RUNNING HEADER: COMPARE US, CHINA AND CANADA

HCM630
IP#2
Donna Rothmann-Ranels
American Intercontinental University
October 28, 2013

RUNNING HEADER: COMPARE US, CHINA AND CANADA

Abstract
The United States Healthcare system has many strengths and weaknesses. This paper
will focus on the United States strengths of the healthcare system and how this healthcare
system measures up the health care system of two other countries. Those two other
countries are Canada and China.

RUNNING HEADER: COMPARE US, CHINA AND CANADA

Introduction
The United States has one of the best healthcare systems in the world. It has
much strength compared to other countries. In order to receive a better understanding of
the strengths of the healthcare system of the United States we must look into the
healthcare systems of other countries. The two other countries that will be discussed are
Canada and China. Once these two healthcare systems are explained we can compare
them to the healthcare system of the United States. The first countrys healthcare system
I will discuss will be Chinas.
China
Chinas New Rural Cooperative Medical Scheme (NCMS) covers about 800
million individuals (NCMS). That is 99% of the country. That is a huge jump from 2003
when only 8 million people were covered by insurance. China has attained near universal
coverage in their rural areas (Wilkinson, 2013). Chinas overall life expectancy is 76
years of age (Healthcare in China, 2013). The life expectancy for males is 74 and for
females it is 77. Most the of the people who have insurance have never had it before.
This is causing serious strains on the delivery of healthcare in China. People now are
looking for the best care they can get and want to utilize the best health care centers.
This has led to long lines that begin bright and early so that people can see a specialist.
Not everyone gets seen that day and some dont get the results there were hoping for.
Most Chinese medical centers are headed by political appointees rather than
professionally trained managers. Since the leaders are not professionally trained this
causes serious governance and performance issues. All low cost items are controlled by
the government. This makes these items broadly obtainable. Hospitals are able to offer

RUNNING HEADER: COMPARE US, CHINA AND CANADA

more expensive procedures, drugs and devices. High tech equipment is charged at a
higher rate with government allowance (Healthcare in China, 2013). Patients end up
paying the higher prices. Much of Chinas healthcare costs are out of pocket. Also there
are kickbacks throughout the healthcare process.
Device and drug companies give hospitals kickbacks. These kickbacks are given
to physicians by hospital executives. Due to the increase of newly insured individuals
there is a shortage of competently skilled doctors in China. Hospitals are government
funded so they are strapped for cash. Drug sales are what keeps the doors open for most
hospitals. Doctors frequently over prescribe medications to help enhance their income.
The patients pay for drugs they dont need at much higher prices (Kaiman, 2013). Many
children in China suffer moderate stunting, which is a reduced growth rate brought on by
malnutrition in early childhood. Its effects are largely irreversible, and can lead to
premature death. At least 10 million pre-school children in China have stunted growth
(Ying & Jingyi, 2012). Many children in China suffer from basic health problems like
iron deficiency anemia. Many do not have proper nutrition. China has about 1,938,000
doctors and about 3,074, 000 hospital beds. Heath expenditures were $224 per capita
which is 5.5% of the gross domestic product, 37.2% of public expenditures was devoted
to health care.
Canada
Canada spends $3,678 per capita for health care. Ten percent of Canadas gross
domestic product is spent on health care (Sanmartin, C., Berthelot, J., Ng, E., Murphy,
K., Blackwell, D., Gentleman, J., Martinez, M. & Simile, C., n.d.). More than half of
Canadas health care spending is financed by the government. The life expectancy in

RUNNING HEADER: COMPARE US, CHINA AND CANADA

Canada is 80. There are about 10 provincial healthcare systems that make up the
Canadian healthcare system. These 10 healthcare systems report to their provincial
government. Government funding for health care is $1,893 per person. The federal
government is dedicated to supplying financial assistance to the provincial government
for health care costs. Certain services are not covered by Canadas universal health care
plan. Outpatient prescription drugs are not required to be included. Some services such
as Optometry may only be included in certain areas and only for children under a specific
age. Non-physician specialists visits could require an added fee. The National health
care system covers every Canadian citizen. Canadians have longer wait times in
emergency rooms compared to the United States. Forty-two percent of patients waited
more than 2 hours in the emergency room compared to 29% in the United States. Fortythree percent waited more than 4 weeks to see a specialist compared to 10% in the United
States. Canada has fewer doctors than the Unites States. There are just over 2 physicians
per 1000 patients in Canada and about 2.5 physicians per 1000 patients in the United
States (Sanmartin, C., Berthelot, J., Ng, E., Murphy, K., Blackwell, D., Gentleman, J.,
Martinez, M. & Simile, C., n.d.).
Health care performance is ranked by World Health Organizations. Canada
ranked 30th and America are ranked 37th. Statistically Americans are less healthy than
Canadians. Canadians exhibit lower rates of many diseases such as cancer. A sick
person has a higher chance of a cure in the United States than in Canada (Sanmartin, C.,
Berthelot, J., Ng, E., Murphy, K., Blackwell, D., Gentleman, J., Martinez, M. & Simile,
C., n.d.). The government is the solitary purchaser of health care insurance so that they
can control health care costs. This means that patients are not able to shop for a better

RUNNING HEADER: COMPARE US, CHINA AND CANADA

price on health insurance. People with non life-threatening emergencies are not able to
pay for time sensitive surgeries out of their own pockets. These people must be added to
a waiting list. This increases the patients mortality risk and the risk that the patients
injuries will become irreparable.
United States
More money is spent on health care in The United States than Canada or China.
Spending on health care per capital was $6,714, 46% of that was financed by the
government. The United States has a life expectancy of 78. Government funding of
healthcare was $2,728 per person (Sanmartin, C., Berthelot, J., Ng, E., Murphy, K.,
Blackwell, D., Gentleman, J., Martinez, M. & Simile, C., n.d.). Direct government
funding is limited to Medicaid and Medicare. It also funds the State Childrens Health
Insurance Program (SCHIP) and the Military Health System. The United States received
more in private spending than Canada or China. In Canada over $900 was spent annually
by private insurance companies or individuals for health care. In the United States this
number is $3,372. The United States employs more doctors than in Canada. Quite a few
doctors leave Canada to pursue higher paying jobs in the United States.
There are limited resources for prescription drug coverage for the needy in both
Canada and the Unites States. Medicare D has enhanced prescription drug coverage for
people who are enrolled in Medicare. All drugs given in the hospital fall under Medicare
in Canada, but other prescription drugs do not (Sanmartin, C., Berthelot, J., Ng, E.,
Murphy, K., Blackwell, D., Gentleman, J., Martinez, M. & Simile, C., n.d.). Prescription
drugs costs are much higher in the United States. In the US the cost per capita for drugs
is $728 while in Canada it is $509. Consumption of drugs is higher in Canada. Twelve

RUNNING HEADER: COMPARE US, CHINA AND CANADA

prescriptions per person per year are filled in Canada while only 10.6 in the United
States. The main reason for this is because drugs cost 35%-45% less in Canada.
The United States spends more on technology than Canada. The United States
has 29.5 MRI Scanners per million patients while Canada only has 4.6. This could be
why wait times are longer in Canada. The unavailability of technology could be why
wait times are longer in Canada. Some people have had to wait up to almost two years
for an MRI in Canada. Life expectancy is about 2 years longer in Canada. The United
States has a higher infant and child mortality rate. Cancer survival rates are higher in the
United States.
In the United States consumers can use health savings accounts (HSAs). They provide
tax incentives for individuals to save for any future qualified medical expenses. The
money placed in these accounts is tax free.
Conclusion
Although there are many strengths in Canadas health care system, I believe that
the United States still has the better system. The United States spends more on heath care
and technology to insure that patients have the best equipment necessary to treat them.
More equipment leads to shorter wait times. The United States also has more doctors and
hospitals to treat patients. The United States has Medicare Part D which helps with
prescription drug coverage for covered recipients. Canadas government controls the
purchasing of health insurance which means that consumers can not shop around for the
best insurance for their needs. Survival rates are better in the United States for cancer
and other life threatening diseases.

RUNNING HEADER: COMPARE US, CHINA AND CANADA

Compared to China, the United States has a much better health care system. Life
expectancy is better in the United States. Access to medical care is better. There are
more doctors and hospitals to treat patients in the United States. Waiting times are also
much less in the United States. Survival rates are higher in the United States. Also infant
and mortality rates are better in the United States.

RUNNING HEADER: COMPARE US, CHINA AND CANADA

References
Health care in China: is there a doctor in the house? (2013). Retrieved on October 28,
2013 from http://knowledge.wharton.upenn.edu/article/health-care-in-china-isthere-a-doctor-in-the-house/
Kaiman, J. (2013). Healthcare in China: GSK claims prompt crackdown on corruption.
Retrieved on October 28, 2013 from
http://www.theguardian.com/world/2013/jul21/china-healthcare-industry-gsk
Sanmartin, C., Berthelot, J., Ng, E., Murphy, K., Blackwell, D., Gentleman, J., Martinez,
M. & Simile, C., (n.d.). Comparing Health and Health Care Use In Canada And
The United States... (n.d.). Retrieved on October 28, 2013 from
http://content.healthaffairs.org/content/25/4/1133.full
Ying, Y., Jingyi, W. (2012) Chinas stunted children. Retrieved on October 28, 2013
from https://www.chinadialogue.net/article/show/single/en/4927-China-s-stuntedchildren
Wilkinson, L. (2013). Universal rural health care in China, not so fast. Retrieved on
October 28, 2013 from
http://www.theatlantic.com/china/archive/2013/09/universal-rural-health-care-inchina-not-so-fast