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Wednesday, May 31, 2006

Canadians healthier, have better access to health-care than Americans: study

By Helen Branswell

(CP) - A new study comparing the health and health-care access of Canadians and Americans suggests that Canadians are in general healthier and have better access to health care than their neighbours to the south.

Sure, Canadian wait times are bad, one of the authors admits. But the inherent inequity in the U.S. system and its failure to cover a huge swath of the American populace is worse, says Dr. David Himmelstein, of Harvard Medical School and the Cambridge Health Alliance.

"I think what our data . . . clearly shows that for any given level of expenditure, you get far more and far better care from a Canadian method of going about financing it (health care) than from the U.S. method," said Himmelstein, a specialist in primary care internal medicine.

"You (in Canada) spend at a very low level. And get very good value for care."

All the extra money Americans spend don't seem to be buying them better health. The study - based on identical large surveys conducted on both sides of the border - showed Americans are more likely to be obese (20.7 per cent versus 15.3 per cent), more likely to suffer from diabetes (6.7 per cent vs. 4.7 per cent) and are more likely to have high blood pressure (18.3 per cent vs. 13.9 per cent) than Canadians.

Americans are also more likely to live an entirely sedentary lifestyle; 13.6 per cent reported they had taken no physical exercise in the three months prior to the study, versus 6.5 per cent of Canadians.

Surprisingly, Canadian respondents smoked more than their American cousins. Nineteen per cent of Canadians reported being a daily smoker versus 16.8 per cent of Americans.

But for reasons that aren't clear, rates of chronic obstructive pulmonary disease - a condition closely linked to smoking - were almost double among American respondents as compared to the Canadians.

"Canadians look a tad healthier on a number of measures, I guess most importantly diabetes and hypertension," said Himmelstein.

"And (they) also report generally that they get care a bit more easily than Americans, despite spending so much less than we do."

Himmelstein and his co-authors analysed data from the Joint Canada/U.S. Survey of Health, which compared health status, access to care and health-care utilization in the two countries.

The data were collected through phone surveys conducted by Statistics Canada and the U.S. National Center for Health Statistics between November 2002 and March 2003, with 3,500 Canadians and 5,200 Americans asked the same questions about their health and health-care usage.

The study was published Tuesday in the American Journal of Public Health.

Though many Canadians report having trouble finding a family doctor, the survey suggests Americans have a bigger problem on this front. Nearly 85 per cent of Canadians reported having a family doctor, versus just under 80 per cent in the U.S.

And only 5.1 per cent of Canadians reported being unable to pay for needed medication; the rate in the U.S. was virtually double.

Overall, 13.2 per cent of Americans said they had unmet health needs, compared to 10.7 per cent of Canadians. Himmelstein said the Canadian problem related to waiting times for care, but in the U.S. it was inability to get care at all because of cost barriers.

"Once you fall ill in the United States, your fundamental barrier to access - if indeed you have one - is your ability to pay. Whereas our fundamental barrier to access here is you get stuck on a long waiting list," said Dr. Tom Noseworthy, director of the University of Calgary's Center for Health and Policy Studies and a founding member of the new group Canadian Doctors for Medicare.

"But when you look at the end service - Do the people with low income have a better shot at getting service? Do our immigrants and non-whites have a better shot at getting service? - we're doing better," he noted.

"So it would suggest that a universal coverage system is acting to ameliorate some of the discrepancies that are otherwise found in our society."

There was one area where Americans fared better than Canadians. Despite being less healthy and having less access to a vastly more expensive health-care system, Americans are happier with their care than Canadians are.




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