Healthcare spending is quite high in both Canada & the U.S. However, the outcomes for people in each country aren’t the same, with a few differences showing up early in life, and others much later. A few of the differences are hidden behind how people interact with the system each day.
Here are ten differences in healthcare outcomes between Canada and the United States. Some are small, and others are much more significant. Which one do you think you’d notice first after crossing the border?
Life expectancy gap
OECD data has consistently shown that Canadians have longer life expectancy than their neighbour south of the border. The average life expectancy for Americans in 2023 was about 78.4 years, but the rate for Canadians is 81.7 years.
Interestingly, the USA’s life expectancy is lower than most of its peers, including the United Kingdom. Canada’s life expectancy is slightly higher than the OECD 38 average.
Infant mortality
The OECD also looked into infant mortality rates across 38 countries, counting the number of deaths before a person reaches the age of one in 1,000 live births. The 2021-2023 average puts the infant mortality rate in the United States higher than that of Canada at 5.5 deaths.
Canada is currently above the very lowest OECD countries at 4.5 deaths. But the infant mortality rate in the United States is still a lot higher than the majority of OECD 38 countries.
Diabetes prevalence
The number of people diagnosed with diabetes in Canada was around 9.7% in 2023-2024, according to data from Canada’s Public Health Infobase. That’s about 3.9 million people. 1.9% of Canadians aged 20 to 79 are reported to have undiagnosed diabetes.
The diagnosed rate in America is slightly higher at 11.6% of the total population, or 38.4 million people. The CDC estimates that 8.7 million Americans have undiagnosed diabetes.
Treatable mortality under age 75
The treatable mortality rate is the number of people who have died from things that could’ve been avoided, had they received timely & proper medical care. The number of deaths from avoidable causes in Canada was approximately 184 per 100,000 people under 75 in 2023.
Sadly, the rate in the United States was much higher at 312 deaths per 100,000 people. The rate in Canada is about the same as it was in 2013, but is quite a bit higher in America since then.
Regular primary care attachment
A regular primary care provider is the professional person you go to for routine checkups & preventive care, and other things. Data from the Commonwealth Fund found that 83 to 90% of Canadians have a regular primary care provider.
The rate in 2019 in the United States was a lot lower at 74%. In fact, figures have fallen by around 10% since 2000 in America, as the regular primary care attachment rate was recorded at 84% in that year.
ED waits
One area that Canada fails in, compared to the United States, is with wait times in the emergency department. The average time Canadians have to wait in the emergency department before they are first assessed by a clinician is between 1.4 & 3 hours.
But the average American only has to wait around 24 minutes to be seen in the emergency departments. The wait time is starting to increase in the United States, yet it’s nowhere near as bad as it is in Canada.
Cost-related skipping of care
One under-reported aspect of healthcare outcomes is the number of people who skip doctor visits or tests, even prescriptions, because of the cost. Around 36% of Americans have skipped necessary healthcare due to the cost, and 21% have avoided getting their prescriptions filled for the same reasons.
Data from the Commonwealth Fund has found that Canada has some of the lowest rates of people avoiding necessary healthcare due to costs. Other reports indicate that Americans suffer from higher out-of-pocket costs than Canadians do. It’s mostly because of Canada’s core public coverage.
30-day hospital readmissions
Leaving the hospital doesn’t necessarily mean that you’re completely cured, and the rate of all-cause hospital readmissions shows that. The number of people readmitted after 30 days across Canada is around 9.4 per 100 people (adjusted for patient risk).
The rate’s a little higher in the United States at 13.9 readmissions for every 100 admissions. It seems that, in America, you have a higher risk of needing to go back to the hospital after you’ve been treated.
Prescription drug spending per person
Most people know that healthcare is expensive in the United States. OECD reports show that the average American spends around USD$1,713 per year on medical drugs, adjusted for purchasing power.
Canadians tend to spend roughly $990 per year on retail pharmaceuticals. The American rate is actually the highest of all OECD countries studied.
Administrative load and paperwork
Nobody likes to fill out a bunch of paperwork before they get treated. Thankfully, Canadian patients often have to deal with fewer billing steps for hospital & physician services than Americans do.
Most Americans have higher administrative costs & complex billing processes to deal with. In fact, around 15 to 30% of healthcare spending in the United States comes from administrative costs.
Sources: Please see here for a complete listing of all sources that were consulted in the preparation of this article.
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