I am a U.S. citizen who moved to Toronto in 1980 to attend graduate school. While there, I met and married my husband, who was a seminary student at the time. In 2010, our nineteen-year-old son was diagnosed with a life-threatening brain tumor. Although the tumor was benign, it was compressing his brain stem, and required complicated surgery in two stages. Two full days' use of an operating room and three surgeons were required, so there was a slight delay until the necessary scheduling could be worked out. From the time of his diagnosis until his surgery took place was only a matter of six weeks. He was hospitalized for two weeks, then had six weeks of radiation a year later, and has had a series of MRIs and follow-up appointments at regular intervals ever since. I would not be able to begin to estimate the cost of his medical care over the past eight years - and the ongoing care he will need for the rest of his life. In all this time, the only bill we ever received was for the rental of a TV while he was in the hospital. We are a single income clergy couple, with a daughter who has her own medical concerns, so we would have been bankrupted several times over had we not had Canada's universal health care. I am happy to say that our son went on to graduate with honors from the University of Waterloo, and now works full time for a computer software company in Toronto. He will always have some disabilities as a result of the tumor, as well as the surgery and radiation. But for now, he is doing well. I'd like to conclude with a story told to us by one of our son's surgeons, who did a post-doctoral fellowship at Stanford. He had operated on a man who developed complications, and required additional surgery. As the man was being wheeled down to the operating room, a message was received from his health insurance provider, stating that the gentleman had maxed out his insurance coverage. The hospital staff were advised to take the man back to his room and discharge him. At that point, our doctor decided that he would return to Canada to pursue his medical career. Based on our family's experience, I cannot imagine living in a country without universal health care.

One reason single payer works in Canada is that each Province runs its own program. Federal involvement is limited. When comparing the US with Canada remember that we have very long wait times. This helps reduce costs but has only worked so far because we are so polite -- that may not last much longer. It will be very difficult to modernize, especially medication and dentistry. Supplementary services are only covered by private insurance and employers don't always make good partners. Canadians like to compare themselves with the US but we don't look so great compared to Europe and other developed countries. Some Canadian doctors are willing to work on a salary, which has some advantages but that would probably not be acceptable in the US.

I am a healthy young adult living in the United Kingdom. Although the NHS certainly has its problems and is underfunded, it is still fantastic! Just knowing that if I were to pass out at work again (I have low blood pressure) I wouldn't be telling the paramedics not to take me to the hospital because I can't afford it, as I did in the US. Even dental work, like fillings, costs about 20 quid, when it would likely cost hundreds of dollars without coverage. Even though I miss the US at times, I'm terrified to return if Obamacare gets repealed. The United States NEEDS a single payer system. It makes no sense to continue lagging behind the developed world. The peace of mind that if there were some accident or if I were to get sick, it wouldn't bankrupt me, is such a comfort.

Costa Rica has a government health care system, for which I pay only about $20 per month, which covers everything, doctor's visits, labs, meds, etc. ; and a private health care system that is a whole lot cheaper than in the USA. The gov. system or "Caja" is excellent for life-threatening situations, but for non-life-threatening situations there are long waits. For a hip replacement, for example, you'd probably have to wait 5 years. Many people use both gov. and private health care, for faster service such as doctor's visit or an X-ray, if they can afford it. The gov. system is under threat of privatization, unfortunately. I tell Ticos to protect the "Caja".

My family in Montana are all jealous of my health care in Austria. I can go to the general practicioner without an appointment and have to wait 20 minutes at the most. If a specialist is required I can make an appointment if the condition is not urgent or the GP gets me in immediately if it is. Doctor visits are free. Prescriptions cost approximately € 5. I had a friend who had leukemia and another who had a stroke. They both spent weeks in the hospital with excellent care - all paid by the system. It gives one peace of mind to know that an illness or accident will not result in your savings being depleted. When politicians tell the American public that "we don't want to be like socialist Europe", they are only speaking for themselves. The rich can afford their medical care. The vast majority of Americans would love the socialized system if only they knew what it does for them. - Brenda in Austria

When my family and I moved to Germany in 1972, we hesitated to go to the doctor, not convinced that it wouldn't cost us anything. But it didn't take long for us to become believers and appreciate the excellent coverage for everything from a cold or flu to checkups, operations, chronic conditions, including dental care, hospital stay, and prescription medications -- everything covered and at a reasonable cost. I would like to share just one example: When our son was just finishing his university studies, rheumatoid arthritis hit him with a vengence. It soon became clear that he would not be able to successfully persue a career in teaching as he had planned and he dropped out of college to concentrate of getting treatment. He was insured through the university, but as a non-student he needed to look for new health insurance. Although his "precondition" was obvious, whatever insurer he chose was obligated to accept him, That company has already paid out hundreds of thousands of euros for him, including two hip replacements and significant regular medication costs . There has never been any balking on the part of the health care provider whatsoever. Imagine what the situation would have been in America, trying to find a provider with that kind of precondition. But here in Germany he and the rest of the family enjoys complete peace of mind, knowing that whatever health issues come along, and there have been many through the years, we have nothing to worry about. Everything will be taken care of. And we look at what is currently happening in the US Congress regarding health care legislation and can only shake our heads and wonder. Unfathomable! Roy Lynn Pugmire Bremen, Germany

Not only am I an American living in Canada, but I'm a doctor as well! Having grown up in the US and seeing how much my family suffered when trying to deal with insurance companies, it's no wonder that I gravitated towards single-payer health care. I've been practicing in my adopted home for several years, and although the system is not perfect -- what system is? -- it gives me great comfort to know that I can treat all of my patients without having to constantly worry about their ability to pay for care, or if their insurance company will cover what's medically necessary for them. If only Congress had the boldness and courage to think about what sort of healthcare _all_ Americans would really benefit from, they would enact a single payer system today!

I worked for the US Peace Corps headquarters in Washington, DC, for 3 1/2 years. I bought the best health insurance I thought I could afford from the options we had available. And I was still scared of getting sick because of all the bureaucracy and caps and exceptions. People think that anyone who works for the US government gets a platinum healthcare plan -- Congress sure, but not ordinary government workers. And we still had things better than people who could only afford more basic plans, if they could afford anything at all. Things here in Sweden aren't perfect -- in no small part due to the creeping privatization of the healthcare system around the edges promoted by the previous government -- but if my healthcare expenses for the year go above a certain modest amount, I don't pay anything more. And the healthcare system here is not only per capita cheaper than in the US, in functions better on a whole bunch of indicators, from infant mortality to life expectancy, too.

I am grateful for Canada's health care system One reader's comment to the New York Times this week captured my feelings exactly: however imperfect our Canadian health system might be (it still needs to bring pharmaceuticals under its umbrella, for example), how reassuring it is to me, to know that my health care will be taken care of, always, even if I have a pre-existing condition, even when I am old, whatever my degree of wealth or destitution. Examples: we are not billed for having babies in hospital - and the birth of my daughter turned into an emergency, with a lengthy hospital stay for baby; my husband's kidney stone was removed - no bill. We pay higher taxes, but in return there are such high dividends in peace of mind - and excellent care. I am deeply grateful for all of this -- it is the polar opposite of what my siblings, still living in the U.S., go through, what with drug prices, insurance and administrative complications. The ones that now qualify for Medicare

My wife & I were both unemployed when a checkup found out she had life threatening anemia. She was admitted to hospital immediately, given multiple transfusions, and a barrage of tests including cardiac stress test, ultrasound, MRI, and colonoscopy. It was a horrible week; I was terrified there was something serious and she was too weak to care. We were lucky - we didn't have to worry about the cost wiping out all our savings. The medical team was terrific, and because she shared a room and didn't rent a TV, and we left the hospital with a bill for zero dollars. Every time I think about that summer I am profoundly grateful for the Ontario Health Insurance Plan, and I shudder to think where we'd be had that happened while we were in the US. Yes, it took me longer than I would have liked to get an MRI for a minor shoulder injury, but the Canadian system came through when we needed it most and if my wait meant someone else with a more serious condition had their life saved after a timely MRI, I'm ok with that. S Stephens

As everyone can tell you, Canada's system isn't perfect, but it is certainly a vast improvement over the US system. In my years here in Canada, I have battled heart disease, including bypass surgery, degenerative disc disease, and two surgeries for cancer. My husband has had several knee replacements. All this has been at no cost to us. Now that we are over 65, prescription drugs are also included. I watched how much my mother paid for her insulin and a plethora of other drugs in the US, even with Part D of Medicare and an Insurance plan and how that ate into her savings in her old age. To be fair, elective surgery and many specialties are rationed based on severity of illness. In my experience they are pretty good at triage, but you can end up on a wait list if your condition isn't urgent. I can see my family doctor within a day or two. All countries ration health care. In the US it's rationed based on who can pay. In Canada, it's rationed more on need. Hope this helps. Nobody should go bankrupt because they get sick. Jackie DiGiovanni

I have been living in England since 2001. My health care here has been excellent. I don’t have a single “story” of why the care here is excellent but I do have a general ability to get on with my life and manage my own health because of the support I can count on from the NHS. I’ve experienced minor illnesses, a skin problem that required minor facial surgery, and mental health difficulties that required months of treatment. None of this cost me anything (okay, a small medicine co-pay but REALLY small – and limited since the NHS prescription card is a thing). Any time my son, who is now 19, was ill I could take him to the doctor (I’ve never lived anywhere more than 15 minutes’ walk from the doctor’s office) because no matter how little money we had, he was taken care of. I think back to my life in the US as a child - where my parents had to decide not only if I needed the doctor, but if we could afford to go. That is not my life and not my reality. I can take risks. I can travel. I can extend and renovate my home. I can buy a new car. I never have to hold money back to make sure I can afford the doctor or the hospital. I can be less than perfect with money and not die because of it. I want that for everyone. I want my friends back home to have the freedom I have that comes with universal health care. Regards, Arwen

I have lived in the UK for almost 20 years and have very much depended on the UK for my healthcare. I know that when I am ill I can see a doctor fairly quickly with little waiting time. I can then walk into the pharmacy and get whatever medicine is prescribed for me for around 8 pounds. I don't have to worry that I am not able to seek out a doctor of fill a prescription. Healthcare is always available for me. As an expat. I also know that there is no real option for me to return to the US until I am old enough to be covered by Medicare as I would be unable to pay for insurance coverage even if I was unemployed for only a short time. Medicare is socialized medicine so logically it really should be a short jump to the concept of providing healthcare for everyone. Healthcare in Europe is considered a necessity and a right for all citizens and so it is astonishing to most of the world that the US doesn't recognize the importance of providing some level of healthcare to its own people.

Here´s a little anecdote of mine: While I was a student in Austria, one night my left ear popped as if I were in an airplane. I couldn´t hear much out of it, but went to bed hoping it would sort itself out by morning. When I woke up and still couldn´t hear, I decided to go to my doctor to check it out. He said, if I wanted, he could refer me to a specialist, and I got an appointment the same day with an Ear Nose Throat (ENT) doctor. This doctor quickly informed me that sudden hearing loss needs immediate treatment and referred me to the hospital where I was admitted that evening. After exhausting different treatment options, I had surgery about a week after my first symptom and then follow-up appointments for the next 6 months. Unfortunately, neither doctors in Austria, nor private specialists in the US have been able to tell me exactly what the cause was, but since the surgery I have regained about half of the hearing that I lost. All in all, I had over 10 doctor´s visits, more than a week´s stay in the hospital, and surgery. My monthly premiums at the time as a student were about 50-60 dollars. The only additional cost I had was 10-15 dollars per day in the hospital to cover meals. Austria´s government insurance program works quickly and affordably and gives the people a sense of security that I´ve never felt in the US health market.

Hi there, I’m a NC voter living in Australia and working for Bupa, a UK-based health insurer and care partner. Long before I had up-close experience with a functioning healthcare system and a private insurer who genuinely cares for its customers, I grew up in rural North Carolina with a chronically ill mother. Suffering from Lupus, cancer, and a wide range of related issues, my mom was often in and out of the hospital. Despite working gruelling hours, my dad always found it difficult to make ends meet. Any child who grew up with a seriously ill parent knows all too well the anguish of seeing a loved one in pain, the pitying head pats from Sunday school teachers, and the stomach-dropping discovery that someone you care about had to be rushed to the ER again. My time abroad has taught me that many Australians can commiserate with experiences like these. But most can’t understand the constant battle my parents waged just to make sure my mom could have health insurance. With so many pre-existing problems, it was always hard for my mom to secure a plan that could account for her many needs. The ramifications of poor health are acute enough; children don’t need to overhear their parents crying because they aren’t sure how to pay their medical bills. Thank goodness most Australians already understand this. While no system is perfect, Australia’s public/private hybrid allows consumers extra choice and extra comforts if they can afford them, while supplying basic care for those who can’t. This likely contributes to the comparable cleanliness, safety, and overall better quality of life that Australians tend to enjoy. President Obama took on great political risk to try and fix our own broken system. He did this by selecting a bipartisan compromise: a market-based solution that originated from the Heritage Foundation. While the ACA is definitely flawed, I know that it helped other little girls avoid at least some of the pain I felt. I am repulsed by the moral failure of politicians who have decided that cynical machinations are more pressing than fixing the ACA’s flaws. Their disregard for American lives is alarming. Other countries have recognised that investing in their citizens’ well-being pays dividends; I pray that one day America will wake up to the value of a similar investment. 

About a year and a half ago, my then-boyfriend (now husband) was out for a bachelor party in Lan Kwai Fong, one of Hong Kong's nightlife districts. As he walked down the street, a crazed man ran by brandishing a broken glass bottle, which cut my husband's arm quite severely. He was taken by ambulance to a public hospital, where he waited several hours to be seen/admitted. He ended up staying in the hospital for a few nights, awaiting exploratory surgery to ensure no glass was embedded in his arm and no nerves were damaged. Thankfully, the eventual surgery went well and he has had no complications to date. Although I was shocked that my husband had to wait hours/days at various points during his treatment, I believe he received a high quality of care, especially considering the cost. Upon leaving the hospital, he paid only about US$50 to cover the entire experience. Subsequently, he needed to go for check-up visits to have his dressings changed, and I think the charges were something like US$2 each time. Hong Kong does not exactly have universal healthcare, rather a combination of public and private systems. I am very grateful that the public option here is extremely affordable and accessible, otherwise my husband's experience could've been much more costly. Thanks, Sydney

As a doctor/medical physician in India, one developing country slowly rising out of the economic pit into a possible new economic super power, still has healthcare for all. There are drawbacks but still available. No one is turned away for reasons of lack of finance or insurance, rather they may be turned away because of the lack of space. Having worked in a Government run hospital, no emergency patient was turned away, once we had to since there was no more space, which means no floor space to place a mattress on the floor, we were working at double capacity with beds filled and beside each bed on the floor another mattress with a patient. We had to refer to our neighboring government hospital. Medicines had to be bought, and those who could not even afford this the doctors would pressure the pharmaceutical representatives to supply the necessary dosages for these poor patients, at times we had to sell our soul to the devil for these precious medications so that we could help patients. I don’t understand while the rest of the world enjoys healthcare, even the poorest, with the help of the government funding, why can’t our government for once ignore the bottom line and those who feed on that line (the “bottom feeders”) and serve the very people they were elected to serve? There is a reason I have invested heavily in health insurance here, I know I will not have to fight long hard battles for my stay in the hospitals etc with a company. People here are worried about the availability of medicines rather than medical care. There is a tier service, however that medical care is available is the issue. It is a sad day when people cannot get care because of cost that is driven not by anything else except the pharmaceutical, health insurance companies, and the legal system demanding high insurance rates from my American resident physicians.

1. For starters, I grew up colonial, in a place with socialized medicine. That is, the former Canal Zone. When people object to calling the Canal Zone socialistic on the grounds that it was racially segregated, I have to agree, up to a point. The townsites were segregated but the hospitals were not, at least not among Canal Zone residents or PanCanal or US military base employees. But Panamanians without such ties could not get treated at Canal Zone hospitals. It was a tiny and odd microcosm, but it's a lie to say that socialize medicine could never prosper under the American flag. 2. My brother, who was not born in Panama and thus was not a Panamanian citizen like me, died a little more than a year ago. It was liver disease, and since he was not a citizen and had no Panamanian Seguro Social benefits, he went to Santo Tomas Hospital, on the Ministry of Health side of the dual public health care system here, and had to pay. He was there for two weeks, with all sorts of tests. It cost the family a little over $3,000. When they referred him to the Instituto Oncologico for further tests to see if it was liver cancer, at that point he was not allowed further access to the Panamanian system and had to go back to the USA for treatment. As in going on SSI and having Uncle Sam pick up the tab, at great expense. He was pretty sure that he was dying when he left and they pretty much confirmed that with a well advanced Hep C diagnosis. He spent the last six months of his life in Colorado, when his preference would have been to die in Panama. And Uncle Sam would have saved an awful lot of money had there been an agreement to reimburse Panama, maybe plus a surcharge, of the cost of what things are here, and treat my brother here. 3. The private side of health care here? The Seguro Social / Ministerio de Salud system drives private costs down, but the private hospitals are rapacious. One example of that was the first of three criminal defamation charges I have fended off over the years here. During the Mireya Moscoso administration one of her key aides was one Álvaro Antadillas, who owned a chain of private kidney dialysis clinics. So the public system did not invest in dialysis and referred patients to his private clinics. And for the US-funded health care plan for the Panamanian PanCanal employees from before the Carter-Torrijos Treaties, Antadillas had a monopoly and jacked the prices WAY up. A prominent nephrologist came to me about it with a story under a pseudonym. I got confirmation from a private hospital owner who told me that none of the importers would sell anyone any dialysis equipment for fear of being put out of business by the government. So I made an exception and published that story under that pseudonym. I got a call from Antadillas, who demanded that I identify the author. I told him that betrayal might be a fun sport in his political circle but that ain't me. I got slapped with papers charging me with criminal defamation. I told Antadillas that he could buy all the judges and prosecutors and stomp me down whatever the facts, but that I would first do my best to make a public stink on the court record about what he was doing in hopes that other media would cover it, and that he could then get his conviction -- and SEE how long his contract with a US-funded health insurance plan lasted once I went to jail -- because I would not be buying my way out with a fine. He dropped the prosecution when he figured out that I meant it, that I did not intend to be ruined with lawyer bills by his nuisance charge but would fight him in a most unorthodox and harmful to him way. 4. My nephew, a banged-up´and lacerated knee from jumping in the wrong spot off of a waterfall: x-rays, tetanus shot, stitches, bandages, medications fo rh pain and swelling and all? $13. 5. When I had a serious case of gout, so x-rays, bloodwork and all that, then medication (allopurinol)? $23. 6. When I had dengue, with a bit of bleeding? All the tests and exams, then palliative medications? $18. 7. I had a check-up and the doctor told me that I should have a colonoscopy as part of it. It cost me $25 at Santo Tomas Hospital. Had I been part of the Seguro Social system, all of the services I described would have been free. Had I been indigent, they would have been free regardless of whatever ties or lack of ties with that part of the public health care system. Such is the socialized medicine that the small part of corporate America that profits from the current system fears....

My husband, then 65, needed a knee replacement. He was able to get it after a 5-month wait. After a group information session--which included one old patient maybe in his 80's--we booked the surgery for September 30, 2013. Everything went like clockwork. Until they noticed that his extremities were showing a lack of oxygen. Worried about a blood clot in the lungs, they sent him immediately down for a CT, which was fine. He stayed in the hospital for 2 days, until he could climb five stairs without help. They released him with a set of bandages along with pain and anti-blood-clotting medications. We followed up by getting him into ten cost-free physiotherapy sessions which started about two weeks after the surgery and went until late November. All went according to plan, and now he is able to golf 18 holes and walk 5 miles a day. Cost: $155 for parking at the hospital, $200 for brand new cane, walker, and cold packs. Thanks for the opportunity to tell this story. Patricia Kirby

young, independent, and empowered Universal healthcare is a fundamental right to all human beings. Recently graduating from college and no longer on my parents healthcare plan, i moved to Brazil where I teach English in Vitoria, Espirito Santo. As a young person making money for the first in my life I feel empowered knowing that no matter what health adversity, I can handle this situation. That language is my only hindrance to receiving assistance because financially, Im guaranteed treatment. This is empowerment and true freedfom. Best, Mary Mary E. Nagel