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

Author

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  • O'Neill June E

    () (Baruch College, CUNY and NBER)

  • O'Neill Dave M

    () (Baruch College, CUNY)

Abstract

It is often alleged that Canada's publicly-funded, single payer health care system, delivers better health outcomes, and distributes health resources more fairly than the mainly private U.S. multi-payer system. Our findings contradict these allegations. Differences between the U.S. and Canada in infant mortality and life expectancy --the two indicators most commonly used as evidence of better health outcomes in Canadacannot be attributed to differences in the effectiveness of the two health care systems because they are strongly influenced by differences in cultural and behavioral factors such as the relatively high U.S. incidence of obesity and of accidents and homicides. Moreover, direct measures of the effectiveness of medical care, show that five-year relative survival rates for individuals diagnosed with various types of cancer are higher in the U.S. than in Canada as are infant survival rates of low-birth weight babies. These successes are consistent with the greater U.S. availability of high level technology, higher rates of screening for cancers, and higher treatment rates of the chronically ill. The need to ration when care is delivered "free" ultimately leads to long waits. Waiting times for medical services are a major problem in Canada and a source of unmet needs. In the U.S. costs are more often cited as a source of unmet needs. Nonetheless, with respect to the issue of inequality, we find that the health-income gradient is at least as prominent in Canada as it is in the U.S. When asked about satisfaction with health services and the ranking of the quality of services recently received, more U.S. residents than Canadians respond that they are fully satisfied and rank quality of care as excellent. To address these issues we use the Joint Canada/ U.S. Survey of Health (JCUSH) along with other data sources.

Suggested Citation

  • O'Neill June E & O'Neill Dave M, 2008. "Health Status, Health Care and Inequality: Canada vs. the U.S," Forum for Health Economics & Policy, De Gruyter, vol. 10(1), pages 1-45, April.
  • Handle: RePEc:bpj:fhecpo:v:10:y:2008:i:1:n:3
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    References listed on IDEAS

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    1. Corman, Hope & Grossman, Michael, 1985. "Determinants of neonatal mortality rates in the U.S. : A reduced form model," Journal of Health Economics, Elsevier, vol. 4(3), pages 213-236, September.
    2. repec:aph:ajpbhl:2002:92:8:1323-1330_3 is not listed on IDEAS
    3. David Cutler & Angus Deaton & Adriana Lleras-Muney, 2006. "The Determinants of Mortality," Journal of Economic Perspectives, American Economic Association, vol. 20(3), pages 97-120, Summer.
    4. Theodore Joyce, 1994. "Self-Selection, Prenatal Care, and Birthweight among Blacks, Whites, and Hispanics in New York City," Journal of Human Resources, University of Wisconsin Press, vol. 29(3), pages 762-794.
    5. Michaud Pierre-Carl & van Soest Arthur H.O. & Andreyeva Tatiana, 2007. "Cross-Country Variation in Obesity Patterns among Older Americans and Europeans," Forum for Health Economics & Policy, De Gruyter, vol. 10(2), pages 1-32, December.
    6. 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.
    7. 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, vol. 34(4), pages 617-629, October.
    8. Janet Currie & Jonathan Gruber, 1994. "Saving Babies: The Efficacy and Cost of Recent Expansions of Medicaid Eligibility for Pregnant Women," NBER Working Papers 4644, National Bureau of Economic Research, Inc.
    9. Joyce, Theodore & Grossman, Michael, 1990. "The dynamic relationship between low birthweight and induced abortion in New York City : An aggregate time-series analysis," Journal of Health Economics, Elsevier, vol. 9(3), pages 273-288, November.
    10. 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.
    11. Hope Corman & Theodore J. Joyce & Michael Grossman, 1987. "Birth Outcome Production Function in the United States," Journal of Human Resources, University of Wisconsin Press, vol. 22(3), pages 339-360.
    12. 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," NBER Working Papers 10715, 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.

    More about this item

    JEL classification:

    • I1 - Health, Education, and Welfare - - Health
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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