The significant difference between Canada and the United States in respective share of productive activity consumed by healthcare has emerged only since 1971, This difference, currently about 2.5 percent of GNP, is concentrated in three components — medical care, hospital care and administration. Highlighted are the Canada-U.S. dissimilarities, both in overall healthcare cost and experiences since 1971. The reasons are tracked to greater U.S. hospital daily servicing intensity, higher U.S. physician fees, and the cost of the fragmented public-private U.S. system of administration and regulation.
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References
1.
SapolskyH.M.1986. Prospective payment in perspective. Journal of Health Politics, Policy and Law11(4): 633–645.
2.
Health Care Financing Administration. 1987. National health expenditures, 1986–2000. Health Care Financing Review8(4): 1–36.
3.
Health and Welfare Canada. 1987. National Health Expenditures in Canada. Ottawa: Minister of Supply and Services.
4.
The rate of exchange used is CAN $1 = US $0.74 to represent the 1985 experience.
5.
McLarenC.1988. OHIP reimburses 600 patients for illegal extra billing by MDs. The Globe and Mail April 12: A17.
6.
TaylorM.1978. Health Insurance and Canadian Public Policy. Montreal: McGill-Queen's University Press.
7.
EvansR.G.1986. Finding the levers, finding the courage: Lessons from cost containment in North America. Journal of Health Politics, Policy and Law11(4): 585–615.
8.
GibsonR.M.WaldoD.R. and LevitK.R.1983. National health expenditures, 1982. Health Care Financing Review5(1): 1–31.
9.
Health and Welfare Canada. 1984. National Health Expenditures in Canada, 1970–1982. Ottawa: Minister of Supply and Services.
10.
HimmelsteinD.U. and WoolhandlerS.1986. Cost without benefit: Administrative waste in U.S. health care. New England Journal of Medicine314(7): 441–445.
11.
BarerM.L. and EvansR.G.1986. Riding north on a south-bound horse? Expenditures, prices, utilization and incomes in the Canadian health care system. 53–163. In Medicare at Maturity: Achievements, Lessons and Challenges, EvansR.G. and StoddartG.L., eds. Calgary: University of Calgary Press for the Banff Centre School of Management.
12.
NewhouseAndersonG. and RoosL.L.1988 forthcoming. What accounts for differences in hospital spending between the United States and Canada: A first look. Health Affairs.
13.
BarerM.L.EvansR.G. and LabelleR.1988 forthcoming. Fee controls as cost control: Tales from the frozen north. The Milbank Quarterly66(1).
14.
EvansR.G.1988. The Long Goodbye: The Great Transformation of the British Columbia Hospital System. Vancouver: Health Policy Research Unit, University of British Columbia.
15.
FeenyD.GuyattG. and TugwellP.1986. Health Care Technology: Effectiveness, Efficiency and Public Policy. Montreal: The Institute for Research on Public Policy.
16.
StoddartG.L. and SeldonJ.1984. Publicly financed competition in Canadian health care delivery: A proposed alternative to increased regulation?121–143. In Proceedings of the Second Canadian Conference on Health Economics, BoanJ.A., ed. Regina: J.A. Boan.
17.
LomasJ. and BarerM.L.1986. And who shall represent the public interest? The legacy of Canadian health manpower policy. 221–286. In Medicare at Maturity: Achievements, Lessons and Challenges, EvansR.G. and StoddartG.L., eds. Calgary: University of Calgary Press for the Banff Centre School of Management.
18.
BarerM.L.EvansR.G. and StoddartG.L.1979. Controlling Health Care Costs by Direct Charges to Patients: Snare or Delusion?Toronto: Ontario Economic Council.