I moved to Canada in 1975 just after I married. At 28 and having been very healthy all of my life, I was quite naïve about the cost of healthcare in the US, and fell very easily into Canada’s single payer system. I bore and raised two children under it, never paying a single penny for healthcare, including maternity care, emergency stitches, tonsillectomies, and allergy specialists. Indeed, having to pay to give birth would have shocked me, I think. Regarding our family health, everything went quite smoothly until 1996 when my husband and I were involved in a car accident which left me a quadriplegic. We lived in Halifax but the accident occurred in New Brunswick and we were taken to the Moncton City Hospital where I spent a month in intensive care. I have nothing but the highest praise for the care I received in that facility, for which I never paid a single penny. At the end of the month I was moved to Halifax where I spent two more weeks in hospital care and then moved on to the Nova Scotia Rehabilitation Centre. I spent 10 months in this wonderful facility, again not paying a single penny. I had to learn how to live all over again down to the basics of going to the bathroom, feeding myself, and finding the best way to read a book. I was helped to regain my strength and taught mobility necessities like how to transfer from the wheelchair to a bed. I met others with mobility issues and became comfortable with the idea that this wasn't the end of my world. At the rehab, my husband and I were counselled on how to best modify our home for my wheelchair needs and compromised hand mobility. We were helped to navigate government bureaucracies and insurance companies for continuing care and future financial needs. My time at rehab was invaluable and my gains could not have been accomplished within the six week time period that I understood US insurance companies allowed for rehab, at least back in 1996. Again, I paid nothing for the care I received in that facility. This past summer, because of severe osteoporosis from sitting in a wheelchair for 21 years, I broke both of my legs at different times. I received immediate care in emergency including same day admission to the hospital. Surgery was planned for the following day until the doctors and I together decided that it would do more harm than good. When deemed necessary, my doctors have been able to secure diagnostic tests for me within a couple of days – x-rays, colonoscopies and ultrasounds. My son was diagnosed with MS at the age of 24 and again has had only positive experiences with healthcare. NS pays for his very expensive drugs. In either of these cases, our family would have been met with catastrophic health care costs, if not then forced to sell our home or possibly go into bankruptcy, were it not for Canada's easy to access single-payer healthcare system.

Hi, I am a Senior and have very little to live on. I have to pay for Medicare, but that still has a deducible, which is a lot of money to me. If I get extremely ill, I will not have the funds to pay for health care. I would hope you would think of your Seniors when forming a health care bill. Most of the Seniors today are still working, I am,because we cannot afford the minimal cost of living and health care. Thank you,

I am both a US and a Canadian citizen. I am in the unusual position of having practiced in Canada before the development of universal government-funded health care known as Medicare, followed by practice in the US without universal health care, followed by practice back in Canada when Medicare had been established. Having experienced the worst of US medical care, I decided to never again practice in the US. I fear today for Canadian health care as it drifts toward a US-style private model. I developed and ran a three centre health care network in Rochester New York 1970-75, where I also practiced. I had good contracts with Blue Cross for the employed of Kodak, Xerox and American Optical, and I had a good reimbursement rate for those who were destitute on Medicaid. In the middle we tried to care for the marginal poor or sometimes employed. It can’t be done. What I faced as an administrator in trying to be fair to those who cannot pay eventually put the system in jeopardy. This loomed large in my decision to return to Canada, where I ran a similar system in Montreal from 1975-1993. There I no longer worried about providing cost effective care. Our Canadian health care system has not had a major overhaul since its inception in the 1970s, but we need to work on fixing those problems through comprehensive health care reform, without destroying a system that most Canadians feel is an expression of the highest values in our society. Those who see an increase in private care as the main way to fix the system seem unable to separate their own financial benefit from the needs of the nation. While I looked in the US for a warm place where my wife Bonnie, who is handicapped, could be independent, in the end I was so distressed with the US private-for-profit system that permeated everything from how poor people were cared for to the educational system that seemed blind to what was happening around them, that I felt that I had no choice but to return to Canada. It is useful to think about how Bonnie was flown without charge from Quebec to Ontario on a specialized intensive care jet to receive landmark surgery unavailable in Quebec, how the costs of her many months in hospital were the price of room TV. Or when I required back treatments then unavailable in Canada, Quebec paid for me to receive care in Minneapolis. Unlike what many in the US believe, there are no restrictions in Canada on choice of physician, assuming availability. In fact, our system is largely entrepreneurial and uncontrolled, unless the doctor is on salary, which is still rare. Some would say that ours is not a health care system at all but a system of paying doctors and hospitals for providing services according to a schedule of payments. And we are unique among comparable Western societies because we do not fund essential drug costs for the patient. I am astonished, though I ought not be, that many Americans, who are one disease short of being destitute, believe that single payer health care is bad for them. Part of the US population’s refusal to embrace the obvious is achieved by scaring them with terms like “socialism” and the spectre of a Canadian system where people cannot choose their own doctor and they will not receive the care that they need. Canadians of course can see their own doctor, and as many times as they need, without cost to them, just by showing their Medicare card. Lies about the Canadian health care system are willfully propagated by US private insurance interests, and ignorant legislators in the pocket of lobbyists are believed by a naïve and unsophisticated public. While there are undeniable problems in the Canadian health care system, compared to the US we are in much better shape, and we can fix our problems, within the existing system-- if we put our minds and pockets to it.

I had a bicycle accident in April. I am 69 years old and it was quite a 'break' in my life. I still work and like anyone who has an accident, i was no prepared. I broke my leg and my elbow (still recovering!). Passers by were helpful. Called the ambulance which took me to the nearest hospital where i was treated the same as everyone else and waited my turn for a very excellent bunch of services including x-ray, CT Scan, MRI and eventually surgery on both parts of my body. Complete with titanium implants. I was then taken to an amazing rehab facility which is attached to the hospital and given really wonderful care until i was able to walk with a cane and get up the 14 steps to my second floor upon returning home. Everything from start to finish was kind, compassionate and quite proficient. Once i returned home i was given 8 sessions of physiotherapy and assistance taking showers until i could manage it myself. all the wonderful care kept me from being depressed (they also provided me with pain killers and any other things i needed, which in my case was minimal). On account of this i was highly motivated to continue my own care after returning home. If i had had to make decisions about what to spend money on or not (i am not insured with work. My care was totally OHIP covered) it would have been a much more stressful and less successful recovery. As it was it took from April 13th when i had the accident to May 6th, when i returned home to get me more or less out of the system. Follow up was good as well. the surgeon kept his eye on me until the bones were successfully knitted. I shudder to think what it would have been like without universal health care. I have watched my niece in the USA decide not to go to the hospital for stitches after cutting herself badly with glass because she couldn't really afford it. Her pensioned mother had to offer. Ridiculous. My other, less specific input is that I was a single mother with a deadbeat ex for many years. I never had to worry about medical care for myself or my daughter. one less form of humiliation not to mention security. I am deeply grateful to live in a country that offers this to all it's people.

I have experience the Canadian health care system as both a patient and a physician. I have nothing but praise for Canada recognizing that health care is a right, not a privilege. As a physician I was always certain that I could provide the best care without worrying if my patient could afford my care. I am a psychiatrist and mental health care is covered just as any physical illness. As a patient I have suffered from a chronic malignant condition. I have received excellent treatment without worrying about losing my finances. The freedom from financial stress is healing in itself. Could the Canadian system be improved? Yes, of course, nothing is perfect. We need universal pharmacare, and dental care. We could better utilize our system to reduce wait times. Some elective tests, treatments are delayed, but any emergency investigation or treatment is available. Everyone is covered and we can use our medical card in any Canadian province. It even covers some benefits outside of Canada.

My general practitioner performed an electrocardiogram in his office and determined that I should be transferred to the Aachen University Clinic for treatment. After numerous tests and pre-treatment therapy, an electrical cardioversion was performed. After two days of in-clinic observation, further tests – including a stress electrocardiogram and an MRI of my heart (Magnetic Resonance Imaging) were performed. Every day during my three-day stay in the clinic a resident cardiologist informed me of the test results. After it was determined that the treatment had been successful, I was released and all test results were forwarded to my GP. With the exception of 10 Euros for the ambulance, all costs were covered by my health insurance. I now have an annual long term and stress electrocardiogram in addition to an echocardiography carried out by a cardiologist. The health insurance that covers all of these expenses costs me approximately $290 per month.

I experienced my entire pregnancy and birth in Spain. I used private insurance, but it's only 30 euro per month and 3 euro per appointment because it is subsidized. Other than that, absolutely everything has been free, from appointments with obstetricians and/or midwives at least once per month, an ultrasound offered at every appointment and a Tdap vaccine to labor, delivery and a 48-hour hospital stay. It would not have cost any more had there been complications during labor. My prenatal classes were free. My lactation consultations and baby massage courses are free. (Or, one could say I got all that for around 33 to 36 euro per month. Had I gone through the public system, it would have been totally free.) It felt strange just waltzing out of the office without stopping to pay after each appointment. My care was and is top-notch, and I'm so glad I was able to have my baby in Spain rather than in the US, which would have left me buried in debt. I have also visited two doctors, a nurse and two midwives in the public system, and have experienced minimal wait times and excellent, thorough care. Here they practice preventative medicine. Of course there are trade-offs. I pay more taxes. It takes longer to go for blood tests, and wait times for non-emergency surgeries are long. But I'd take the Spanish system over the US one, no contest.

I have lived in the UK since 1995. I’ve had 2 children here. They’re both fully vaccinated. My husband and daughter have both had emergency appendectomies. Both children have had braces. I’ve broken a tooth. My daughter has worn glasses for ten years. We’ve had a run-in with Lyme disease. I’ve had cervical cysts removed twice. The list goes on and on. My maternity care included pre-natal classes and follow-up visits after the children were born; my 8-year-old daughter’s appendectomy included a place for me to stay with her in the hospital for most of a week. The care we’ve received has been first rate. I can get an appointment on the same day for non-emergency care. Yes, I pay for this service in my taxes. No, it is not an unreasonable cost. I can visit any country in the European Union and expect the same level of care there. For all the flaws in the system, it is a fantastic system. I am privileged to be covered by it and extremely grateful. My husband, daughter and son have all LITERALLY had their lives saved by the NHS: I would be a childless widow without their expertise. And there has never been a bill for any of it. I am self-employed. As I approach retirement age, I have to face the hard reality that I will never be able to move back to the United States because I will not be able to afford the health care. Please, please help fix this broken system for all the generations to come. Elizabeth Gatland

As a Canadian born US citizen who has spent time living and working in Europe I can comment from experience on life under four different systems -- one universal single payer (Canada), two universal multi payer (Holland and the UK) and on non-universal (USA). I would say, and international studies agree, that the universal multi payer option systems far out perform the others. Canada consistently ranks second last, and the USA last in rankings of healthcare outcomes in advanced nations and it's time we both stopped using each other as "the alternative" and looked further afield. Both our systems ration availibility, either through resource scarcity as a cost management measure or by effectively denying coverage to a large portion of the population. The universal coverage mixed payer systems offer both choice broad access. The NHS co-exists with private, at cost system and the Dutch systems mandates that all residents have coverage either through the government system or private coverage. Both operate as a smaller percentage of GNP than Canada's 12% or the US's 16% and deliver broader coverage. That said, let's review the Canadian health care journey to single-payer to make sure we understand it's evolution and current reality: 1) It is NOT a national system, it's a network of Provincial (State) systems that adher to certain national standards -- primarily -- universality, portability and (it's achilies heel) no additional patient fees -- in exchange for BLOCK GRANTS from the Federal level. (Constitutionally health Care is a Provincial, not a Federal responsibility) Most of the funding comes from the Provincial not Federal level (it's the largest Provincial budget item for most) and the decision on coverage is made Provincially not nationally. About 70% of all healthcare costs are government funded, the rest from private citizens directly or through insurance (I believe in US about 60% already government funded) 2) Costs are a major issue to provinces and smaller ones already require extra federal funding. Aging populations risk bankrupting the system unless costs are curtailed (governments are already fighting Drs over salary levels) or the obsession with a "one tier" program with no private coverage options and no co-payment is eliminated. 3) It took nearly 50 years to get to it's current state: - it was first introduced in Albert in the 1935 but scrapped the next year with a change in government (sound familiar?). It was introduced in 1936 in BC but pulled over opposition by Drs. - it was first successfully introduced in Saskatchewan in 1947 but not federally funded until 1957 and by 1961 all provinces had a program similar to Medicare Part A. - in 1962 Saskatchewan introduced the equivilant of Medicare Part B and there was a bitter strike by physicians. - but by 1966 federal funds were made available physician cost as well. Almost 2 decades of turmoil followed with issue like Drs. leaving the country, opting out of the program and billing privately or extra-billing in the system. - in 1984 the current "universal single payer system" was introduced. 4) Despite all the above, the difference between my aging Canadian friends, and my aging US friends, all of whom are getting new knees or a stent or managing diabetes is that the Canadians all have the peace of mind to know where and how they will get the treatment they need. Whether measured in longer lifespans or lower infant mortality rates, or just the minimization of iatrogenic bankruptcy, there is a measurable quality of life increment from universal access. So it's worth the battle. But it's a long complex road so here are some insights from the Canadian experience: - it's an incremental evolution, not a massive one shot reshaping of "one sixth of the economy" - focus has to be on addressing costs not just on "insurance" and access - long term sustainability means exploiting both government and private funding options - and the scale and complexity mean it needs to be State focused within national guidelines (which is why lthe current loss of Democratic stature at a State level is so dangerous) While the ACA was not perfect, I saw it as an important first step on the journey. Constant revision from the ACA core is the right way to go and setting the expectation that it's is a work in progress not the end in itself Loosing issue leadership to Bernie Saunders with an out of left field, scarey-to-many "single payer proposal" is a dangerous step backwards when, when the PR is spinning right, the voter middle ground is quite comfortable with an evolutionary ACA. While the GOP flounders with repeal and replace, the crime is that an active viable ACA v2 hasn't been visiably championed by party leadership. My two cents worth, Robert Thompson

While I was in college Ohio, I had a severe staph infection and had to be hospitalizd for nearly a month. When I returned home, I still needed outpatient care for about 3 weeks. I had a Student Healthcare plan, but the insurance company denied payment b/c of pre-existing conditions. (I suffer from extreme neurodermitis since birth, and the staph infection is a common secondary effect). I wound up owing the hospital nearly 30,000 dollars. Fast forward 3 years. I am laying in a hospital in Germany for a month, and have only been insured for 10 months. I paid but 10 Euros (roughly the same in dollars) a day for care and treatment rivaling that which I received in the US. I also suffer from allergies, asthma, and Keratoconus, and require constant medical aid, which is only affordable through Universal Health Care. In the US, I constantly lost or had to give up jobs b/c of my condition. Thanks to Germanys fair and stable Universal Health Care system, I can work steadily and enjoy life with my family. -- Pay attention and listen to the sayings of the wise; apply your heart to what I teach, for it is pleasing when you keep them in your heart and have all of them ready on your lips. - Proverbs 22:17-18

Regarding Costa Rica's public health care system, I have belonged to the CAJA for 19 years. The cost based on income is affordable. I pay on a voluntary basis. I pay per month. I receive all medical treatment and prescriptions without additional cost. However I supplement CAJA care with private specialists such as my dentist and ophthalmologist. I pay for eyeglasses myself. These services are available through the CAJA but I prefer having my choice of providers in these cases. Lynda Page

When I got my residency in Canada I was told I was covered by their healthcare system which is single payer, universal care. To my surprise I felt liberated and safe in a way I never felt in the US. I was no longer chained to an expensive, unforgiving insurance company whose primary purpose was not the health of Americans but their own profit margin. I remain a happy resident and citizen of Canada, and receive excellent if not perfect healthcare. Rachel Ps: no copay

Cancer sucks, but cancer in Switzerland does not bankrupt you and does not require a masters degree in Bureaucracy and Insurance Codes to get BETTER treatment than in the US. As a 2nd generation cancer person (mom had breast cancer in the US, I got it while living here) I can compare the level of care, the medicines used, and the paperwork burden (almost nonexistent here) and am planning to never return to the US system unless forced. Kay

Hi, there. I just thought I would offer my experience using the Universal Healthcare system in Canada. At about the time I moved to Canada, I was diagnosed with Mixed Connective Tissue Disorder (MCTD)---while still living in Atlanta., Georgia I remember anxiously waiting while the insurance company approved the tests my doctor said I required as well as the medications to relieve my pain. When I moved to Canada, I had not signed up for the Medical Services Plan (MSP) ($!08/month for my entire family), so I had to get some meds and tests and pay out of pocket. I was stunned at how much less the same treatments costs in Canada! After signing on to the MSP, all of my healthcare needs are covered, with the exception of prescriptions--although there is a Pharmacare system that adjusts the cost of prescriptions according to your income. I have been in Canada now for 15 years and love how my doctor can order a test and it is done. I don't have to wait for procedures, with the exception of surgeries. The surgery wait times are always being addressed and improved. The queue is organized in a triage-like fashion. If I have a life threatening situation, I am in surgery immediately and others are bumped. I don't mind being bumped because the other person is helped and the system is providing high-quality care in a timely fashion, based on patient need. As I understand it, many physicians left Canada when the country first changed to universal healthcare amid cries of Canada becoming a socialist or communist state....the usual epithets hurled when folks get nervous about a change. I can honestly tell you that I wouldn't want any other kind of healthcare and, returning to the US would make me quite nervous in terms of what would be covered and approved by folks sitting at a computer with a checklist rather than the doctor who knows my personal situation. My MCTD morphed into Rheumatoid Arthritis, as it often can. It is a very serious condition that requires close monitoring, which I get from a specialist, just as I would in America--only I am referred and it happens....No one can tell me I can't have a procedure done. My doctors and I are in charge of my healthcare decisions, not profit-making businesses. With this focus on healthcare, I find that my doctors give me extraordinary amounts of consultation time. Patients get 15 minutes with a doctor here. FIFTEEN MINUTES! I was lucky to even see the doctor in the States and if I did, it would only be for about 3 minutes. Please don't believe the fear-mongering of folks that stand to profit from continuing the American healthcare system the way it has been done. Singe-payer is the way to go. Cheers, Jack Dr. J. Lucius Edwards Victoria Conservatory of Music

My husband, Leonard Kosiec, was diagnosed with esophagus cancer in October of 2011. He was admitted to the Foot Hills hospital in Calgary in December, 2011 and had his esophagus removed. The Canadian system was timely and the doctors and other health professionals excellent. In March of 2012, he was admitted to the Kelowna Cancer Centre for chemo and radiation. There he received both excellent personal and professional treatment. We were hopeful that he had made a full recovery. However, in October of 2012, there was signs that the caner was returning. From this time until he passed away in December of 2012, the Canadian system gave him excellent attention and care both with local doctors and at the hospital. We had not doubt but what he had the best research and care available. During this time, we had no personal medical expenses. This would not have happened in the United States. We would have lost our home and been in heavy debt. The Canadian system works in an efficient and ethical manner. The United States should adopt the model. Barbara McFarlin-Kosiec, Ph. D., Leadership

I live in Canada which has a single payer universal healthcare system. While it has its problems with regard to aging infrastructure, wait times for some elective surgery and doctor shortages in some areas, I am very satisfied with the system overall. The general population in Canada is healthier because visits to doctors and treatments don't cost anything except in taxes. This makes preventative as well as curative health care available and accessible to all. Within Canada healthcare varies somewhat from province to province because of the funding structure. I think some European countries have done it better, and I would encourage those designing a new system for the US to take the best of several systems, but public funding and universality are fundamental. Catherine Kingston

I have lived in Canada virtually my whole life. I have been privileged to have had access to the Canadian universal health system. It is true for elective assistance, one is in a queue , but for emergencies, the system can't be beat . Widely known that the Canadian per capita expenditure on health care is approximately 50% of the US expenditure and that includes the whole population. My doctor friends are supportive because when a patient appears at their door, they are all treated the same without regard to ability to pay. Hard to believe, as was pointed out in the most recent presidential campaign,the US is the only country in the developed world that does not have universal health care for its citizens. There does not seem to be the same hang-up about government assistance to the victims of hurricanes! Stephen Freedhoff

To Whom It May Concern in the USA— From my youngest daughter’s $7.00 tonsillectomy in the mid-70s to my recent hospital overnight sleep apnea test (“free”—covered by my taxes and an annual family insurance cost of just over $1,000 per year with no direct out of pocket expenses for the hospital stay or sophisticated testing), as a USAmerican citizen living in CANADA (and voting regularly in CO) it escapes me the resistance to universal, single payer health care coverage in the USA! R. G. Doll, BC

I can't sing the praises of universal health care enough. When I immigrated to Canada I was pregnant. I went from paying for each prenatal visit and not knowing how I'd pay for the delivery to free prenatal care both from my family doctor and the local health nurse. Free hospitalization during even during a nursing strike and free post natal care. I had complications requiring a week stay in hospital. I paid nothing. Now, over 30 years later my family and I never worry about how we are going to afford health care nor health care premiums. In my province the poor pay no premiums. And we choose a doctor of our choice (not limited to any one HMO plan). My son requires ongoing specialist care - completely free. No problem with a sub-class of service due to his lack of income (disability pension only). He sees the same specialists as everyone else. I hear from my family in the US about their worries about health care both quality and cost. I have a sister who had to refinance her home just to afford the deductible for a surgery. I have never had to worry about obtaining or affording quality health care since residing in Canada. It's a blessing beyond measure.

When I was in my 20’s I almost died because we didn’t have health insurance and left going to the doctor to long. I ended up in the emergency room at a county hospital. I was quickly seen and released because of the amount of people waiting to be seen. An exam by the emergency room doctor showed I had a kidney infection. I was put on antibiotics and told to rest. What the exam didn’t show was that I also had a blockage in one of my fallopian tubes. The combination of antibiotics and pain meds made me very sick, causing dehydration and a hernia from throwing up. Another trip to an emergency clinic the following morning for dehydration lasted 6 hours, because we couldn’t afford to go back to the hospital. I was fortunate that my husband was from Ireland and we went across when I was well enough to have surgery. After, we returned my in-laws paid for our health insurance for a year; my Irish in-laws paid for US health insurance, ironic to say the least. As a mother of two daughters under the age of 25, I am so grateful that they can stay on my husbands health insurance until they start their careers and get insurance of their own. No, American citizen should have to sacrifice their health, or the health of their loved ones for lack of ability to pay. Our hospital emergency rooms, should be for the use of TRUE emergencies, not doctor visits for the poor and uninsured.