The U.S. and Canadian health care systems: views of resident physicians.
OBJECTIVE
To evaluate U.S. and Canadian resident physicians' views about their health care systems.


METHODS
Self-administered questionnaire survey in 1989.


METHODS
Senior family medicine and internal medicine residents in Canada and in ten geographically representative American states.


RESULTS
American and Canadian residents had similar levels of professional satisfaction and almost universally agreed on the ethical obligation to provide care to persons of all social circumstances, but U.S. residents were more likely to perceive a serious access problem in their country (75% compared with 18%) and to think that current controls on the medical profession interfere with patient care (81% compared with 58%; P less than 0.001). In addition, U.S. residents were more likely than Canadian residents to believe that primary care salaries were too low (78% compared with 38%) and that salaries of medical subspecialists (57% compared with 17%) and surgeons (85% compared with 28%) were too high. In general, residents preferred their own country's predominant health care system. Whereas 87% of U.S. physicians supported private fee-for-service health care, 85% of Canadian physicians supported government-funded national health insurance. Nonetheless, 42% of U.S. physicians supported and only 17% strongly opposed national health insurance as an alternative approach. About two thirds of respondents from both countries opposed a salaried national health service.


CONCLUSIONS
American residents perceived greater problems with access, overall intrusions into medical practice, and fee disparities than did their Canadian counterparts. They preferred private fee-for-service health care, but few strongly opposed government-funded national health insurance as an alternative approach to the health care needs of the United States.
Hayward
R A
RA
University of Michigan, Ann Arbor.
Kravitz
R L
RL
Shapiro
M F
MF
D001291:Attitude of Health Personnel; D002170:Canada; D003695:Delivery of Health Care / Q000458:organization & administration; D005194:Family Practice / Q000193:education; D006076:Government; D007182:Income; D007388:Internal Medicine / Q000193:education; D007396:Internship and Residency; D010819:Physician's Role; D012941:Social Responsibility; D011795:Surveys and Questionnaires; D014481:United States