The healthcare systems in the United States, Canada, and Great
Britain provide interesting comparisons to one another, especially
since the U.S. system is considered private and Canada and Great
Britain each have national health systems that supply universal
coverage. National health systems are theoretically designed to
provide accessible, affordable care for all segments of the
population, but critics of such systems often question the quality
of that care. Conversely, critics of the U.S. system often point to
the fact that affordable, high-quality healthcare is not equally
available to all who need it.
How do Americans, Canadians, and Britons compare in their views
of the availability and quality of healthcare in their respective
countries? In surveys conducted in January* and February 2003**,
Gallup asked residents of these three nations identical questions
regarding the availability of affordable healthcare and the quality
of medical care.
The Availability of Affordable Healthcare
One-fourth of American respondents are either "very" or
"somewhat" satisfied with "the availability of affordable
healthcare in the nation," (6% very satisfied and 19% somewhat
satisfied). This level of satisfaction is significantly lower than
in Canada, where 57% are satisfied with the availability of
affordable healthcare, including 16% who are very satisfied.
Roughly 4 in 10 Britons are satisfied (43%), but only 7% say they
are very satisfied (similar to the percentage very satisfied in the
United States).
Looking at the other side of the coin, 44% of Americans are very
dissatisfied with the availability of affordable healthcare, and
nearly three-fourths (72%) are either somewhat or very
dissatisfied. The 44% in the United States who are very
dissatisfied with healthcare availability is significantly higher
than corresponding figures in either Canada (17%) or Great Britain
(25%).
The views of Americans on the quality of medical care in
their country are not overly different -- 48% of Americans, 52% of
Canadians, and 42% of Britons say they are satisfied. However,
Americans are slightly more likely than Canadians or Britons to
rate this issue at one extreme or the other. The proportion of
respondents who are very (as opposed to somewhat) satisfied with
the quality of healthcare in the United States is 17%, while the
proportion who are very dissatisfied is 26% -- so 43% of
Americans fall at the extremes of this scale. In the other two
countries, the middle ground of "somewhat" satisfied or
dissatisfied respondents tends to be larger. In Canada, 13% are
very satisfied, while 22% are very dissatisfied -- so 35% of the
public is at the extremes. In Great Britain, 11% are very
satisfied, while 23% are very dissatisfied -- a total of 34% is at
the extremes.
Bottom Line
In all three countries, there is great variation of opinion
within the population on both the quality of medical care and the
availability of affordable healthcare. It is a testament to
national health systems that people in Canada and Great Britain are
significantly more satisfied with availability of affordable
healthcare than their American counterparts are.
In Great Britain, satisfaction with access to affordable
healthcare (43%) is consistent with satisfaction with
quality (42%). In Canada, satisfaction with access to
affordable healthcare (57%) is slightly higher than satisfaction
with quality (52%). But the most dramatic variation in satisfaction
with these two facets of the healthcare system occurs in the United
States, where only 25% are satisfied with the availability of
affordable healthcare, but 48% are satisfied with quality. Once
again, this dichotomy seems to support the hypothesis that private
healthcare encourages high-quality standards, but may be a barrier
to access and affordability.
On a less relative basis, the fact that 72% of Americans say
they are dissatisfied with the availability of affordable
healthcare, and 50% are dissatisfied with the quality of medical
care are cause for concern. Regardless of how these numbers measure
up to those in Canada and Great Britain, they indicate that the
U.S. healthcare system has considerable room for improvement.
*Results are based on telephone interviews with 1,000 national
adults, aged 18 and older, conducted Jan. 13-16, 2003. For results
based on the total sample of national adults, one can say with 95%
confidence that the maximum margin of sampling error is
±3%.
**Canadian results are based on telephone interviews with a
randomly selected national sample of approximately 1,000 Canadian
adults, aged 18 and older, conducted Feb. 3-9, 2003. For results
based on this sample, one can say with 95% confidence that the
maximum error attributable to sampling and other random effects is
±3%.
British results are based on telephone interviews conducted by
the Gallup U.K. poll with approximately 500 respondents, aged 18
and older, from across Great Britain, conducted Jan. 29-Feb. 10,
2003. For results based on this sample, one can say with 95%
confidence that the maximum error attributable to sampling and
other random effects is ±5%.
