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Health Status, Health Care and Inequality: Canada vs. the U.S

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  • June E. O'Neill
  • Dave M. O'Neill

Abstract

Does Canada's publicly funded, single payer health care system deliver better health outcomes and distribute health resources more equitably than the multi-payer heavily private U.S. system? We show that the efficacy of health care systems cannot be usefully evaluated by comparisons of infant mortality and life expectancy. We analyze several alternative measures of health status using JCUSH (The Joint Canada/U.S. Survey of Health) and other surveys. We find a somewhat higher incidence of chronic health conditions in the U.S. than in Canada but somewhat greater U.S. access to treatment for these conditions. Moreover, a significantly higher percentage of U.S. women and men are screened for major forms of cancer. Although health status, measured in various ways is similar in both countries, mortality/incidence ratios for various cancers tend to be higher in Canada. The need to ration resources in Canada, where care is delivered "free", ultimately leads to long waits. In the U.S., costs are more often a source of unmet needs. We also find that Canada has no more abolished the tendency for health status to improve with income than have other countries. Indeed, the health-income gradient is slightly steeper in Canada than it is in the U.S.

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Bibliographic Info

Paper provided by National Bureau of Economic Research, Inc in its series NBER Working Papers with number 13429.

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Date of creation: Sep 2007
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Publication status: published as June E. O'Neill & Dave M. O'Neill, 2008. "Health Status, Health Care and Inequality: Canada vs. the U.S," Forum for Health Economics & Policy, Berkeley Electronic Press, vol. 10(1).
Handle: RePEc:nbr:nberwo:13429

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  1. Kaestner, Robert & Joyce, Theodore & Wehbeh, Hassan, 1996. "The Effect of Maternal Drug Use on Birth Weight: Measurement Error in Binary Variables," Economic Inquiry, Western Economic Association International, Western Economic Association International, vol. 34(4), pages 617-29, October.
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  6. Sandra L. Decker & Dahlia K. Remler, 2004. "How Much Might Universal Health Insurance Reduce Socioeconomic Disparities in Health?: A Comparison of the US and Canada," Applied Health Economics and Health Policy, Springer Healthcare | Adis, vol. 3(4), pages 205-216.
  7. Theodore Joyce & Andrew D. Racine & Sandra McCalla & Hassan Wehbeh, 1994. "The Impact of Prenatal Exposure to Cocaine on Newborn Costs and Length of Stay," NBER Working Papers 4673, National Bureau of Economic Research, Inc.
  8. Hope Corman & Theodore J. Joyce & Michael Grossman, 1985. "Birth Outcome Production Functions in the U.S," NBER Working Papers 1729, National Bureau of Economic Research, Inc.
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Cited by:
  1. Duclos, Jean-Yves & Échevin, Damien, 2011. "Health and income: A robust comparison of Canada and the US," Journal of Health Economics, Elsevier, vol. 30(2), pages 293-302, March.

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