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I believe single payer could work in the US, but not as long as people continue to believe disinformation promulgated by the players entrenched in your current system to support their current business models.I’m rather tired of some Americans who like to state as fact their misconceptions about how other peoples health case systems work, in particular around assumptions that a single payer system has all of the restrictions of your highly bureaucratic government run health insurance schemes.I live in Alberta, Canada.For the record, I have been using the Alberta Health Care system for over 50 years. I am asthmatic, with lots of allergies. I have 2 children, one of whom had juvenile arthritis requiring extensive diagnostics, multiple MRIs, and surgery.In all of that time I have never spoken to anyone from Alberta Health Care.I can go see any doctor I like without asking permission from any government agency. Subject to the basics of needing a referral to a specialist from my GP, and needing to find a doctor who is accepting new patients if I want a new GP.Fee rates for various services are determine by Alberta Health Care. Doctors do not have the option to just charge more than that. Doctors are not “employed by the government” other than Doctors employed in hospitals. They have their own businesses, but they submit their bills to Alberta Health Care instead of to the patients.I NEVER have to negotiate whether something will be covered by Alberta Health Care. If I go to my doctor, it is covered. If the doctor prescribes a test or procedure, it is covered. Alberta Health Care pays the fees, it doesn’t try to optimize its bottom line (like an insurance company does) and try to make its own determination of whether something is medically necessary or covered before paying. Doctors determine what is necessary, submit the bills, Alberta Health Care pays the doctor.Alberta Health Care does not cover some things, like dental, vision, or prescription drugs, and most people have employer health care to cover those, and they have all the same issues one always has when dealing with insurance companies, generally around them refusing to cover anything they can find a way to deny.Also, while many Americans seem to believe that Canadians are flocking to the US to get health care, I have never met a single Canadian who has gone to the US for health care, while I have met Americans who have moved to Canada to get health care. I know people who have gone to Mexico for dental work because it is really cheap there. I also know plenty of people who are terrified of visiting the US for fear that the might get sick while they are there.While you can always find someone in any system who has had a bad experience, I don’t know a single person who would trade our system for the train-wreck that Americans put up with.

I wish it was easier to convey my feelings on this in writing. But let me try:Oh… oh… OH GOOD GOD NO. Absolutely not. Under no cricumstances, for any reason, at any time would I accept that. I'd consider armed revolution to be a viable option if any Canadian government seriously tried it.You know the most difficult experience I've had with Canadian health care recently? I moved from Alberta to Ontario and there's a 3 month waiting period before you can switch from one province’s insurance system to another. In that time your province of origin gets billed for any services you access in your new province. I had to access some specialist ear, nose, and throat care at one of the big downtown research hospitals in Toronto in that three month waiting period and discovered I'd lost my Alberta Health Care card in the move. I had my Alberta Health Care number, but the receptionist (let's call her Cheryl) said they'd need a copy of the actual card, or I'd get a bill from the hospital.I ordered a replacement card, but in a comedy of errors they sent it to my old Alberta address and the mail redirect didn't catch it, so I still didn't have the replacement card by the time I had to go in for my follow-up.Fearing I'd be presented with a demand for payment before I could see the doctor again, I walked up to the receptionist with a light sweat. Her reply?“Oh sorry, Cheryl was new here. We have your Alberta number on file, we don't need the card. You're all good, have a nice day!”Oh, and for the Americans who think our system comes with unacceptable trade offs around timing and access - I booked the appointment with my GP to discuss my issue on Monday morning, saw her that same afternoon and she made the referral. The hospital called me on Tuesday, and I saw the ENT on Friday. Total cost to me for outpatient care with a specialist at an enormous research hospital… The $9.00 uber I took to that hospital. It was a nice day, so I walked home.The US can kindly keep its dysfunctional, unjust, expensive, inadequate, bloated, confusing, and broken system to itself, thank you very much.

Hospitals in Canada are government funded so unlike in the US, hospitals don’t compete for business. So there is no “best” hospital. Which hospital you use depends on location for some things (ie, closest emergency room) and specialty required for others. Many specialties are split up between hospitals. IE, if you require heart surgery, you go to one hospital. If you need cancer treatment, you go to another. There are also many specialized services outside of hospitals that are part of the government funded healthcare system, especially for testing and diagnosis.Some of these can be accessed and paid for privately but most require that you have an Alberta Health Care card and require referral from a doctor. You can choose a personal doctor at one of the many medicenters throughout the city but these facilities are limited to short visits which result in either prescriptions or referrals for further testing. And they also require that you have an Alberta Health Care card.Some things are not covered by the health care system at all, notably, dental care and basic eye care, such as optometrists for eyeglasses. For those you either pay out of pocket or with a benefits package provided by your employer.It’s a complicated system with a lot of interconnected components. It’s cumbersome but in the end, for the most part, it gets the job done. And I speak from personal experience because as a senior, I’ve had occasion to use it for several different medical issues over the last number of years. All were eventually successfully dealt with.