The Rheumatologist
COVID-19 News
  • Connect with us:
  • Facebook
  • Twitter
  • LinkedIn
  • YouTube
  • Feed
  • Home
  • Conditions
    • Rheumatoid Arthritis
    • SLE (Lupus)
    • Crystal Arthritis
      • Gout Resource Center
    • Spondyloarthritis
    • Osteoarthritis
    • Soft Tissue Pain
    • Scleroderma
    • Vasculitis
    • Systemic Inflammatory Syndromes
    • Guidelines
  • Resource Centers
    • Ankylosing Spondylitis Resource Center
    • Gout Resource Center
    • Rheumatoid Arthritis Resource Center
    • Systemic Lupus Erythematosus Resource Center
  • Drug Updates
    • Biologics & Biosimilars
    • DMARDs & Immunosuppressives
    • Topical Drugs
    • Analgesics
    • Safety
    • Pharma Co. News
  • Professional Topics
    • Ethics
    • Legal
    • Legislation & Advocacy
    • Career Development
      • Certification
      • Education & Training
    • Awards
    • Profiles
    • President’s Perspective
    • Rheuminations
  • Practice Management
    • Billing/Coding
    • Quality Assurance/Improvement
    • Workforce
    • Facility
    • Patient Perspective
    • Electronic Health Records
    • Apps
    • Information Technology
    • From the College
    • Multimedia
      • Audio
      • Video
  • Resources
    • Issue Archives
    • ACR Convergence
      • Systemic Lupus Erythematosus Resource Center
      • Rheumatoid Arthritis Resource Center
      • Gout Resource Center
      • Abstracts
      • Meeting Reports
      • ACR Convergence Home
    • American College of Rheumatology
    • ACR ExamRheum
    • Research Reviews
    • ACR Journals
      • Arthritis & Rheumatology
      • Arthritis Care & Research
      • ACR Open Rheumatology
    • Rheumatology Image Library
    • Treatment Guidelines
    • Rheumatology Research Foundation
    • Events
  • About Us
    • Mission/Vision
    • Meet the Authors
    • Meet the Editors
    • Contribute to The Rheumatologist
    • Subscription
    • Contact
  • Advertise
  • Search
You are here: Home / Articles / A Comparison of the Canadian and U.S. Healthcare Systems

A Comparison of the Canadian and U.S. Healthcare Systems

February 3, 2012 • By Simon M. Helfgott, MD

  • Tweet
  • Email
Print-Friendly Version / Save PDF

Second, the Canadian system delivers care privately (such as office, clinics, or hospitals) yet is financed by taxpayer dollars. For the most part, doctors are free to run their practices as private businesses. Depending on the province, physicians can bill patients separately for noncovered services, such as cosmetic dermatology or certain imaging and lab studies. Some rheumatologists in Quebec will charge their patients an additional $40 for the cost of supplies for joint injections. Other physicians have taken a page out of the American concierge medicine experience and adapted it to their system. Because there is a dire shortage of primary care physicians (PCPs), many are charging patients annual membership fees of about $200–$500 in order to join a practice. If a patient chooses not to join, then they must contend with an a la carte menu of eye-popping charges for the work their doctors perform. For example, the fee to fax a prescription refill can run as high as $30, and an e-mail reply to a patient costs about $50 to $75. Many of the provincial regulators have allowed these charges to continue, preferring not to clash with the dwindling number of PCPs.

You Might Also Like
  • Aetna CEO Urges Debate on What ‘Single-Payer’ Healthcare Would Be
  • Incident-To Guidelines for Nonphysician Healthcare Providers
  • Affordable Care Act Latest in Half-Century of Healthcare Reform
Explore This Issue
February 2012
Also By This Author
  • The ACR/ARHP Annual Meeting Provides Look Back at History of Rheumatology

Third, the system is fairly simple to operate. Everyone is issued a healthcare card, which serves as the “credit card” to cover services. This is great for the patient because there is no paperwork to complete and for the most part few, if any, copayments. Physicians submit their charges electronically so that most offices can run on a skeleton support staff. There is only one insurance plan to deal with and the rules and coverage are universal. According to a recent study in Health Affairs, physicians in Ontario only spent about 27% of the total money spent by the average U.S. physician in administrative costs. The per-physician cost of dealing with payers was $22,205 a year in Canada and $82,975 in the United States. They also wasted (my word) only 1/10th the amount of time spent by U.S. physicians in dealing with health plans, according to the study.

ad goes here:advert-1
ADVERTISEMENT
SCROLL TO CONTINUE

This ties into the fourth point; there is single list of covered procedures and charges. This is fairly straightforward when compared with the Untied States, where there are separate lists for Medicare, Medicare advantage plans, Medicaid, the Blues, the privates, the indemnities, the HMOs, and so on. In Canada, the submitted physician charge and the payment are identical. It is a non-negotiable amount and does not vary from provider to provider. No more bloated “paper charges” in an effort to drive up the cost of the receivable.

Potential Problems with Single Payer

So these are some of the wonderful attributes of the single-payer universal healthcare system. A casual observer may wonder why this type of plan has met with so much resistance in the United States. I think I can offer a few reasons.

ad goes here:advert-2
ADVERTISEMENT
SCROLL TO CONTINUE

Pages: 1 2 3 4 5 | Single Page

Filed Under: Legislation & Advocacy, Professional Topics, Rheuminations Tagged With: ACA, Affordable Care Act, Billing, Coding, drug, Healthcare Reform, Helfgott, imaging, International, Legislation, Medicare, Practice Management, single payerIssue: February 2012

You Might Also Like:
  • Aetna CEO Urges Debate on What ‘Single-Payer’ Healthcare Would Be
  • Incident-To Guidelines for Nonphysician Healthcare Providers
  • Affordable Care Act Latest in Half-Century of Healthcare Reform
  • Where the Presidential Candidates Stand on Key Healthcare Issues

Simple Tasks

Learn more about the ACR’s public awareness campaign and how you can get involved. Help increase visibility of rheumatic diseases and decrease the number of people left untreated.

Visit the Simple Tasks site »

Meeting Abstracts

Browse and search abstracts from the ACR Convergence and ACR/ARP Annual Meetings going back to 2012.

Visit the Abstracts site »

American College of Rheumatology

Visit the official website for the American College of Rheumatology.

Visit the ACR »

The Rheumatologist newsmagazine reports on issues and trends in the management and treatment of rheumatic diseases. The Rheumatologist reaches 11,500 rheumatologists, internists, orthopedic surgeons, nurse practitioners, physician assistants, nurses, and other healthcare professionals who practice, research, or teach in the field of rheumatology.

About Us / Contact Us / Advertise / Privacy Policy / Terms of Use

  • Connect with us:
  • Facebook
  • Twitter
  • LinkedIn
  • YouTube
  • Feed

Copyright © 2006–2021 American College of Rheumatology. All rights reserved.

ISSN 1931-3268 (print)
ISSN 1931-3209 (online)

loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.
This site uses cookies: Find out more.