Health Care Access in Three Nations: Canada, Insured America, and Uninsured America

Abstract

This analysis provides new statistics for one of the oldest and fiercest debates in American health policy: whose residents have better access to health care, the United States' or Canada's? Data from the 2002–2003 Joint Canada U.S. Survey of Health show that, despite major differences in their health systems, most Canadians and Americans get the care they need. However, one group of Americans is much more likely to report serious access barriers—the uninsured. About one-third of currently or recently uninsured Americans, aged 18 to 64, said they could not get needed health care (over three times the rate of insured Americans or Canadians). Compared with Canadians and insured Americans, the uninsured are less likely to use hospital or physician services, and those who do are less satisfied with the care they receive. They are also less likely to purchase prescribed medications, due to cost. From a consumer perspective, the most salient feature of the Canadian system is its universality. In contrast, insured Americans under age 65 are at risk of losing their insurance and facing substantial access barriers.