But some of the paper's most striking results don't have to do with specific treatments. Instead, they have to do with health insurance.When researchers took the 32,699 American patients who visited American cystic fibrosis centers between 2009 and 2013, and broke them down according to their insurance coverage, the comparison with their 4,662 Canadian counterparts was telling.The Canadians, all of whom get government-provided health coverage, had the same risk of dying as those Americans who had private insurance. When compared with Americans on continuous Medicare and Medicaid, though, Canadians' risk of death was 44 percent lower. And the disparity was even greater when it came to Americans with no insurance at all.Medicaid coverage is very different from one state to the next, but those in the cystic fibrosis community were not completely surprised that patients who qualify for the government insurance might not have the best outcomes overall.
The biggest challenges, he said, are access to medications, given that cystic fibrosis patients often have to take some 10 to 15 drugs every day, some of which may not be covered under Medicaid.There is, however, a confounding factor: "It's difficult to separate the access to care and your socioeconomic status," said Stephenson.Yet Gorey's studies have found that even among cancer patients who have similarly low incomes in each country, "Canadians are much more likely to get the indicated surgery, much more likely to get chemotherapy, radiation therapy, much more likely to live longer," he said.