1. It relies on federal block grants (antithima to Dems) because even in a country as small a Canada, a national program would be too unwieldly and unresponsive (imagine DVA healthcare for all). Dems oppose state level programs because we are so shockingly thin in state government. This needs to be a co-priority in healthcare reform 2. Its not an instant process. Canada took 35 years from first provincial program to the current legal framework. So the US clock started running in 2006 with RomneyCare in Mass. The interim period for Canada featured intense political wrangling, industry push-back (Drs. Strikes, opting out, practitioners leaving the country) and constant tweeking and tuning. So US may be on or even ahead if course 3. Universal healthcare is not synonymous with affordable healthcare as all funding levels in Canada are acutely aware. 4. Finally and probably most importantly, since universal health care, universal health insurance and single payer healthcare are not synonymous he should look for a role model from amongst the dozen or so countries whose mixed funding universal systems regularly outscore Canada (and US) on both costs and health outcomes. We Americans equate choice with quality and choice and universality are not incompatible. Robert Thompson Kanata ON