Red tape costs U.S. doctor four times what Canadian physicians pay.

Sean Nicholson, professor of policy analysis and management, co-authored a study that finds that American medical practices spend $82,975 each per year dealing with insurance companies and government entities--roughly four times the $22,205 spent on average by Ontario doctors. The paper, published in the August 2011 issue of the journal Health Affairs, attributes the cost differences mainly to Canada's simpler single-payer system, whereas U.S. practices grapple with different sets of regulations, procedures, requirements, formularies, and forms mandated by each health insurance plan or payer. "It's the nurse time and the clerical time, rather than physician time, that's different ... and is driving the increased costs," Nicholson said.

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