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HCA 4303, Comparative Health Systems 1
Course Learning Outcomes for Unit IV

Upon completion of this unit, students should be able to:

1. Compare and contrast the financial and interventional factors found within both a developed country
and also a developing country.

Reading Assignment

Chapter 5: The Healthcare System in Canada

Chapter 12: The Healthcare System in India

Unit Lesson

In this unit, we will examine the Canadian and Indian healthcare systems. More specifically, we will compare
and contrast the two countries in relationship to their status financially and functionally. Although these two
cultures are very different and describing those differences would be relatively easy, they are actually very
similar in comparison. For example, both Canada and India have a government-managed and funded care

The Canadians passed a healthcare act in 1984 that provides universal access to, and payment for
emergency care, as well as many routine and preventive care procedures. India’s system is also administered
by the government with the bulk of the hospital and clinical care provided by private corporations. Unlike
Canada, the Indian healthcare system is grossly underfunded and inadequate (Lovett-Scott & Prather, 2014).

Other similarities between India and Canada include the fact that both countries have difficulties with access
to health care in rural areas, both face long waits for diagnostic tests and non-emergency procedures even in
urban settings, and neither health system provides any significant funding for dental care. Additionally, the
people of both countries have the security of knowing that they will not be burdened with exorbitant hospital
bills and other medical costs incurred from a catastrophic medical condition. But both report paying for much
of their routine care out of their own discretionary funds.

In this unit, you are asked to do something very similar to the paragraphs above by developing a “memory
matrix” to practice gathering information about two countries and comparing and contrasting their primary
characteristics. This is as simple as drawing a table and using a y axis (vertical) to list the characteristics you
are examining and the x axis (horizontal) to list the two groups you wish to compare and contrast; in this case,
it would be India and Canada. Sorting and cataloging these characteristics helps to show patterns as well as
to highlight certain aspects that might be missed if not examined side-by-side.

A comparative analysis requires us to look for similarities and dissimilarities between two or more groups. It is
also important to look for connections that are not immediately apparent. There is one very interesting
connection related to the Canadian and Indian healthcare delivery systems; Canadians are large consumers
of medical tourism in India (Turner, 2011). The term medical tourist is typically used to describe someone that
travels outside of their own country to receive medical care that they would not be able to receive or afford in
their home country.

According to research conducted by the Deloitte consulting firm, healthcare costs are increasing each year in
most developed countries, yet the cost is being managed better in certain developing nations (Deloitte Center
for Health Solutions, 2008). The former legitimate concerns about the safety and quality of care available in
India Compared to Canada in Regards
to Finance and Interventional Strategies

HCA 4303, Comparative Health Systems 2

many countries is no longer an issue since organizations such as the Joint Commission International (JCI)
and others are accrediting these facilities.

Knowing that Canadians face lengthy waits for numerous medical procedures, it stands to reason that those
with the financial means to do so would entertain the concept of seeking care in other countries. Although
many of the countries provide outstanding care in state-of-the-art facilities, their decreased overhead allows
them to provide the care at a fraction of the cost. Much of the medical tourism business has an element of
tourism along with the medical care. Hotel chains, resorts, and spas often offer a complete package allowing
patients to rest and recuperate in first-class style. Companies in Canada specialize making all the
arrangements to include air travel to India, ground transportation, passports, visas, meals, sight-seeing, and
luxurious living accommodations.

As a point of reference, Table 1 compares the cost of six common surgical procedures in the United States
and Canada. No wonder why affluent Americans and Canadians would choose to maximize their resources
by shopping around for the best deal. Other specialty services include reproductive health, dental care, and
plastic surgery. People from around the world also visit developing countries to purchase organ transplants—
an illegal practice in most countries.

Table 1. Comparative Analysis of Cost of Care in United States versus India

Hysterectomy $20,000 $3,000 15
Knee Replacement $40,000 $8,500 21
Hip Replacement $43,000 $9,000 21
Angioplasty $57,000 $11,000 19
Heart Bypass $130,000 $10,000 7
Heart Valve
$160,000 $9,000 6
(Woodman, 2008)

One interesting and rapidly growing component of medical tourism surrounds the elderly. Canadians face
long waiting lists to enter a long-term care facility and then often experience poor quality of care once
admitted. Conversely, the Indian culture reveres the elderly and puts forth great effort to make their final years
pleasurable and to maintain their health as long as possible. This concept was driven home in the movie The
Best Exotic Marigold Hotel, a 2012 British comedy-drama film directed by John Madden in which a cast of
elderly men and women find life in India to be tranquil, restorative, and affordable.

It is worth reiterating here that India is not the only country that is developing a niche market within health
care by providing services at a reduced price to those from wealthier countries. However, it is important to
understand this phenomena is not likely to end in the near future since the supply under managed care will
continue to exist as will the desire for countries such as India to capitalize on the opportunity.

Hopefully, this discussion comparing and contrasting the financial and interventional aspects of India and
Canada as well as elaborating on their connection within the business of medical tourism has been helpful.
You will now have an opportunity to review this material by building your memory matrix. By being able to do
this, you are one step closer to being able to comparatively analyze any two countries on the eight key factors
of determining true access to care!


HCA 4303, Comparative Health Systems 3

Deloitte Center for Health Solutions. (2008). Medical tourism: Consumers in search of value.

Lovett-Scott, M., & Prather, F. (2014). Global health systems: Comparing strategies for delivering health
services. Jones and Bartlett Learning.

Turner, L. (2011). Canadian medical tourism companies that have exited the market: Content analysis of
websites used to market transnational medical travel. Globalization and Health, 7(40), 1–16.

Woodman, J. (2008). Patients beyond borders: Everybody’s guide to affordable, world-class medical travel
(2nd ed.). Healthy Travel Media.

Key Terms

1. Activities of daily living
2. Long-term care
3. Medical tourism
4. Single payer
5. Universal health coverage

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