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Research Letter
Dec 10/24, 2012

Cost Control in a Parallel Universe: Medicare Spending in the United States and Canada

Author Affiliations

Author Affiliations: School of Urban Public Health at Hunter College, City University of New York, New York, New York.

Arch Intern Med. 2012;172(22):1764-1766. doi:10.1001/2013.jamainternmed.272

As the United States was implementing Medicare in 1966, Canada was phasing in its own Medicare program, which covered all Canadians under provincially administered plans. While these provincial plans varied, all incorporated significant payment reforms—global budgeting of hospitals and stringent capital expenditure controls—and banned copayments and deductibles.

Before the mid-1960s, the 2 nations' health care financing systems were similar, and health care costs were comparable.1 Since then, overall US costs have grown more rapidly, but no study has compared spending for the elderly—the populations covered by Medicare in both nations.

We obtained official figures for Medicare spending for persons older than 64 years in Canada and the United States for 1971 (when Canadian Medicare became fully operational) through 2009. Since available Canadian data for 1971 through 1979 are less detailed, we focus principally on changes since 1980.