This paper compares the economic performance of Canada's health insurance system against the health insurance systems of 27 other countries that are members of the Organisation for Economic Co-operation and Development (OECD). According to the most recent internationally comparable data from 2009, Canada had the sixth most expensive health care system (defined by total health spending as a percentage of GDP) among OECD countries without adjusting for differences in the population age distributions between countries. Despite being ranked as the sixth most expensive health insurance system among OECD countries in 2009, Canada ranked below the majority of the other 27 OECD countries in almost every indicator of medical resource availability and the output of medical services for which comparable data were available.