Milbank Quarterly

Volume 77 Number 3, 1999



POLICY FORUM: THE CANADIAN AND U.S. HEALTH CARE SYSTEMS
What Is Right about the Canadian Health Care System?

Robert Evans and Noralou P. Roos

Canadians tend to dwell on problems in their health care system, looking to the United States for magical fixes. Evidence on comparative system performance, which rarely surfaces in public debate, indicates that Canadians are healthier, not only because the social environment is more benign, but also because health care is allocated by need rather than ability to pay. Expenditures are much lower, but Canadians receive equivalent care because their system is more efficient. Although Canadian "waiting lists" are highly publicized, the United States avoids the issue by excluding those who cannot pay. Why, then, would any Canadian advocate U.S.-style care? The most obvious explanation is economic interest.


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