Canada’s single-payer health system is the envy of some Americans. Under Canadian Medicare, every province runs a single public health insurance plan with very low administrative overhead: in this sense, the system is efficient. It is also a natural fit for the goal of health equity: everyone is in the same plan; everyone has the same benefits.
A single-payer system is no panacea, however. Much rides on what the single payer covers and does not cover. For example, Canada scores poorly on international comparisons of health equity. This is largely, but not entirely, the result of what we exclude from Medicare: prescription drugs, as well as non-physician care (physical therapy, dental care, speech language pathology, etc.—any function not performed by physicians), in the community. As a result of these exclusions, Canada has a high rate of private health insurance for extended benefits, and one of the highest levels of private expenditure among universal health care systems. If you need rehab, or have on-going prescription drug costs, moving to Canada might or might not save you from American-style inequities in access to care.
Continue reading