I made six charts comparing US and Canadian healthcare spending
Last edited Mon Nov 30, 2015, 01:08 AM - Edit history (1)
I'm still playing around with Mathematica, and I thought I'd practice doing charts again.
I took these data from Canada's CIHI NHE report and the US's CMS NHE report, and converted Canada's amounts to US dollars.
First, let's look at Canada's healthcare spending by the source of the money:
As you can see, the lion's share of healthcare payments are made by the provinces, with a sizeable chunk by out of pocket spending and private insurance (not all drugs are covered in all circumstances; you can pay for a room upgrade in a hospital; some voluntary procedures aren't covered, etc.; it's not as if literally all healthcare spending in Canada is public money, in fact about a quarter is private money).
Now we can compare it to the US's healthcare spending by source:
As you can see, the Federal government and private insurance roughly split the lion's share, there's a whole category of "charity" that doesn't exist in Canada (it actually does; I just couldn't make it visible on the Canada chart because it's so small), and out of pocket and state/local governments pick up most of the rest (the "capital" wedge in both cases is an accounting convention about how you deal with things like mortgages on buildings and R&D -- a hospital might pay $100 million for a new wing, but that cost notionally gets spread out over decades).
One interesting point pops out immediately: Canada funds a higher percentage (14%) of its total spending out-of-pocket than the US does (12%), though because our costs are so much higher our per capita out of pocket spending is more, as we'll see here:
This is per capita healthcare spending in US dollars (Canada is on the left, the US is on the right).
We exceed Canada in per capita spending from every source except local government (I'm using "local" to encompass mostly both provinces and states, though smaller jurisdictions do also provide some funding in both countries). However, that may just be a Federalism issue: our per capita public spending ($4129) is fairly close to Canada's per capita public spending ($3245), we just do more of that spending federally.
Our per capita capital spending is higher too: $516 in the US vs. $148 in Canada. Some of this reflects the fact that we have more research labs and institutions in the US, but it also points to a bigger issue. Canada has 4.17 hospitals per 100K people, while the US has only 1.79 hospitals per 100K people -- the fact that their capital expenses are so much lower than ours is surprising, given that, and particularly given their lower population density overall (which generally makes infrastructure more expensive).
And, of course, our huge funding difference is in private insurance: $3022 per capita in the US vs $560 per capita in Canada.
So that's where our monies are coming from. Where are they going? Here's Canada:
and here's the US:
Not really much of a difference stands out there. We are spending more than Canada as a percent of total on overhead (8% vs 3.1% -- this includes public program administration costs and private insurance profits in both countries), hospitals (35.7% vs. 29.6%), and physicians (22.3% vs. 15.5%), while spending less than Canada as a percent of total on nursing homes (5.9% vs 10.1%), and drugs (10.1% vs. 15.8%).
But, again, that's only relative to each country's total healthcare spending. When you look at absolute per capita spending, it's immediately apparent how much more we pay for every service than Canada does:
Note that pharmaceuticals and nursing homes (labeled "other institutions" here) are essentially identical per capita between both countries -- we aren't really paying much more for drugs than Canada is. We're paying more in overhead (though not all that much in absolute terms), a lot more for physicians, and a hell of a lot more to hospitals.
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