A Tale of Two Healthcare Systems
American healthcare is so expensive that it's driven folks to rob banks to pay for coverage (Brian Randolph).
It's even driven cats to murder (Luigi Mangione).
79 million Americans have medical bill debt, with 20 million owing more than $ 1,000.
But on the flip side, there is the Canadian healthcare system, with universal coverage funded by the government.
But that comes with its own trade-offs that you can't appreciate until it's held up to ours.
When a government pays for everything, the cost doesn't go away. Instead, the ability to provide an adequate supply to meet the demand does.
The American system is a crisis of affordability; the Canadian system is a crisis of rationing
Watching Broken Country, the documentary by Canadian filmmaker Mira Metter and
@mjwerry about some of the social issues Canada is facing, has put this into perspective.
For my American audience, here are some things to consider that we don't have to deal with. My Canadian audience, chime in if the following reflects your experience.
-Death by wait time: From 2023-2024, over 15,000 Canadians died while on a waitlist for scheduled surgeries or diagnostic scans like MRIs.
-Emergency room gridlock: The median wait time for a patient admitted to a Canadian ER is 16 hours. 1 in 10 will wait over 48 hours just to get a bed on a ward.
-Not enough beds: Canada has just 2.5 hospital beds per 1,000 people. The global OECD average is 4.2.
-Hospitals packed past capacity: 85% occupancy is the international safety benchmark; Canadian hospitals routinely run at 100% to 106% capacity.
Healthcare is expensive here in the States, but you can get seen fairly quickly.
If you need an MRI for a torn ligament or an urgent oncology consult, you can generally get it within days or weeks.
In Canada, getting a routine specialist appointment or a non-emergency ultrasound routinely takes six months to a year.
In fact, Canadians with the cash frequently cross the border to the U.S., paying entirely out of pocket just to bypass their own system’s lethargy.
They can’t just pay cash to jump the line back home; while the federal Canada Health Act doesn't explicitly ban private care, it penalizes provinces that allow it.
To protect their federal funding, individual provinces have passed strict laws that effectively outlaw private billing for medically necessary procedures, leaving patients with no domestic alternatives.
The relationship between fast and free healthcare is not so mutually exclusive in other countries. It just happens that two of the world's greatest extremes share a border.
Watching this documentary has been fascinating. I highly recommend you check out Broken Country—especially if you're a Canadian.
brokencountry.com/