Earlier work (Blendon et al.1990) has shown that most Canadians are satisfied with their healthcare system, while most Americans are not. In the current study, conducted between February 21, 2011, and September 16, 2011, a random sample of 81,417 distinct Web users – 7,174 Canadians and 74,243 Americans – responded to the question, "How do you rate your healthcare system?" Positive confidence scores ranged from 41.3% to 66.9%, with an average of 52.0% for the US versus 63.4% for Canada. This difference is significant at the level of state versus province and at the inter-country level (p < .0001 student's t-test). The healthcare confidence score is the sum of the proportion of respondents who answered "good" or "excellent" as compared to "okay," "poor" and "terrible." The technology used in this study can track changes of public opinion as they occur in real time and, in this way, provide actionable data for decision makers.

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