A Comparison of Perceptions of and Experiences in the Health Insurance Systems of Canada, France, United Kingdom, and the United States of America

Health insurance systems are a hot topic within the contexts of current events, politics, health policy, and health administration. Analysis of variables within the 2010 Commonwealth Fund International Health Policy Survey reveals interesting and noteworthy similarities and differences between citizens' experiences of Canada's National Health Insurance model, France's Bismark model, the United Kingdom's (UK) Beveridge model, and the United States of America's (US) mixed-model of healthcare. Kruskal-Wallis tests (p≤.001) and Goodman and Kruskal tau tests (p≤.001 on 6 variables and p≤.05 on 1 variable) of survey responses to the themes of “system views and confidence,” “affordability and cost-related access barriers,” “access to needed care and wait times,” and “primary care and patient-centered care” identified significant differences between the countries. The results suggest that although the US leads in patient-centered care and short wait times for specialists, it lags behind the other three nations on the confidence of receiving effective care, affordability of needed care, and affordability of pharmaceuticals. The majority of French respondents reported confidence in the affordability of needed care; however, they had the second longest wait time to see a specialist. Canadian respondents had the most concern about lengthy times for diagnosis. The UK had the most favorable responses across the four themes. Policy makers and administrators can apply these results to policy development and reform decisions.