Americans’ Experience of Health Care Systems: An Exploratory Study

Highly educated, high-earning Americans do not uniformly favour either the Canadian or the American health care systems, but approve of different elements of each


The purpose of this project was to inform health policy debates by determining how American émigrés to Canada view the Canadian health care system. The study was delimited to include only Americans who had experienced both the Canadian and the American health care systems as adults. It intended to provide important information on the relative strengths and weaknesses of the two systems, create an opportunity to inform and influence both systems, and thereby impact Canadian health care policy about priorities, resource allocation and the organization of care. The Americans targeted in this study represented a highly educated population, with an above average income – a sample population which while unrepresentative of Americans generally, reflected Canadian immigration policy. The study tested the hypothesis that Americans would find the American system superior to the Canadian system, on the basis that the sample group likely experienced the best of the American system when they lived in that country. Findings that rejected the hypothesis were seen to constitute an implicit, unexpected and significant endorsement of the Canadian system.

Grant Outputs

What Prosperous, Highly Educated Americans Living in Canada think of the Canadian and US Health Care Systems –

This study assessed the views of 310 American émigrés living in Canada. They reported on their experiences using both the Canadian and American health care systems. The sample group was unrepresentative of Americans more generally, as 58% of respondents held a master’s degree or higher and 51% of those surveyed had an annual yearly household income of over $100,000. The report concludes that 45% of this group preferred the American medical system to the Canadian system, but 40% preferred the Canadian system to the American system. The features of the US system rated most positively were timeliness and quality, while those rated most highly in the Canadian system were equity and cost-efficiency.

Grant Details

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