Elective surgery In its 2016 international health survey, the Commonwealth Fund found that 18 percent of patients in Canada had waited four months or longer for elective surgery in the previous two years, compared to 3 percent of patients in the United States, 6 percent in Switzerland, 4 percent in the Netherlands, and 0 percent in Germany. Life expectancy at birth Based on OECD 2018 data, in terms of life expectancy at birth by gender, women in France is 85.9, Switzerland's 85.7, Canada's 84.1, the Netherlands's 83.4, Germany's 83.3, and the U.S.' 81.2 years. The Commonwealth Fund report ranked Canada at slightly above average in life expectancy and the U.S. at the bottom of the list with a life expectancy of 78.6 years. Of the eleven countries, the U.S. spends the most of healthcare. Life expectancy at 65 Based on Statistics Canada data from 2017 to 2019, women in Canada have a life expectancy at 65 of 22.2 years or 87.5 years and men at 65 have a life expectancy of 19.5 years or 84.5 years. Under-five mortality rates From 1971 to 2020, the under-five mortality rate per 1000 live births rate for Canada dropped gradually from 20.9 deaths per 1000 live births to 4.98 deaths per 1000. In comparison, in the U.S. during the same period, the rate decreased slowly from 22.49 to 6.98 deaths per 1000. Maternal mortality rate per 100,000 live births In 2018, the maternal mortality rate per 100,000 live births in Canada was 8.3 deaths. Since 2008, the rate has been between "4.5 and 8.7 deaths per 100,000 live births". Physicians per 1000 people According to the Commonwealth report, 11 wealthy countries have a higher number of physicians per 1000 people, than Canada. Norway has 4.8, Canada has 2.7 and the U.S. has 2.6 physicians per 1000 people. Healthcare spending by country Legal challenges to Canada's healthcare system There have been several court cases that have challenged Canadian and provincial health systems including the Chaoulli v. Quebec (Attorney General) and the high-profile, multi-year lawsuit against the provincial government, Cambie Surgeries Corporation v. British Columbia (Medical Services Commission) which ruled in favour of the BC MSC. In June 2005, the Supreme Court of Canada ruled in Chaoulli v. Quebec (Attorney General) that Quebec AG had violated the Quebec Charter of Human Rights and Freedoms by forbidding private health insurance for medically necessary health services. The ruling