I don’t think there is a single soul in Canada that is claiming that universal healthcare is in any way shape or form more effective or provides better care than private. It’s actually the total opposite. But that emergency appendectomy won’t put you in crippling debt.
Like every other service or industry in Canada, the biggest problem is having such a huge country with such a small population, it’s hard to be efficient. Putting a hospital four hours away from a major center to service five towns with a population of 1000 people each isn’t cost effective, but it needs to be done.
I’d be curious to hear what our European members have to say about their universal heath care system's.
I can chip in on that, relevant to the UK system. Pretty much the exact opposite of Canada in terms of country size and population density.
Pros, it's affordable to the average Joe at the point of administration
Cons, the service is poor and if examined objectively, it's actually NOT particularly cheap.
If you make less than median wage, I'd take the UK system in a heartbeat. It won't bankrupt you, it's not going to be a major source of financial stress if you get sick, you aren't going to ignore a minor problem now over fears you can't afford it, which probably does reduce the chances of that developing into a life threatening illness later (e.g cancer screening, basic check ups for heart conditions, etc). That is
a mark of a good healthcare system I would argue, and in the US, that's simply not the situation.
However, if you make more than median wage, it's a pretty awful system. Because 'free healthcare' ISN'T free, and the high wage earner is the one paying through the nose for it. Earn above approx $100K year, and the tax delta of UK vs US is significantly higher than health insurance costs for example.
Then there's the service. The issue with public healthcare is that it's a massively expensive black hole, that can never be resolved. You can never treat every condition, you can never save everyone, you can always do more, the more you do to treat people now, the longer they live, which leads to even more treatment... on and on it goes.
More money saves more lives, if you don't spend it you must be a monster and you don't get elected. I mean, I get that. If your granny is seriously ill of course you want the best treatment at any cost. Her life to you is priceless, what's another million of someone else's money?
This generally means that the NHS invests a lot of money in treating people who are going to die anyway. Palliative care, end of life care, quality of life care. That works, which then means that even more money is needed because that sick person now has another 5 years of life at a cost of X/month in treatment. As a result, they're terminally underfunded at any level of funding, and so service suffers.
Getting access to that service is slow, wait lists are long, the treatments offered aren't necessarily the best. It's like taking public transport in that regard. The bus will arrive eventually, it will be cheap, and it will get you to work. But it's not going to arrive precisely when you want it, and it's probably not the most efficient route. Pretty crowded and uncomfortable as well.
There also isn't a clear incentive structure towards efficiency, because no part of the system expects (or needs) to turn a profit. So the conversion of $ into Quality of Life Years (loosely, a treatment which delivers 1 additional year of good health has a 'value' of 1 QALY. A treatment that lets a cancer patient survive 1 additional year at 60% quality of life = 0.6QALY, etc) is pretty poor vs an insurance based system.
In the US by contrast, the 'solve' for that conundrum is simple; you get precisely as much health care as you're willing to pay for, or you purchased insurance for. If that's not enough... you die. A harsh solution perhaps, but a workable one.
For me, personally, I prefer the US system. It's still pretty poor overall, but for my situation, it's a better system. If I was earning less, I prefer the UK. If my health was worse, I might consider the UK.
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