Canada’s healthcare system could be enabling practitioners to give patients better care
A recent study published in the Annals of Internal Medicine found that cystic fibrosis (CF) patients in Canada live an average of ten years longer than their American counterparts, in part because of the two countries’ different healthcare systems.
The decade-long study showed that after age, severity of disease, and other variables were taken into account, the death rate for Canadians was 34% lower than for American patients overall, reported BBC News. When the American sample was segmented based on insurance coverage status, the results diverged: Canadian patients’ had a similar death rate when compared to privately insured US patients, but had a 44% lower death rate compared to Americans on Medicaid. Their death rate compared to Americans without any insurance was 77% lower.
“I think there may be some sort of inherent differences in the systems themselves, but teasing it out is hard,” Dr. Anne Stephenson, the study’s lead author and a researcher at St. Michael’s Hospital in Toronto, told the BBC.
While the differences may be difficult to verify from an academic standpoint, they can be plain to see for those with on-the-ground experience. Michelle Brotherwood, a registered dietician who has worked with children suffering from CF in Canada in the US, told the news service she experienced a stark contrast when she shifted from St. Michael’s to an LA-based CF clinic.
“In Canada, I make clinical decisions. I look at [a patient’s] case and I decide whether or not they would benefit from meeting with me,” Brotherwood said. “There [in the US], the decision is driven by their insurance.”
She reported being unable to see patients with real need because they had no coverage, while others who were doing well got her attention simply because it was covered in their plan. Even some patients with insurance had to reduce their hospital visits or medication because they could not deal with the high co-pays.
Other studies have shown parallel results. According to Dr. PJ Devereaux, a researcher at McMaster University, studies focused on patients with end-stage renal failure showed Canadians living longer than Americans because they had better-quality care. He said US for-profit clinics would spend on marketing when they could be spending more on qualified staff.
However, McGill University public health researcher Erin Strumpf is not convinced. “People like the explanation of universal health coverage … But it is a challenging thing, to really understand what causes those differences,” she said, citing a broad swath of other factors including lifestyle, genetics, and socioeconomic factors that could contribute to the difference in outcomes.
In 2007, Statistics Canada and the Centre for Disease Control conducted a joint study that showed similar health outcomes between Canada and the US. Reports of health problems were higher among the lowest-income Americans (31%) compared to Canadians (23%), and cost issues were often cited by Americans complaining of unmet healthcare needs. Canadians in the study were more likely to express concern about waiting times.
Related stories:
BC refuses coverage for regulator-approved, life-saving cystic fibrosis drug
Canada’s high healthcare spending belies modest-to-low performance
The decade-long study showed that after age, severity of disease, and other variables were taken into account, the death rate for Canadians was 34% lower than for American patients overall, reported BBC News. When the American sample was segmented based on insurance coverage status, the results diverged: Canadian patients’ had a similar death rate when compared to privately insured US patients, but had a 44% lower death rate compared to Americans on Medicaid. Their death rate compared to Americans without any insurance was 77% lower.
“I think there may be some sort of inherent differences in the systems themselves, but teasing it out is hard,” Dr. Anne Stephenson, the study’s lead author and a researcher at St. Michael’s Hospital in Toronto, told the BBC.
While the differences may be difficult to verify from an academic standpoint, they can be plain to see for those with on-the-ground experience. Michelle Brotherwood, a registered dietician who has worked with children suffering from CF in Canada in the US, told the news service she experienced a stark contrast when she shifted from St. Michael’s to an LA-based CF clinic.
“In Canada, I make clinical decisions. I look at [a patient’s] case and I decide whether or not they would benefit from meeting with me,” Brotherwood said. “There [in the US], the decision is driven by their insurance.”
She reported being unable to see patients with real need because they had no coverage, while others who were doing well got her attention simply because it was covered in their plan. Even some patients with insurance had to reduce their hospital visits or medication because they could not deal with the high co-pays.
Other studies have shown parallel results. According to Dr. PJ Devereaux, a researcher at McMaster University, studies focused on patients with end-stage renal failure showed Canadians living longer than Americans because they had better-quality care. He said US for-profit clinics would spend on marketing when they could be spending more on qualified staff.
However, McGill University public health researcher Erin Strumpf is not convinced. “People like the explanation of universal health coverage … But it is a challenging thing, to really understand what causes those differences,” she said, citing a broad swath of other factors including lifestyle, genetics, and socioeconomic factors that could contribute to the difference in outcomes.
In 2007, Statistics Canada and the Centre for Disease Control conducted a joint study that showed similar health outcomes between Canada and the US. Reports of health problems were higher among the lowest-income Americans (31%) compared to Canadians (23%), and cost issues were often cited by Americans complaining of unmet healthcare needs. Canadians in the study were more likely to express concern about waiting times.
Related stories:
BC refuses coverage for regulator-approved, life-saving cystic fibrosis drug
Canada’s high healthcare spending belies modest-to-low performance
