Countries with developed economies like Canada, the United States, and the United Kingdom are home to advanced healthcare facilities and capable healthcare professionals. However, despite their best-in-class service, their respective healthcare systems do not operate the same, and the differences among them are generally determined by cost and access.
Explainer: The Similarities and Differences in the Healthcare Systems of Canada, the United States, and the United Kingdom
Specific Healthcare System Model
The healthcare system model of a country provides the structure and organization for determining how a government funds, delivers, and manages healthcare services. It defines who pays for healthcare, who delivers the services, and how people access these services. A particular model essentially affects not only cost and access but also quality and healthcare outcomes.
Both Canada and the United Kingdom have a single-payer healthcare system that is funded by the public through taxes. Canada has Medicare while the U.K. has the National Health Services. Both are also prime examples of universal healthcare. However, when it comes to structure and organization, their respective healthcare systems are based on two different models.
Canada follows a national health insurance model in which the healthcare system is funded by the government through general taxation. Provinces and territories manage their own healthcare systems and run their own public health insurance based on federal Medical principles. The hospitals and healthcare professionals remain private. Private insurance still exists.
The United Kingdom follows the Beveridge model in which the government not only funds the services but also owns hospitals and employs healthcare professionals. Funding comes from both general taxation and national insurance contributions. Overall management is also centralized since the National Health Services is centrally managed by the national government.
However, when it comes to the United States, its healthcare system is based on a mixed system that combines an out-of-pocket or market-based model and some elements of national health insurance, Beveridge, and employer-based or Bismarck models. Note that employer-based private insurance is common. Public programs cover low-income individuals, the elderly, and disabled.
Discrepancies in Access and Cost
The United States is the only developed country and advanced economy in the world without universal healthcare coverage because it is still dominated by a market-based model where employer-based insurance dominates. This results in millions remaining uninsured or underinsured due to either unemployment and underemployment or lack of financial resources.
In comparison, because both Canada and the United Kingdom have a single-payer and universal healthcare system funded by their governments, all of their residents have access to essential healthcare services regardless of their income level or employment status. There are no direct costs at the point of use or no medical bills for general doctor visits, surgeries, or hospital stays.
Several data sources indicate that the U.S. spends about USD 12900 per capita on healthcare. It has the highest healthcare cost per capita in the world. The per capita cost in Canada is around USD 5700 and in the U.K. is around USD 4600. These lower costs come from the fact that the Canadian and U.K. governments directly negotiate prices for medical services.
A simple MRI scan in the U.S. can cost a patient more than USD 1000. This is about 85 percent and 130 percent higher than the cost of a similar procedure in Canada and the U.K. Administrative costs also account for 25 to 30 percent of overall healthcare spending in the U.S. This is higher than the 10 percent administrative costs in Canada and 2 percent similar costs in the U.K.
Canada and the U.K. also regulate drug prices by negotiating directly with pharmaceutical companies to set lower prices. The U.S. does not have national price controls and negotiations are separately done by private and public health insurers. A single vial of insulin costs around USD 35 in Canada and USD 10 in the U.K. The cost of the same insulin vial is over USD 100 in the U.S.
Healthcare Quality and Outcomes
The single-payer model and universal healthcare systems of Canada and the United Kingdom are not without drawbacks. Wait times for specialists and elective procedures in Canada can be long. The same is true in the U.K. However, in the United States, access to specialists is quicker and wait times are shorter for those who can pay or have comprehensive insurance coverage.
It is also worth mentioning that the United States has a high availability of advanced treatments and medical technologies. It also leads in medical research and drug development. Canada has strong research institutions but is still dependent on U.S. innovations. The U.K. has strong public research. Both countries offer some advanced treatments and technologies but access can be limited.
Nevertheless, despite the apparent robustness of its infrastructure and capabilities, Both Canada and the U.K. still outperform the U.S. in terms of critical healthcare outcomes. The American population has a lower life expectancy at around 77 years. The infant mortality rate is higher at around 5.4 deaths per 1000 live births and the preventable death rate is at 177 deaths per 100000 people.
Life expectancy in Canada is higher at around 82 years. Its infant mortality rate is around 4.3 deaths per 100 live births. The preventable death rate is around 110 deaths per 10000 people. Life expectancy in the U.K. is also higher at around 81 years. Its infant mortality rate is lower at 3.9 deaths per 100 live births. The preventable death rate is around 120 deaths per 10000 people.
The United States fundamentally has the best quality of care for those who can afford it. The same is true for access to specialists and cutting-edge treatments. However, because of financial barriers, access is not universal. Both Canada and the United Kingdom demonstrate the effectiveness of a single-payer and publicly funded model for providing universal healthcare coverage.
FURTHER READINGS AND REFERENCES
- Donnelly, P. D., Erwin, P. C., Fox, D. M., and Grogan, C. 2019. “Single-Payer, Multiple-Payer, and State-Based Financing of Health Care: Introduction to the Special Section.” In American Journal of Public Health. 109(11): 1482-1483. American Public Health Association. DOI: 2105/ajph.2019.305353
- Grosios, K., Gahan, P. B., and Burbidge, J. 2010. “Overview of Healthcare in the UK.” In EPMA Journal. 1(4): 529-534). Springer Science and Business Media LLC. DOI: 1007/s13167-010-0050-1
- Hunter, D. J. 2023. “At Breaking Point or Already Broken? The National Health Service in the United Kingdom.” In New England Journal of Medicine. 389(2): 100. Massachusetts Medical Society. DOI: 1056/nejmp2301257
- Manns, B. J., Hastings, S., Marchildon, G., and Noseworthy, T. 2024. “Health System Structure and Its Influence on Outcomes: The Canadian Experience.” In Healthcare Management Forum. 37(5): 340-350). SAGE Publications. DOI: 1177/08404704241248559
- Naylor, C. D. 1992. “The Canadian Health Care System: A Model for America to Emulate?” In Health Economics. 1(1):19-37. Wiley. DOI: 1002/hec.4730010106