems and the key distinctions in how each is structured.
Health care insurance coverage
In the US, individuals are required to pay for their health care insurance. An exception is given to those who qualify for eligibility in a government-provided insurance program offered to individuals in particular income, age, or disability brackets.
Health insurance in the US is usually provided by employers with insurance coverage in the package of benefits they offer their employees. The type of coverage offered will depend on the employer, and coverage is not guaranteed.
On the other hand, all Canadian citizens under provincial governments that follow regulations outlined in the Canada Health Act (CHA) of 1984 are provided with health care insurance through the national health care system and the Canadian federal government.
Private industries and their role to health care
Health care insurance and health care services in the US are provided by private enterprises.
Insurers compete for customers. They sell insurance policies to employers as benefits packages for employees and to individual consumers. Health care providers compete for patients through cost, quality, or areas of medical specialty. Therefore, individual consumers impact the market. Their choices for insurance policies are limited by services, benefits, or the doctors available.
In Canada, most health care services are provided by private providers. Health workers work independently in private practice or are employed by private hospitals or private health service management organizations. This means the majority of the revenue made by doctors and physicians is by billing government health insurance.
Types of health care covered by the insurance
In the US, health care coverage provided by private enterprises depends on the benefits packages negotiated by employers or the policies individuals choose or can afford. However, individuals are required to secure a minimum essential coverage according to the Patient Protection and Affordable Care Act (ACA) in 2010. This act also requires insurers to cover essential health benefits (EHBs), including ambulatory patient services, emergency services, hospitalization, laboratory services, maternity and newborn care, mental health and substance use services, pediatric services, prescription drugs, preventative care services, and rehabilitative services.
Meanwhile, the coverage from the universal health care system that provides coverage for all Canadian citizens is limited to services provided by hospitals, medical practitioners, or surgical dental services provided in a hospital. As for health care services that are not included in the coverage, provinces are allowed to provide insurance for additional services, such as coverage for dental care, home care, long-term care, mental health care, prescriptions, and vision care.
Conclusion
While there are distinct differences between the health care systems in the US and Canada, both countries ensure to provide public health care access and insurance coverage.
Through global health or the understanding of health care in an international and interdisciplinary context, countries are able to learn from one another, observe and adapt the excellent health care practices, and make developments and improvements for their own health care system.
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