And this is despite the fact that in Canada, there are many more smokers than in the U.S., although the demographics of poverty, arguably, are much different than they are south of the Canadian border.
So how do Canadians save so much money on healthcare?
Woolhandler tells me that the overriding secrets seem to be two-fold.
First, she says, primary care physicians far outnumber specialists in Canada relative to their ratios in the United States. That translates to less invasive care and fewer surgeries and a more medical approach to treatment to keep conditions from worsening.
"What we do know is that primary care-based healthcare systems tend to be thriftier. We know that from international evidence, as well as evidence from within the U.S.," she says.
"I'm a primary care doctor," she adds. "And when my patients need specialists, I rely on those specialists and appreciate them. But you need to have an ample supply of primary care doctors and focus on primary care, and that’s one of the things that works so much better in Canada."