Forget Hockey – Who Gets Better Healthcare?

Danny Williams, the premier of the Atlantic Canadian province of Newfoundland and Labrador raised heckles in his home country and cheers for private healthcare from Canadian and American conservatives when he recently decided to travel to Florida for a complex heart operation.  Although Williams’ decision does reveal something important about the difference between the Canadian and U.S. healthcare systems, however, it’s hardly a clear cut case of American medical superiority.

The facts are these: the underlying surgery that Williams wanted, mitral valve heart surgery, is done at just about every major hospital in the developed world. The specific procedure he had in mind, a minimally invasive one that has a shorter recovery time and leaves a much smaller scar, is a big patient comfort improvement but doesn’t necessarily improve long-term survival rates. A number of Canadian hospitals—mostly in the vicinity of Toronto—do perform the same procedure but it originated in Miami with the surgeon that did Williams’ operation.

So it appears that Williams went to the United States because he would have had to travel a long distance anyway to get the procedure he wanted done (Toronto is more than 1,500 miles from Newfoundland’s capital in St. John’s) and because the United States has a more innovative medical system that provides superior patient comfort. The overall medical outcome, although not his recovery time or physical appearance, probably would have been the same if a surgeon in Newfoundland had done mitral valve surgery on him. (Williams probably would have had to wait longer to get the surgery in Canada although the most skilled American medical specialists also tend to have pretty long waiting lists themselves.)

Williams’ need to travel, furthermore, does stem from different national healthcare priorities rather than economics. While Newfoundland is poor—the per capita income of $29,000 is lower than that in any American state—poverty can’t explain the difference. West Virginia, America’s poorest state by some measures, has a per capita income just only a few dollars higher than Newfoundland’s but at least one hospital there does the procedure Williams traveled to Miami to get.  U.S. hospitals, in general, have more high-tech imaging devices (CT scanners and MRIs) than their Canadian counterparts, invest much more in research, and tend to require much shorter waits for most procedures.

That said, it’s easy to make too much of the differences between. Both the Canadian and U.S. healthcare systems consist of mostly privately run hospitals and doctors that compete with one another manage their own practices but receive a large percentage of their revenue from the government. Both governments, furthermore, engage in central planning that determines whether new hospitals and other large scale facilities can be built. In both systems, furthermore, well off people get better care and tend to be in better health than the poor. (In fact, the health/wealth gradient is slightly steeper in Canada.)

Danny Williams’ decision, in short, does illustrate some of the American medical systems’ advantages over its Canadian counterpart. But, as the systems have so many similarities, it isn’t surprising that these advantages aren’t all that large.