Canadian Health Insurance Lessons for the United States

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Abstract:

Recent polls indicate widespread dissatisfaction with the way the United States finances and controls the cost of health care. Health spending consumes a steadily rising share of our national incomealmost 12 percent of gross national product in 1989, headed to 16 percent by the end of the decade. Yet many Americans who lack health
insurance face severe difficulty gaining access to health care. This situation has revived national debate over the way we finance health care. Meanwhile, other industrialized nations assure that everyone has access
to the health care system, have health status indicators that equal or exceed those of the United States, and accomplish these goals while spending less than the United States. This contrast between the U.S. and
foreign experience suggests that the way other nations finance health services may contain useful ideas that might be adapted to the U.S. system. Some have looked to Canada, where the health program has broad popular support and all residents are covered by the program, but per capita spending is significantly less than in the United States. Yet the Canadian program has some features in common with the United States. Canadians choose their own private physicians, those physicians are compensated on a fee-for-service basis, and most hospitals are private,
nonprofit institutions. The Chairman, House Committee on Government Operations, asked GAO to assess whether the Canadian health care system had useful lessons for the United States. He asked GAO to review salient features of the Canadian system and analyze the likely effects on cost and access of adopting elements of a Canadian-style system.