Canada does not have one-tier or uniform delivery of health care

Using figures from the massive Joint Canada/U.S. Survey of Health (JCUSH), health economists June and Dave O'Neill suggest that what Americans may be getting for their extra health care dollars is precisely what Canadians have always thought they had created: a system that is fairer to the poor and excels at granting broad access to basic care.

The O'Neill's new regression analysis, which claims to be the first that tackles this issue by comparing apples to apples, suggests that Canadians' health is actually more income-dependent than Americans'.

There are other surprises for Canadians in the JCUSH numbers:

Although Americans generally have a higher incidence of chronic disease, an American is more likely to actually receive ongoing treatment for such a disease than a Canadian.

Emphysema, hypertension, diabetes and heart disease are all more common in the United States.

But across the board, Canada tends to have higher numbers of untreated sufferers, despite universal insurance.

Still more significant, perhaps, is the apparent divide in access to preventative care:

JCUSH has confirmed existing figures showing that the number of middle-aged Canadian women who have never had mammography for cancer screening is nearly double that of the United States, and the number of Canadian women under 70 who have never had a Pap smear is triple the U.S. figure.

More than half of American men in middle age have had at least one PSA test for prostate cancer; in Canada it's only one-sixth.

And the United States is five to six times as effective at getting middle-aged men and women into a clinic for colorectal cancer screening.

Source: Colby Cosh, One-tier health care? Not quite; The 'health-income gradient' here is actually higher than in the U.S., National Post, October 4, 2007.

For text: http://communities.canada.com/nationalpost/blogs/fullcomment/archive/2007/10/04/colby-cosh-one-tier-health-care-not-quite.aspx

For JCUSH study: http://www.cdc.gov/nchs/about/major/nhis/jcush_mainpage.htm

For more on Health Issues: http://www.ncpa.org/sub/dpd/index.php?Article_Category=16

FMF Policy Bulletin/ 16 October 2007