It's pretty normal to hear our health system compared to that of Canada or England. And it makes sense. Canada is nearby -- just hang a right when you hit Michigan. And the UK is considered our closest analogue in Europe. Their English may sound funny, but it's still English. When comparing policy options, it's sensible to examine relatively like environments. The problem is that Canada and England's health care systems are about as far in the other direction as possible. In the community of developed nations, we're on one side of the spectrum and they're on the other. The private market has virtually no involvement in their structures. It dominates ours. France, Germany, the Netherlands, Switzerland, and Japan are all much closer to the sort of futures we'd be considering, but they're discussed much more rarely. You can read that in part as a plot to scare Americans with the most extreme visions of change. But it's also an odd quirk. It's natural to look to England. It's just not all that useful. We will never have a situation in this country where you are not allowed to purchase your own care on the private market. It won't happen, it's not under consideration, and it's not a plausible outcome of any plans being seriously examined. Conversely, something like France, where the government provides base insurance and the private market offers supplementary products, or Germany, where heavily-regulated non-profits compete with each other to offer coverage, is fairly likely. This is a good way for me to link to my piece comparing the systems of different nations, but more broadly, it's just a reminder that Canada and England are not the only other options, and they're not even likely outcomes of reform. They're interesting to study as a sharp contrast, but not as a way to predict the outcome of whatever hybrid reform we eventually settle on.
