[cmiles74]

I'm not entirely sure that this paper supports your theory. While they do establish that the risks for this subset of premature babies is higher in Canada than in the US, they do not attribute this to a better level of care from US hospitals or the US healthcare system. Reading through their conclusions, it sounds like they didn't even think that was an issue worth investigating. Instead they looked for population differences and end up theorizing that the difference might be due to age estimation errors.

The fact that the births of premature children in this category is lower in Canada could, perhaps, point to the opposite conclusion: because health care in Canada is less driven by profit, we are seeing better care before birth which could be lowering this number.

"Our results were fairly consistent between the United States and Canada. The RRs of mortality associated with mild and moderate preterm birth were generally higher in Canada. A small part of these differences in gestational age–specific mortality was explained by the lower absolute and relative mortality risks among US black vs white preterm infants, but the RRs for Canada remained substantially higher than those for the United States even after restricting the US analysis to non-Hispanic whites (ie, 8.1 vs 15.2 at 32-33 gestational weeks and 3.3 vs 4.5 at 34-36 gestational weeks for total infant mortality among all singleton live births). An even smaller part of the difference was the result of the slightly lower absolute risks for term (birth at ≥37 gestational weeks) births in Canada (ie, total infant mortality of 3.0 vs 3.1 per 1000 live births for Canada in 1992-1994 vs the United States in 1995). We are currently investigating other potential explanations and particularly whether the differences might be artifacts caused by errors in estimation of gestational age. Regardless of the explanation, however, the prevalence of births in these gestational age categories was much lower in Canada than in the United States, and the EFs were therefore similar in the 2 countries."

https://jamanetwork.com/journals/jama/article-abstract/19299...