My goal today is to expose the false promise of a fully government-run healthcare system — “Medicare for All,” as some progressives style it. Under this vision, private insurance would be illegal, and all Americans would be enrolled in a single, federally run insurance plan. That’s why some people call it “single-payer health care.”
With a Republican trifecta set to take power in Washington, some of you may think that the threat of single-payer health care has been eliminated.
I wish that were the case. Medicare for All isn’t dead — only dormant. It remains popular among much of the population, particularly young people. Seven in ten Americans between the ages of 15 and 34 favor a single-payer healthcare system like Medicare for All.[1]
To MBA students like you who understand the value of free markets, that may be a sobering statistic. But I’d venture to guess that many of those young people simply don’t understand the reality — and immense tradeoffs — of government-dominated health care. Young people also tend to be healthy. So they may not pay much attention to health care.
A government guarantee of health insurance may sound great. But what good is a Medicare card if you can’t put it to use? Having access to a government health plan is not the same as having access to care.
I have firsthand experience with this reality. I was born and raised in Canada, which has subjected its citizens to single-payer health care for six decades. My mother died after the government forced her to wait for care. I’ve seen how single-payer health care works — or more accurately, doesn’t work.
Today, I’ll give you a glimpse into the horrors of Medicare-for-All-style health care. I’ll marshal hard evidence to demonstrate the abject failure of the government-dominated healthcare systems in Canada and the United Kingdom.
I’ll also relate the personal stories of people who have suffered under the cold, bureaucratic cruelty of socialized medicine.
I’ll conclude with a few ideas for making affordable, high-quality health care available to more Americans through market-oriented reforms. Competition and transparent pricing have yielded higher-quality, lower-cost, better-value goods and services in other sectors. We need to empower patients, not the government. These principles can deliver the same outcomes in health care.
***
Let’s start by discussing what sets the British and Canadian healthcare systems apart — and how Medicare for All would be even more radical here than those of either country.
The British National Health Service, or NHS, is a fully socialized healthcare system. It was founded in 1948. The government enrolls everyone in the system. The government pays for virtually all care. And the government directly employs nearly all the doctors, nurses, and other providers. Care is largely “free” at the point of service — courtesy of British taxpayers, of course.
With that said, even the NHS doesn’t ban private health insurance. Roughly one in five Britons has private health insurance.[2] Some companies now provide private coverage. There are private clinics, too. People can pay privately to get around the extremely long waits for care that are common in the NHS.
Britons have long considered the NHS a national treasure. But its reputation has suffered mightily in recent years. A report released in September by the British government found that patient satisfaction with the NHS has reached the lowest point in its history.[3] Meanwhile, the private healthcare market in the UK is larger than ever before.[4]
British physician and world-renowned cancer expert Karol Sikora summed up the NHS’s problems in a recent piece for London’s Daily Telegraph, writing: “Nobody takes responsibility and suffering patients are passed around the warped system like an unwanted problem . . . Where is the accountability? Currently patients have absolutely no power.”[5]
Canada is a single-payer system. The government doesn’t directly employ most providers. Instead, it has a monopoly on paying for care deemed “medically necessary.” Individual provinces administer their own healthcare systems with funding from provincial taxes and the federal government. Saskatchewan was the very first province to launch single-payer in 1961. The other provinces eventually followed suit.[6] In 1984, Ottawa enacted the Canada Health Act, which established the structure by which the federal government funds health care through the provinces.
Medicare for All — as conceived in th United States by Sen. Bernie Sanders, I-Vt., the pied piper of single-payer health care — would entail an even more extreme government takeover of health care.
Sanders and his disciples want to go further than the UK by outlawing private insurance for all services nominally covered by the federal government. And they want to go further than Canada by
centralizing their single-payer plan in Washington rather than in the states. Bureaucrats in our nation’s capital would make life-or-death decisions for virtually every single American, no matter where they reside.
The good news is that Medicare for All won’t happen anytime soon, given looming Republican control of Congress and the presidency.
The bad news is that attempts to implement single-payer here in California will undoubtedly continue. Four of the leading candidates in California’s 2026 gubernatorial race have already professed their support for a statewide single-payer system.[7] The most recent attempt to impose single-payer in our state would have cost taxpayers roughly $400 billion a year, almost double the entire state budget this year.[8]
Democrats in Congress will undoubtedly take steps to bring us closer to single-payer whenever they next have the chance. In the past, they’ve proposed to lower the age at which people become eligible for Medicare to 50, create a new public health insurance option that would compete alongside private plans for customers, ratchet up premium subsidies for coverage purchased through Obamacare’s exchanges, and massively expand Medicare benefits.
The 2022 “Inflation Reduction Act” — which, of course, has done nothing to reduce inflation — allowed Medicare to impose price controls on prescription drugs starting in 2026 with 10 drugs under Medicare Part D, just as governments in countries with single-payer systems do.
In other words, the political left in America is doing everything it can to nudge America toward single-payer in fits and starts.
Single-payer systems have an impossible task — satiating unlimited demand for care from patients with limited supply.
When demand for any good or service outstrips supply, waits, rationing, and outright denials follow.
In the healthcare context, that means people wait days, weeks, months, or even years for care.
According to research from the Fraser Institute, a nonpartisan think tank based in Vancouver, the median wait in Canada for treatment from a specialist following referral by a general practitioner last year was 27.7 weeks. That’s more than six months. It’s the longest wait recorded by Fraser — and nearly triple the median wait in 1993, when the think tank began keeping track of wait times.[9]
Canadians also lack timely access to routine tests. The median wait for a CT scan was more than six weeks last year. An MRI entailed a median wait of nearly 13 weeks; an ultrasound, more than five weeks.[10]
Waits are the norm for our friends across the Atlantic, too. As of September, over 7.6 million people in England were on waiting lists for care. Nearly 300,000 of them have been waiting more than a year for care.[11]
Roughly one of every four patients in England has to wait more than six weeks just to get a diagnostic test. And nearly one-third of patients in England have to wait over two months for cancer treatment after being referred by a general practitioner.[12]
The privileged tend to opt out of those waits. Members of the British Royal Family, for instance, are notorious for receiving their care from privately run facilities, including the London Clinic.
It reminds me of George Orwell’s famous aphorism: “All animals are equal — but some animals are more equal than others.”
Onerous wait times also immiserate patients financially. Sickness saps our productivity and, in some cases, makes it impossible to hold down a job. A recent study quantified the costs of Canadian wait times at $10.6 billion — nearly $9,000 per patient.[13] This cost is also borne by their families and the economy as a whole.
These aren’t just statistics. They’re stories of pain, anxiety, deteriorating physical and mental health, even death.
Earlier this year in the UK, a man who had suffered a stroke was forced to wait more than eight hours in an ambulance before even being admitted to the emergency room. After several hours of waiting, with every bed in the emergency room full, paramedics took the man inside to a chemical decontamination room to diagnose him — and after determining he needed a brain scan, brought him back out to the ambulance to wait some more.[14]
According to the BBC journalist who accompanied him, the man wasn’t waiting alone. “While the frail, ill and old lie outside in the ambulances, those who couldn’t or didn’t need an ambulance are inside, some spilling out onto the pavement,” she reported.[15]
In another incident this year, a woman from Ashford, England, was referred to a specialist clinic after suffering a seizure. But demand at the clinic was so great that the woman was told she wouldn’t be seen for at least seven months. Desperate, she tried making appointments with general practitioners, to no avail.[16]
She never ended up getting a second opinion. After spending nearly five months on the NHS waiting list, she suffered another seizure, which was fatal.[17]
In research published this spring, the Royal College of Emergency Medicine estimated that more than 250 patients a week died unnecessarily last year because of long waits in England’s emergency departments.[18]
Harrowing stories like these may only become more common. Earlier this year, junior NHS physicians went on strike for six days — the longest labor action in NHS history.[19] Between March 2023 and September 2024, recurring strikes caused more than 1.5 million appointments to be canceled.[20][21]
The NHS is pushing doctors to do more with less. As one physician told a columnist at the Daily Telegraph earlier this year, “The NHS is run by managers for the benefit of managers. Patients don’t count.”[22]
The doctors’ angst is understandable. They make a lot less than their counterparts in the United States. According to Medscape’s International Physician Compensation Report 2023, British doctors make $122,000 a year — roughly one-third as much as American doctors.[23]
A 2022 study from the British Medical Association found that around four in ten junior doctors in the UK planned to leave the NHS as soon as they could find another job. Of those, one-third planned to move abroad in the next year; over 40% said Australia was their ideal destination.[24]
Britain used to send its criminals to Australia. Now, it sends its doctors.
Canada is looking at a similar doctor deficit. Over 6.5 million Canadians have no access to a general practitioner.[25] By 2028, Canada — with a population of 36 million, similar to California’s — is expected to be short 44,000 physicians.[26] Among 30 countries with universal health care, Canada ranks 28th in the relative availability of doctors.[27]
***
One of the fundamental concepts of economics is scarcity. We could define economics as the study of how to allocate scarce resources.
Governments with single-payer health care don’t have unlimited resources. They have to figure out how to divvy up tax revenue for all sorts of priorities: national defense, pensions, education, infrastructure, other government programs, and of course, health care.
The result is that single-payer healthcare systems pinch pennies where they can. That usually means slow-walking the adoption of new treatments and technologies.
As of October 2022, patients in the United Kingdom had access to just 59% of new drugs that launched anywhere in the world between 2012 and 2021. Canadian patients had access to just 45% of those drugs.[28]
By contrast, patients in the United States had access to 85% of drugs released in that ten-year window.[29]
As for technology, one of the reasons that Canadians wait weeks for an MRI is because the government under-invests in them. Consider what a friend of mine who lives in Vancouver has been forced to endure. After falling off a ladder at home, she’s been suffering from dizzy spells. She was told last week that the wait for an MRI would be six months!
Canada has 10 MRI machines per million residents. Among 31 countries with universal health care, Canada ranks 27th in access to MRI units, according to research from the Fraser Institute.[30]
The United States, by contrast, has 38 MRIs per million people — almost four times as many.[31]
The NHS is even more technologically retrograde. The Organisation for Economic Cooperation and Development’s most recent data show that there are about ten CT scanners for every million Britons.[32] The United States has four times as many.[33]
No one says no to a free diagnostic test or a free treatment. So health authorities in Canada and Britain say no for them.
These discrepancies in access to drugs and technology have massive implications for patient health — especially when it comes to cancer. The United Kingdom has a cancer mortality rate of 222 deaths per every 100,000 people — one of the highest of any developed country.[34] Canada’s is 200 per 100,000 people.[35]
In the United States, meanwhile, the cancer mortality rate is just 182 per 100,000 — even though our population has higher rates of obesity and other chronic conditions that increase the risk of developing and succumbing to cancer.[36]
Simply put, cancer patients have a better chance of surviving in the United States than in Canada or Great Britain. The overall five-year cancer survival rate is 64% in Canada;[37] it’s 69% in the United States.[38] The five-year survival rate for prostate cancer in the United States is 98%,[39] compared with 91% in Canada[40] and 87% in the United Kingdom.
For colorectal cancer, the five-year U.S. survival rate is 65%; it’s 59% in the UK.[41]
To see these disparate outcomes in effect, consider the case of Sharon Shemblaw. According to reporting from the Toronto Star, the 46-year-old mother of three from Ontario was in excellent health when she was diagnosed with acute myeloid leukemia in August of 2015. Doctors told Shemblaw she was a “prime candidate” for an allogeneic stem-cell transplant, which replaces a patient’s cancerous bone marrow with healthy blood cells from a donor.[42]
AML patients who receive a transplant while in remission have a 20% to 25% chance of surviving. Shemblaw was told she had an 80% chance. There was just one problem. Her local hospital, Princess Margaret Cancer Centre in Ontario, didn’t have the resources to treat her. Doctors recommend AML patients receive a stem-cell transplant “no longer than two to three months” after their cancer has gone into remission.
In 2016, the year Shemblaw sought treatment, the average wait at Princess Margaret was six to eight months. As a testament to the inadequacy of Canada’s healthcare system, The Ontario Ministry of Health agreed to spend $100 million sending cancer patients to the United States for stem-cell transplants.
Hospitals in Buffalo, Detroit, and Cleveland agreed to accept over 200 sick Ontarians. Patients who wished to receive treatment in the United States needed to commit to three months away from home and bring a full-time caretaker. That wouldn’t be cheap, of course. So most patients opted not to go. Shemblaw was one of the few who made the journey.
Finally in remission after three rounds of chemotherapy, she headed to the Roswell Park Cancer Institute in Buffalo with her daughter, who had taken time off from her doctoral program to be her mother’s caretaker. By the time Shemblaw arrived in Buffalo, the cancer had returned. At the time, a Health Ministry policy refused to cover stem-cell transplants for patients who weren’t in remission, even though the procedure would likely be just as effective at treating the disease.
Denied treatment, Shemblaw returned to Ontario, where she underwent experimental chemotherapy. The procedure was ineffective and yielded a bladder infection so painful she hallucinated for nearly two weeks. On May 4, 2016, Shemblaw’s husband brought his wife a bouquet of her favorite pink tulips. Looking at him with eyes wide open, she began repeating, “I want to see them, I want to see them.”
Sharon never saw her husband’s last gift, because she had gone blind. It was also one of the last times he would ever hear her voice. She died the next day.
***
When presented with stories like these, proponents of single-payer health care tend to accuse critics of cherry-picking. They assert that healthcare outcomes in countries with socialized medicine are still, on the whole, superior to those in the United States.
To support their claims, they point to a host of metrics where the United States supposedly underperforms. But these oft-touted statistics are nearly always misleading.
For example, U.S. life expectancy is indeed lower than life expectancy in many of our peer countries. But that’s primarily because there are more murders,[43] fatal car accidents,[44] and drug overdoses[45] per capita in the United States.
The World Health Organization says there were 14.2 “road traffic deaths” per 100,000 people in the United States in 2021. In Britain, by contrast there were just 2.4 road traffic deaths per 100,000 people — roughly one-sixth as many. In Canada, the road traffic death rate was 4.7 per 100,000 — again, roughly one-third the rate in the United States.[46]
Meanwhile, Americans suffer from obesity at higher rates than citizens of similar countries. That puts them at greater risk of complications from all sorts of conditions, from heart disease to diabetes to COVID-19.[47] [48] [49] [50]
These are serious public policy problems. But they tell us nothing about the quality of our healthcare system. No health system can force people to be more virtuous — to consume fewer calories, exercise more, wear their seat belts more often, or commit less crime.
Single-payer advocates also frequently contend that the United States has a much higher infant mortality rate than our peer countries. But this, too, is deceptive.
For one, the United States has a broader definition of what constitutes a “live birth.” According to the National Institutes of Health, the United States reports “as live births more low-birth-weight babies who are at risk of dying on the first day, and then registers those who die as infant deaths.”[51]
But in many European countries, an infant needs to meet certain height or weight requirements to be considered a “live” birth.
Similarly, many countries classify infants who die within 24 hours of being born as “miscarriages,” which are excluded from infant mortality calculations.[52]
Once these differences are accounted for, the United States actually has one of the lowest infant mortality rates for babies born prematurely. It’s no coincidence that Canadians often turn to the United States for assistance when they face a difficult pregnancy.
The facts are clear: single-payer’s combination of long wait times, low-quality care, and bureaucratic barriers to treatment results in manifestly worse health outcomes for patients. Economists Robert L. Ohsfeldt and John E. Schneider have calculated that the United States has a higher life expectancy than all other OECD countries after adjusting for fatal injuries.[53]
I would challenge any apologist for single-payer to find an injustice in the U.S. healthcare system that parallels the case of a British infant named Charlie Gard.
Charlie was born on August 4, 2016. About a month later, his parents noticed that he could not move his head or support himself. His parents took him to the doctor, where he was diagnosed with a form of mitochondrial DNA depletion syndrome.[54]
Charlie was thought to be one of 16 babies in the world with this rare genetic disorder, which causes muscle weakness and respiratory failure. There is no known cure, and most babies born with MDDS die in infancy.
NHS doctors reiterated his “bleak” prognosis. But his parents wanted to fight for his life. Dr. Michio Hirano, a neurologist at Columbia University Medical Center in New York, offered Charlie an experimental treatment called nucleoside therapy. There was no guarantee it would work. But his parents wanted to give it a try.
By April 2017, they had raised £1.2 million to pay for the treatment. There was just one problem. In March 2017, doctors at Great Ormond Street Hospital, where Charlie had originally been treated, began petitioning the British government for permission to stop Charlie’s life support.
In the United Kingdom, it’s up to the courts — not doctors and parents — to decide how to treat a sick child and when to cut off life support. On April 11, 2017, a judge ruled that doctors could end Charlie’s life.
Thus began a legal battle that would take the Gards to the British High Court, Supreme Court, and the European Court of Human Rights. Charlie’s parents petitioned for permission to bring their son to the United States for treatment. But the judiciary stonewalled them. The Gards had prominent allies in the fight for their son’s life. Pope Francis released a statement of prayer “that their desire to accompany and care for their own child to the end is not ignored.”
They also offered to bring Charlie to Bambino Gesu, a Vatican-owned children’s hospital, “to develop a protocol for experimental treatment for Charlie.”
Despite massive pushback, the British government held fast. Charlie died in hospice on July 28, 2017, after the court denied his mother’s request to bring her son home for his final hours.
Canada is rationing care in similarly unthinkable ways. They’ve enthusiastically embraced euthanasia — what they call “medical assistance in dying” — as a viable treatment option for people suffering from conditions as common as hearing loss and depression.[55] [56] One father is suing the government to prevent his autistic 27-year-old daughter from receiving state help ending her life.[57]
In 2022, over 4% of all deaths in Canada were a result of medical assistance in dying.[58]
Legal euthanasia is morally fraught under any circumstances. But it’s especially so when the government has a financial interest in the deaths of its citizens. After all, euthanasia is much cheaper than guaranteeing a “right” to unlimited health care for the rest of a person’s life.
When opponents of Medicare for All use the term “death panel,” we’re often derided as fearmongers. But Charlie Gard’s story — and Canada’s euthanasia program — prove that such panels are an inevitable consequence of socialized medicine.
When the government rations care, society’s most vulnerable are abandoned first.
***
Government-mandated rationing also doesn’t save patients as much money as it first appears.
To be sure, U.S. health expenditures are higher as a percentage of our economic output — around 17% of GDP[59] — than are health expenditures in nations with single-payer. Canada spends a bit over 12% of GDP on health care;[60] the United Kingdom, just over 11%.[61]
But Canadians and the British face considerable non-monetary costs — like longer wait times, shortages of treatments, and a lack of access to necessary procedures.
And don’t forget about all the taxes needed to pay for that “free” care. In Canada, the average family of three pays over $17,000 in taxes for its government-provided coverage each year. That amount has soared by more than 90% since 1997.[62]
Even though Canadians have public health coverage, they still pay for a greater share of their care out of their own pockets than do Americans, according to the World Bank.[63]
A 2022 report from the think tank Civitas says that the United Kingdom spends £10,000 per household — roughly $12,500 — on health.[64] That may not sound like much. But remember that incomes are much lower in the United Kingdom than in the United States — almost 40% lower.[65] So the taxes necessary to fund the NHS eat up a substantial portion of household income.
Bringing single-payer health care to the United States would require almost comical amounts of taxpayer money.
Most estimates place the 10-year cost of Medicare for All around $34 trillion. But some run as high as $46 trillion over 10 years.[66] Today, the total cost of health care in the U.S. is $4.6 trillion.
Sen. Bernie Sanders has floated several ideas for paying for Medicare for All. Among them: a 7.5% employer payroll tax that would extract $3.9 trillion over ten years from employers. Large financial institutions could be hit with $117 billion in taxes over ten years. Sanders has even called for changes to accounting rules that would result in $112 billion in additional corporate taxes.[67]
Those are just the taxes that hit businesses directly. Many business owners take low salaries but realize most of their income as capital gains or dividends. Sanders would raise taxes on capital income for those who make more than $250,000 a year.[68]
Of course, ordinary employees would not be exempt from Medicare for All’s flurry of new taxes. Sanders has proposed to raise $3.5 trillion over a decade by levying a new 4% tax on every American household.[69]
All these new taxes would still be insufficient to cover Medicare for All’s tab. As former Medicare trustee Charles Blahous has pointed out, it’s likely that “the actual cost of Medicare for All would be substantially greater than these estimates.”[70]
Currently, the United States spends more on health care largely because we consume twice as much care per person as citizens in the average developed country.[71] We undergo more surgeries, visit the doctor more often, and take more prescription drugs because we have those options in the first place.
Praising single-payer countries for having lower per-capita spending on health care would be like praising a famine-wracked country for having low per-capita spending on food. Yet that’s precisely the backwards logic used by Medicare for All’s proponents.
***
The U.S. healthcare system is not perfect, of course. But the evidence from abroad makes clear that heavy-handed government intervention will not improve American health care.
Our system works best when Washington refrains from getting between doctors and patients — and empowers individuals to make informed decisions about their own health.
With that in mind, I’d like to suggest a few ways that lawmakers can bring about a better-functioning, more competitive healthcare market that results in higher-quality, higher-value care.
First, we need to roll back certificate-of-need laws, which prohibit hospitals and other healthcare providers from modifying or expanding facilities without first getting government permission.
Certificates of need were intended to keep health costs down by preventing marginal spending that could, in theory, be caused by the construction of excess medical capacity. If a hospital pays for a new MRI machine, the thinking goes, providers will feel compelled to use it — potentially by ordering unnecessary procedures.
These laws are on the books in 35 states and the District of Columbia. And they’ve utterly failed in their intended pursuit.[72] Instead, they stifle competition by giving incumbent healthcare providers the opportunity to block the entry of competitors into the market.
Scope-of-practice laws deserve to be rolled back, too. These rules prevent nurse practitioners and physician assistants from diagnosing, treating, and prescribing drugs to patients without a doctor’s supervision. As such, they artificially constrain the supply of health care, which, of course, results in higher costs.
Research has repeatedly and conclusively shown that nurse practitioners perform as well as physicians in both primary and specialty care settings.[73] [74] There are over 350,000 nurse practitioners in the United States. They all have graduate degrees, advanced training, and prescribing privileges.[75] [76]
In other words, America’s healthcare system has hundreds of thousands of qualified practitioners who could see and treat more patients — but government regulation blocks them from doing so.
When supply goes up, prices tend to go down. Indeed, repealing scope-of-practice laws for nurse practitioners alone could save the healthcare system $810 million, according to a 2017 study.[77]
It’s also imperative that we give patients more control over their healthcare dollars.
The healthcare status quo is opaque and rife with misaligned incentives. Insurers’ customers aren’t beneficiaries — they’re the employers who pay for their coverage. Providers’ customers aren’t patients — they’re insurers. Patients are almost afterthoughts.
Consumers have little incentive to shop around for the best-value care, since they don’t generally share in any savings they generate.
We need to make the market for health care much more like the market for other goods and services, where consumers are in charge and have choices.
The best way to do so is by expanding different types of tax-advantaged healthcare savings accounts.
Chief among these are health savings accounts, or HSAs. These accounts are triple tax-advantaged: savers are not taxed on contributions or withdrawals, and money in the accounts grows tax-free.
Next year, individuals will be able to put up to $4,300 tax-free in an HSA. Families will be able to contribute up to $8,550.[78]
Because patients are spending their own money, they have an incentive to shop around for the best value. Those market incentives force providers to compete for patients’ business. As more and more patients shop around for care, quality will go up and prices will come down.
These are just a few ideas for reform that can yield a more efficient healthcare market — and help patients live longer, happier, more fulfilling lives.
***
I hope I’ve given you some sense of why the calls for Medicare for All are siren songs — ones that would lure America into a future where long wait times, government rationing, and a lack of access to cutting-edge technologies and treatments imperil millions of lives.
As my friend the scholar John Hinderaker has said, “In a parallel universe, you might expect the disastrous experience of socialized medicine in the UK to deter American Democrats from trying to impose the same system here. But in our universe, of course, that is exactly what they are doing.”
President-elect Trump said on December 3rd that he would like to make Canada the 51st state. Senator Sanders said he would endorse the idea if we imported their single-payer health care system!
I’ll close with a quote from one of my favorite thinkers, the English philosopher Sir Roger Scruton, who once asserted that “good things are easily destroyed, but not easily created.”[79]
America’s system of free enterprise didn’t emerge by accident. It was forged through centuries of deliberate choices made by millions of people acting in their own self interest. And it has made us the freest and wealthiest people in human history.
As adherents of this tradition, it’s incumbent upon you to defend it in the decades to come. If Medicare for All’s supporters prevail — if blind faith in government eclipses wisdom of its limitations — the resulting damage may be irreversible.
I have faith that the members of the Adam Smith Society will be at the forefront of this crucial policy battle.
I look forward to answering any questions you may have. Thank you.
[1] https://www.pbs.org/newshour/politics/poll-most-young-americans-support-government-run-health-insurance-program
[2] https://www.statista.com/chart/29261/share-of-uk-paying-for-private-health-insurance/#:~:text=Where%20the%20percentage%20of%20adults,had%20climbed%20to%2022%20percent.&text=This%20chart%20shows%20the%20share,paying%20for%20private%20health%20insurance.
[3] https://assets.publishing.service.gov.uk/media/66f42ae630536cb92748271f/Lord-Darzi-Independent-Investigation-of-the-National-Health-Service-in-England-Updated-25-September.pdf#page=5
[4] https://www.theguardian.com/society/2024/oct/25/private-healthcare-boom-fuelled-by-nhs-waiting-lists
[5] https://www.telegraph.co.uk/news/2024/09/10/the-nhs-only-leads-the-world-in-propaganda/
[6] https://www.historymuseum.ca/history-hall/tommy-douglas-medicare/
[7] https://www.politico.com/news/2024/09/29/california-2026-governor-hopefuls-single-payer-health-care-00181585
[8] https://www.kqed.org/stateofhealth/333573/single-payers-price-tag-in-california-400-billion-a-year
[9] https://www.fraserinstitute.org/studies/waiting-your-turn-wait-times-for-health-care-in-canada-2023
[10] https://www.fraserinstitute.org/studies/waiting-your-turn-wait-times-for-health-care-in-canada-2023
[11] https://researchbriefings.files.parliament.uk/documents/CBP-7281/CBP-7281.pdf, p. 10-11
[12] https://researchbriefings.files.parliament.uk/documents/CBP-7281/CBP-7281.pdf, p. 13, 19
[13] https://www.fraserinstitute.org/article/canadians-face-serious-economic-costs-due-to-health-care-wait-times#:~:text=After%20we%20account%20for%20patient%20leisure%20time%20outside%20of%20work%2C%20the%20estimate%20for%202023%20increases%20to%20%2410.6%20billion%20or%20%248%2C730%20per%20person%20waiting.
[14] https://www.bbc.com/news/articles/c3e981e4ex4o
[15] https://www.bbc.com/news/articles/c3e981e4ex4o
[16] https://www.kentonline.co.uk/ashford/news/mum-s-tragic-death-after-months-on-nhs-waiting-list-for-seiz-310503/
[17] https://www.kentonline.co.uk/ashford/news/mum-s-tragic-death-after-months-on-nhs-waiting-list-for-seiz-310503/
[18] https://www.bbc.com/news/health-68707883
[19] https://www.reuters.com/world/uk/record-breaking-doctors-strike-pile-pressure-health-service-england-2024-01-03/
[20] https://www.bbc.co.uk/newsround/articles/c62rjrq3973o
[21] https://www.gov.uk/government/news/junior-doctors-accept-government-pay-deal
[22] https://www.telegraph.co.uk/columnists/2024/04/09/nhs-enemy-of-british-people-cancer-deaths-waiting-lists/
[23] https://www.medscape.com/slideshow/2023-us-vs-global-compensation-report-6016711
[24] https://fullfact.org/health/doctors-nhs-rishi-sunak-australia/
[25] https://www.theglobeandmail.com/opinion/article-canada-needs-doctors-so-why-is-the-country-forcing-canadian-physicians/
[26] https://thoughtleadership.rbc.com/proof-point-canada-needs-more-doctors-and-fast/
[27] https://www.fraserinstitute.org/studies/comparing-performance-of-universal-health-care-countries-2024
[28] https://phrma.org/-/media/Project/PhRMA/PhRMA-Org/PhRMA-Refresh/Report-PDFs/A-C/2023-04-20-PhRMA-Global-Access-to-New-Medicines-Report-FINAL-1.pdf
[29] https://phrma.org/-/media/Project/PhRMA/PhRMA-Org/PhRMA-Refresh/Report-PDFs/A-C/2023-04-20-PhRMA-Global-Access-to-New-Medicines-Report-FINAL-1.pdf
[30] https://www.fraserinstitute.org/studies/comparing-performance-of-universal-health-care-countries-2024
[31] https://data.oecd.org/healtheqt/magnetic-resonance-imaging-mri-units.htm
[32] https://www.bma.org.uk/advice-and-support/nhs-delivery-and-workforce/pressures/nhs-diagnostics-data-analysis#:~:text=The%20UK%20has%20just%2010,while%20the%20UK%20has%208.6.
[33] https://data.oecd.org/healtheqt/computed-tomography-ct-scanners.htm
[34] https://data.oecd.org/healthstat/deaths-from-cancer.htm
[35] https://data.oecd.org/healthstat/deaths-from-cancer.htm
[36] https://data.oecd.org/healthstat/deaths-from-cancer.htm
[37] https://cdn.cancer.ca/-/media/files/research/cancer-statistics/2023-statistics/2023_pdf_en.pdf?rev=7e0c86ef787d425081008ed22377754d&hash=DBD6818195657364D831AF0641C4B45C&_gl=1*1bek9ba*_gcl_au*NzczOTE5ODYxLjE3MTI4NDgyNjU.
[38] https://cancercontrol.cancer.gov/ocs/statistics#stats
[39] https://www.wcrf.org/cancer-trends/cancer-survival-statistics/
[40] https://cdn.cancer.ca/-/media/files/research/cancer-statistics/2023-statistics/2023_pdf_en.pdf?rev=7e0c86ef787d425081008ed22377754d&hash=DBD6818195657364D831AF0641C4B45C&_gl=1*1bek9ba*_gcl_au*NzczOTE5ODYxLjE3MTI4NDgyNjU.
[41] https://www.wcrf.org/cancer-trends/cancer-survival-statistics/
[42] False Premise, False Promise p. 61
[43] https://ucr.fbi.gov/crime-in-the-u.s/2016/crime-in-the-u.s.-2016/topic-pages/murder; https://data.worldbank.org/indicator/VC.IHR.PSRC.P5?locations=GB ; https://www150.statcan.gc.ca/t1/tbl1/en/tv.action?pid=3510006801
[44] http://gamapserver.who.int/gho/interactive_charts/road_safety/road_traffic_deaths/atlas.html
[45] http://www.unodc.org/wdr2017/en/maps-and-graphs.html, table 3.1
[46] https://www.who.int/data/gho/data/indicators/indicator-details/GHO/estimated-road-traffic-death-rate-(per-100-000-population)
[47] https://www.medicalnewstoday.com/articles/diabetes-rates-by-country#type-1
[48] https://www.cdc.gov/obesity/data/adult.html#:~:text=Obesity%20is%20a%20common%2C%20serious,from%204.7%25%20to%209.2%25.
[49]https://commonslibrary.parliament.uk/research-briefings/sn03336/#:~:text=Adult%20obesity%20in%20England,are%20overweight%20but%20not%20obese.
[50] https://www150.statcan.gc.ca/n1/pub/82-625-x/2019001/article/00005-eng.htm
[51] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4193257/
[52] https://www.forbes.com/sites/physiciansfoundation/2016/04/12/infant-mortality-not-a-truemeasure-of-a-successful-health-care-system
[53] http://www.aei. org/wp-content/uploads/2014/03/-the-business-of-health_110115929760.pdf, pp. 21–22
[54] False Premise, False Promise p. 90
[55] https://apnews.com/article/covid-science-health-toronto-7c631558a457188d2bd2b5cfd360a867
[56] https://catholicvirginian.org/news/global/canada-assisted-suicide-decision-blatant-devaluing-of-persons-with-disabilities/
[57] https://www.americamagazine.org/politics-society/2024/04/04/canada-autism-assisted-suicide-asd-spectrum-medical-assistance-dying
[58] https://www.canada.ca/en/health-canada/services/publications/health-system-services/annual-report-medical-assistance-dying-2022.html
[59] https://www.cms.gov/data-research/statistics-trends-and-reports/national-health-expenditure-data/historical#:~:text=U.S.%20health%20care%20spending%20grew,For%20additional%20information%2C%20see%20below.
[60] https://www.cihi.ca/en/national-health-expenditure-trends-2022-snapshot
[61] https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/healthcaresystem/bulletins/healthcareexpenditureukhealthaccountsprovisionalestimates/2022
[62] https://www.fraserinstitute.org/sites/default/files/price-of-public-health-care-insurance-2024.pdf
[63] https://data.worldbank.org/indicator/SH.XPD.OOPC.CH.ZS?locations=CA-US
[64] https://www.telegraph.co.uk/news/2022/07/23/uks-runaway-health-spending-costs-10k-per-household-produces/
[65] https://data.worldbank.org/indicator/NY.GDP.PCAP.CD?locations=GB-US
[66] https://www.americanactionforum.org/weekly-checkup/the-real-cost-of-berniecare/
[67] https://www.forbes.com/sites/sallypipes/2019/06/24/medicare-for-all-is-a-trap-for-businesses-and-employees/?sh=279abc143b50
[68] https://www.forbes.com/sites/sallypipes/2019/06/24/medicare-for-all-is-a-trap-for-businesses-and-employees/?sh=326fcc963b50
[69] https://www.forbes.com/sites/sallypipes/2019/06/24/medicare-for-all-is-a-trap-for-businesses-and-employees/?sh=326fcc963b50
[70] https://www.forbes.com/sites/sallypipes/2019/06/24/medicare-for-all-is-a-trap-for-businesses-and-employees/?sh=326fcc963b50
[71] https://www.oecd.org/health/health-systems/Health-Care-Prices-Brief-May-2020.pdf pg 2-3
[72] https://www.ncsl.org/health/certificate-of-need-state-laws
[73] https://pubmed.ncbi.nlm.nih.gov/32384361/
[74] https://www.aei.org/wp-content/uploads/2018/09/Nurse-practitioners.pdf
[75] https://www.aanp.org/news-feed/state-of-new-york-grants-full-and-direct-access-to-nurse-practitioners
[76] https://www.aanp.org/about/all-about-nps/np-fact-sheet#:~:text=There%20are%20more%20than%20290%2C000,NPs)%20licensed%20in%20the%20U.S.&text=More%20than%2030%2C000%20new%20NPs,academic%20programs%20in%202018%E2%80%932019.&text=89.7%25%20of%20NPs%20are%20certified,all%20NPs%20deliver%20primary%20care.
[77] https://www.mercatus.org/research/policy-briefs/scope-practice-laws
[78] https://www.fidelity.com/learning-center/smart-money/hsa-contribution-limits
[79] https://www.pacificresearch.org/pris-2023-holiday-book-list/
