The system still records high levels of satisfaction. “The health care system is consistently Canada’s most popular social program, and the country’s health insurance system is often cited as a defining feature of Canada,” an international report noted in 2000. The fact that anybody who needs health care can get it, without payment, satisfies the basic collectivist spirit of the nation. No Canadian dies because he can’t afford a doctor; no Canadian goes bankrupt from medical bills. “It’s not really part of the Canadian psyche to feel superior to anybody,” Marcus Davies, an official with a Canadian medical society, told me. “But there are two areas where we enjoy feeling smugly superior to the United States: hockey and health care.” This is mainly because Canada guarantees health care to everyone who needs it while the richer country to the south does not. Beyond that, Canada has better health statistics overall than the United States, a longer health life expectancy, and a lower rate of infant mortality. And it achieves all that for about half the cost per capita of the U.S. system. “Canada’s cost advantage,” the Canadian health care economist Robert Evans, told me, “is due to a much more efficient payment system and to the sheer clout that a universal system has in price negotiations.”
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