At the Cato Institute, Jeffrey Singer explains the significant similarities in the Canadian and American healthcare systems. He concludes:

Both Canada and the US have government-run health systems—but the US version is more fragmented, relies on private intermediaries, and costs more because federal spending is open-ended rather than budgeted.

Both systems ration care but along different margins. Canada uses budgets to control spending, which shows up as longer wait times and limited capacity. The US relies on prices and insurance design—premiums, deductibles, networks, and utilization controls—which can restrict access financially even when services are available.

But the similarities don’t end there.

In both Canada and the US, federal regulators restrict adults’ right to self-medicate by deciding which drugs are available and whether a permission slip (prescription) from a licensed gatekeeper (clinician) is required.

In both Canada and the US, governments use licensing laws to control which clinicians patients may see, while established professions lobby to keep allied providers from practicing to the full extent of their training.

Many were surprised to learn how much the two systems have in common. They shouldn’t be. When governments control financing, regulation, and access, the result isn’t fundamentally different systems—it’s different versions of the same constraints on patients and clinicians.

Read more here.