Executive Summary
Comparing the healthcare systems of the United States and Canada is often undertaken by the government and public policy analysts. The United States and Canada deployed similar healthcare system during the period between the 60s and 70s. The United States expenditure on healthcare is more compared to the amount that Canada spends on healthcare delivery. As of 2006, the per capita expenditure for healthcare in Canada was approximately USD 3678 while for the case of the United States it was approximately USD 6714, which translates to about 10% and 15.3 percent respectively. 70% of healthcare spending in Canada is funded by the government while the United States government only funds 46 percent. Studies have reported different inferences with respect to the variations in the spending in healthcare for the two countries. Life expectancy in Canada is longer compared to the life expectancy in the United States; in addition, the infant mortality rate in Canada is lower compared to the United States infant mortality rates. The average life expectancy in Canada is 80.34 years while the mean life expectancy in the United States is 78.6 years. The Canadian healthcare system receives funding from both the public and the private sector with the private sector delivering most of the end-services.

Population and Health Status
Demographic characteristics of population
Canada’s 2006 census statistics reported that the population of Canada totaled to 31,612,897. This depicted an increase by a margin of 5.4 per cent in the previous census. This population growth can be significantly explained by increased immigration in Canada. The ethnic composition of Canada as reported by the 2006 census depicted the following: English (21 %), French (15.8 %), German (10.2 %), Ukrainians (3.6%), Scottish (15%), Chinese (4%) and Italians consisting of 5 %. Canada’s population is experiencing a demographic shift towards the older people, having more retirees and fewer people who are still of working age. Religious patterns indicate that indicate that 77 percent of Canadians identify themselves with Christianity, of which majority Catholics are making the largest group (The Daily 2008).
The population of the United States as of October 5, 2011 stands at 312, 313,000 ranking third in the globe. The United States is highly urbanized, with approximately 82 percent of its population residing in the urban centers, implying that most of its country has few inhabitants.
Mortality, Infant mortality data
The United States has a death rate of 8.3 per 1000 population. The US infant mortality rate stands at 6.2 deaths per 1000 live births. Life expectancy of the total population is 78.11 years.

Availability of Services
Basic organization/general description of services institutions, providers of care
The Canadian healthcare receives funding using a single payer system that makes use of the tax revenue. This means that the government incurs a significant part of the medical costs in Canada. Canadian health care is provided and delivered via a publicly funded health care, which is more often than not free at the time of use and offers most services that might be offered by other private hospitals. It is usually guided by the provisions provided by the Canadian health act. The Canadian government has to assure and offer its citizens the quality healthcare services they deserve through the federal standards that have been set. The Canadian government does not participate in the daily activities of the hospitals; neither does it collect any sort of information about the health of an individual. Such vital information remains to be private and confidential between the customer and the hospital or rather the physician or doctor.
Health care has been a contentious subject in the United States since the historical times. This is evident through the various reforms that have been witnessed under different government regimes, including the recent Obama regime. The federal law has always lacked enough provisions towards the health care sector. In the US, healthcare ownership is mainly concentrated in the private sector, with the state, federal and local governments owning some of the healthcare facilities. The United States lacks a nationwide system of medical facilities that are under the ownership of the government that are supposed to be accessed by the public.

Issues related to access
In both countries, access to healthcare is a significant problem. Research has reported that approximately 40 percent of the United States citizens lack sufficient healthcare insurance. In Canada, approximately 5 percent of the population lacks the capability to access a regular doctor while an additional 9 percent have never bothered looking for a doctor. The difference is that every Canadian citizen is sufficiently covered by the national healthcare system.
In the United States, the federal government does not guarantee universal access to healthcare; however, there are programs under the publicly funded healthcare system that addresses the healthcare needs for the old people, children, poor and people with disability.
Utilization of services
The Canadian healthcare system makes use of the Medicare based systems that are provincially based, this is because they make the administration of the healthcare easy and cost efficient. In each of the provinces, the doctors are responsible for handling the insurance claims against the medical insurance companies. This implies that the patient is not directly involved in the billing and the process of reclaiming; rather it is the responsibilities of the doctors (Krauss, 2010). The Canadian healthcare system comprises of a mix of both private and public hospitals. The healthcare institutions, whether private or public has the mandate to report to the provincial administrations. An overview of the Canadian healthcare system depicts that it is a public system due to that it is publicly funded and that the delivery of healthcare is based on public policies. The costs incurred in receiving care are catered for by the funding received from the income taxes and monthly premiums that are fixed. Those having low incomes have the benefit of either having the premiums subsidized or waived. In some cases, individuals can enroll for the health Card program, which is an initiative of the Provincial Ministry of Health (Gao, 2008). Those under the program are subject to receive the same level of healthcare. An important aspect of the Canadian Healthcare system is that healthcare coverage is not affected by factors such retirement, loss of jobs and change of jobs. Provided the premiums are paid on a regular basis and they are up to date, there is no limits or exclusions for the beneficiaries of the healthcare coverage (National Bureau of Economic Research, 2011). Medications that are considered to be of pharmaceutical nature are catered for by the public funds for the elderly. Canadians who are employed can cater for pharmaceutical medication by using employment based private insurance. An important aspect of the Canadian healthcare system is that the Government is in charge of controlling the drug prices and distribution, as result, the distribution of healthcare services is equitable in Canada. Individuals have the mandate to choose their family physicians (Krauss, 2010).

Expenditures
The Canadian healthcare system is a single payer system, implying it is majorly publicly funded, with the government accounting for approximately 70 percent of the healthcare costs (Krauss, 2010). Under the Medicare provisions, healthcare costs are only cared for if delivered in the hospitals or by known physicians. Most of the government funding originates from the provincial level, which is approximately 94 Per cent of the total government funding. Different provinces have different Health costs per capita, with Quebec province having $4891, British Columbia having $5254 at the lower end and Alberta having $ 6072 and New Found land having $ 5970 at the higher end (National Bureau of Economic Research, 2011).
Government incurs a significant portion of the healthcare costs in Canada; approximately 70 percent. The largest government initiative in Canadian healthcare is the Medicare program, which is implemented at the provincial levels (Krauss, 2010). The Medicare program is based on the provisions under the Canada Health Act. Most of the government spending is directed towards the healthcare of the Canadians. The government also administers healthcare directly to organizations such as the Canada military, the Federal prisons and the Police. Native Canadians are the most prioritized by the Canadian Government and the government guarantees full medical coverage to them through an initiative under the Medicare plan called Native Reserves. Despite most of the health care costs being under the provincial government, the Federal Government significantly funds healthcare initiatives (National Bureau of Economic Research, 2011). The private sector accounts to approximately 30 per cent of the Canadian Health care costs. This is mostly due to the services that are not provided for under the Medicare. Such services include prescriptions and dentistry. Despite the public funding of the Canadian Healthcare system, most of the services are delivered by the private sector. Approximately 75 per cent of the Canadian healthcare services are delivered privately.
Data on total expenditures
Present estimates report that the United States expenditure on healthcare stands at approximately 16 percent of the Gross Domestic Product, which is high compared to Canada, who healthcare expenditure accounts for only 10 percent of the Gross Domestic Product. The United States spends more on healthcare compared to Canada both in terms of the per capita basis and as a percentage of the Gross Domestic Product. On a per capita basis, the United States USD 6714 on healthcare while Canada spends USD 3768 on healthcare delivery 70 percent of healthcare expenditure is undertaken by the government compared to Canada whereby the government undertakes 46 percent of the healthcare expenditure.
Macro environmental Influences
Political
The Canadian and the United States governments are both actively involved in the healthcare systems of both countries. The only difference that is structural is in terms of health insurance. In Canada, the federal government has an obligation to offer funding support to the various provincial governments to take care if the healthcare expenses provided that the provincial government complies with the requirements of the Canada Healthcare Act. The Canadian healthcare system also offers coverage for private healthcare delivery. This is contrary to the United States whereby the direct funding of healthcare by the government is restricted only to Medicare, Medicaid and the State Children’s Health Insurance Program
The overall nature of the health care sector required major reforms coupled by the fact that the federal law has fewer provisions for the health care sector in the United States. The starting point of these reforms was through the enactment of the new health care law by President Barrack Obama. One of the significant driving factors for the health care reform in the United States was the need to regulate the health care insurance industry. The new health care law was aimed an extending coverage to the health care insurance mandate. The new health care law has provisions which are to be implemented in the coming four years. One of them including an expansion of the Medicaid to include 133 per cent of the federal poverty level, a reduction of the insurance premiums for individuals in the 400 per cent of the federal poverty line, provision of incentives for business organizations to cater for health care insurance schemes for its employees, restricting health care insurance firms from set up of the yearly insurance caps, and provide adequate support in the field of medical research. The new health law also aims regulation of the health insurance industry through the establishment of the health insurance exchanges.
Socioeconomic
Most of the hospitals in Canada are cost effective. This is attributed to the fact that their administration is simple and easy to deal with. It therefore goes without say that Canadian hospital services are better off as compared to those in other countries, which are highly contributed by the fact that Canada has a good governing system in place that ensures order, and the law is adhered to the later.
Cultural
There are notable demographic differences between the United States and Canada, which in turn imposes significant differences regarding the health outcomes of the countries. Despite the fact that all the countries have a significant white population, Canada has a larger percentage of immigrant minority population compared to the United States. in addition, there are significant differences regarding the composition of the racial groups. Studies have reported that aboriginals in both the countries have high rates of mortality and less life expectancy compared to the white population. The Canadian aboriginals have a shorter life expectancy compared to the aboriginals in the United States. In addition, there are health outcome variations between the aboriginals and the whites in Canada is larger compared to the differences in the United States.
Technological/Other relevant influences
The United States invest more on healthcare technology compared to Canada. A study regarding the use of medical imaging in Canada reported that Canada has approximately 4.6 MRI scanners/ a million populations. The United States on the other hand had approximately 19.5 MRI scanners per one million populations. The technological disparity among the countries results to long wait times in Canada compared to the United States

Summary comments
Presently, the health care sector is one of the most vibrant industries in the United States. Different players in the sector have different roles ranging from the provision of health care services, health care insurance schemes and other associated medical services. With the current nature of the sector, major reforms were required in order to streamline the industry, and consequently, there is possibility that the United States can try the Canada healthcare system to evaluate its applicability on the United States population.

Bibliography
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