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Of course a $450/month plus a $7,000 deductible healthcare plan is not better than a Canadian $150/month plust a zero deductible healthcare plan. But this is a very unfair comparision.The only people paying this $450/month plan with the gigantic deductibles are 11 million or so Americans who lost their individual health plans due to Obamacare. You remember the “If you like your health care plan, you can keep it” lie of the year. Lie of the Year: 'If you like your health care plan, you can keep it'About 160 million Americans have employer sponsored healthplans. My premium through work is $200/month and I’m very pleased with my physician choice, the easy and quick access to specialists, and hospital options. 55 million Americans have Medicare. Up to 70 million Americans have Medicaid.Prior to Obamacare, 80–85% of Americans were happy with their healthcare. Even now, with the continual drum from the progressive left, it’s 60–65%.The Canadian healthcare system is laudible for their universal coverage. That doesn’t mean that there are not very long waiting time for specialists or that there are not extra costs for some specialty care like cancer.Whether you ask physicians or patients, the answer is the same: Canada is failing to provide timely access to medical care.The U.S.-based Commonwealth Fund, in conjunction with the Canadian Institute of Health Information, just published the results of its health policy survey of adults in Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom and the United States. The results indicate that Canada is not just lagging, but is literally scraping the bottom when it comes to indicators of timely access to health care.Here’s a sample of our most spectacular failures:• Ability to get a same or next-day appointment when sick: Worst• Ability to get after-hours care (without resorting to visiting an emergency department): Second-worst• Wait for treatment in the emergency department: Worst• Wait to see a specialist: Worst• Wait for elective surgery: Worst Barua: Why are Canada’s health-care wait times the worst?https://www.usnews.com/news/best-countries/articles/2016-08-03/canadians-increasingly-come-to-us-for-health-careThe High Cost of Pharmaceuticals: Canada’s Drug Problem - Episodes - The Fifth EstateThe cost of drugs: breaking the bank to stay aliveI live in Ontario and can’t afford my cancer drug. What can I do?Canada doesn’t have your back: Free health care only goes so far, especially for some seniors

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Most Americans want the same kind of healthcare that the wealthy get. They want high tech tests without having to wait for it. They want immediate surgery for severe back pain or an arthritic hip. They want single private rooms while hospitalized, not wards with multiple beds. They want the latest cancer treatment that they read about in The New York Times or The Wall Street Journal and damn the costs.Americans also want great results. When Americans don’t get great results they want someone to pay for the failure, even if they’ve gotten the lastest and greatest at the best hospital in their city. They expect to sue the doctors and hospitals and receive multi-million dollar payouts.That is why the American healthcare system is so incredibly expensive. 170 million Americans who have employer-sponsored healthcare plans have that level of care and that kind of access. It’s the same level of care that the wealthy receive. To a great extent, the 54 million Americans who have Medicare have that level of care also, although Medicare payments are heavily subsidized by those who have employer sponsored plans. In a sense, they are modified free riders but not as much as the many healthy working individuals who did not (and still don’t to a lesser extent since Obamacare) choose to pay for insurance. These are the people that Obamacare was designed to coerce into buying insurance.America’s poor have always had government-sponsored healthcare in the form of Medicaid. It wasn’t and isn’t ideal because there are long queues for doctors appointments, tests and treatment. It’s not dissimlar to the delays experienced by America’s veterans at the Veterans Health Administration facilities. Long waiting times, months of delays in testing and sometimes even longer for treatment. But patients within these systems can get high end care like dialysis, hip and knee replacements, heart bypass surgery, and bone marrow and liver transplants. It just takes a lot of waiting time and this results in patients falling through the cracks.Sound familiar?Paul Krugman, a liberal economist writing in The New York Times, has likened national healthcare systems to a level of care comparable to Medicaid.Put it this way: for all the talk about being honest and upfront, even Sanders ended up delivering mostly smoke and mirrors — or as Ezra Klein says, puppies and rainbows. Despite imposing large middle-class taxes, his “gesture toward a future plan”, as Ezra puts it, relies on the assumption of huge cost savings. If you like, it involves a huge magic asterisk.Now, it’s true that single-payer systems in other advanced countries are much cheaper than our health care system. And some of that could be replicated via lower administrative costs and the generally lower prices Medicare pays. But to get costs down to, say, Canadian levels, we’d need to do what they do: say no to patients, telling them that they can’t always have the treatment they want.Saying no has two cost-saving effects: it saves money directly, and it also greatly enhances the government’s bargaining power, because it can say, for example, to drug producers that if they charge too much they won’t be in the formulary.But it’s not something most Americans want to hear about; foreign single-payer systems are actually more like Medicaid than they are like Medicare.And Sanders isn’t coming clean on that — he’s promising Medicaid-like costs while also promising no rationing. The reason, of course, is that being realistic either about the costs or about what the system would really be like would make it a political loser. But that’s the point: single-payer just isn’t a political possibility starting from here. It’s just a distraction from the real issues. Health Reform Is Hard