Is the Canadian health care system more effective at expenditure control than previously thought? A reply to Peter...

In an article published by the Journal of Public Health Policy (Summer 1990), Peter C. Coyte argues that it is not empirically valid to say that the introduction of universal medical insurance in Canada successfully contained the growth in the share of society's resources devoted to the health care industry. During the period under consideration, both Canada and the United States witnessed several major policy changes in the provision and regulation of health services. Coyte's decision to apply a simple time trend to the data assumes away these changes, especially the introduction of universal medical insurance in Canada in 1971, whose influence on health expenditures is itself the primary subject of inquiry of this paper. We conclude that both the unadjusted and the adjusted data suggest that the Canadian universal health system has been a resounding success economically, once the appropriate periodization is applied to the data, reflecting the institutional and policy changes that took place. Finally, we propose suggestions for future research with respect to measuring resource usage in the Canadian and U.S. health care systems.