The obvious solution.

Byline: The Register-Guard

They may not know how to pronounce "about," but Canadians could teach Americans a thing or two a-boot getting good value for their health care dollars.

Less than a month after Americans learned that they were half as healthy as their British counterparts despite spending twice as much as the Brits on health care, a new study revealed remarkably similar results comparing Americans and Canadians.

Once again, even though the United States spends almost twice as much per capita on health care as Canada, the extra money isn't buying better health. The Harvard Medical School study found that compared with Canadians, Americans are more likely to be sedentary and obese and to have higher rates of lung disease, diabetes, arthritis and high blood pressure.

Harvard researchers analyzed responses from more than 8,700 Canadians and Americans over the age of 18 who participated in the Joint Canada/U.S. Survey of Health, a one-time phone survey conducted between 2002 and 2003. Canada, like Britain, has a tax-supported, single-payer, universal coverage health care system. The United States uses a combination of government and private sector plans to deliver health care, but the inefficient, patchwork system leaves a shameful 46 million Americans without any medical coverage at all.

The advantages of the far less expensive Canadian system were clear in the survey results. In addition to being healthier overall than Americans, Canadians also fared better on these measures:

Nearly 85 percent of Canadians reported having a family doctor, compared with 79 percent in the United States.

Only 5.1 percent of Canadians said they were unable to pay for needed medication, compared with more than 10 percent of Americans.

Overall, 10.7 percent of Canadians reported having unmet health needs, compared with 13.2 percent of Americans.

The study's co-author, Dr. David Himmelstein of Harvard Medical School, acknowledged that wait times for care are a big frustration for some Canadians. But that disadvantage paled when compared with the inherent inequity and cost barriers built into the U.S. system.

When asked about the biggest obstacles to obtaining needed health care, Americans cited costs, and Canadians mentioned waiting times. Even with the aggravating waits, only 3.5 percent of Canadians reported being adversely affected by treatment delays. On the other hand, almost 16 percent of the U.S. population - including 8.3 million children - has no health insurance coverage of any kind.

Compounding the problems caused by the disgraceful number of uninsured is the alarming effect that sedentary lifestyles have on Americans' health. The survey found that 13.6 percent of Americans do no exercise at all, compared with just 6.5 percent of Canadians. That helps explain why the incidence of diabetes is 50 percent higher in the United States.

It also might explain why Canadians on average live three years longer than Americans.

The Harvard researchers' conclusion wasn't startling: Universal health care coverage should be implemented in the United States. The nation's health care professionals, hospitals and medical education system are the best in the world. Given what is now being spent in the United States, compared with what half as many dollars would purchase in Canada or Britain, the only question is why more isn't being done to solve the problem.

"We can do better," Himmelstein said, "if we just had national health insurance and were allowed to do it right."