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Health Care Reform
by Michael Haederle, June 15, 2010
When she launched a comparative study of how middle-age people in the United States and Canada see their lives and the challenges of aging, Canadian sociologist Susan McDaniel thought Americans, with their can-do spirit of hardy individualism, would be the most resilient.
Instead, she found just the opposite.
“The Americans were saying–and this is a recurrent theme in almost every case–they felt as if they as individuals and as members of families had little control. And the Canadians much more often said, ‘Well, times are tough, but they could be worse. At least we have universal health insurance.’ ”
The study began in the fall of 2008, just as the U.S. housing market imploded and plunged the country into recession, ending this spring as the health care reform bill was making its way through Congress.
“Even though universal health insurance might be coming down the pike, these people are worried right now,” McDaniel says. “It’s almost on every front, this notion of ‘Oh my gosh, this is worrisome, and I don’t know what will happen if we age.’ ”
McDaniel, a professor at the University of Lethbridge in Alberta, recently presented some of the study’s findings at the 2010 Congress for the Humanities and Social Sciences in Montreal.
She and collaborators from Canada’s York University, the University of Utah and Duke University interviewed hundreds of working-class and middle-class Canadians and Americans ages 50 to 64. They resided in a Canadian city and a U.S. city that shared similar demographic profiles (although the cities were not identified).
“We asked people in midlife what life looks like for them on a variety of fronts, and then we asked them what they thought it would look like as they aged, how they thought it would compare with their older relatives now and how they thought it would be like for their younger relatives when they get to their senior years,” McDaniel says.
The study also found that more Americans live in multigenerational households than their Canadian counterparts, McDaniel says. “The national data tell us that there’s a much greater tendency in the past five years for large numbers of people to huddle together in the same home,” she says.
Middle-age respondents might share a house with their children or grandchildren, as well as their parents and even grandparents. “They’re really caught in the middle,” she says.
The health-related anxieties McDaniel and her colleagues uncovered among Americans appear to be grounded in fact.
A team of researchers from Portland, Ore., reviewed data from the Joint Canada/United States Survey of Health 2002-03 and found marked disparities in health-related quality of life and life expectancy between the two countries.
“A 19-year-old Canadian can expect to experience 2.7 more years of perfect health than her/his U.S. counterpart over their lifetimes,” they wrote in a paper published in April in the journal Population Health Metrics. At the same time, life expectancy is growing at a faster rate in Canada than in the United States.
The paper noted that Canada’s poverty rate is lower, particularly among the elderly. Meanwhile, income inequality is higher in the United States than in Canada, and the American insurance system is a patchwork of employer-based programs, while Canada provides universal health coverage with no copayments for medical and hospital services.
When quality of life in the United States is measured as it relates to illness, disability and overall health care, “There is evidence of a relationship between inequality and health,” the researchers found.
Michael Haederle is a freelance writer whose work has appeared in People, the New York Times and the Los Angeles Times.
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