American and Canadian fists Ifyou ask a Canadian if they like their single-payer health caresystem, you'll usually get a strong “Yes!” followed by a detaileddescription of how it's better than America's system. (Image:Shutterstock)

When was the last time you went to Canada? A trip north of the49th parallel is a fantastic excursion. You'll likely find yourselfthinking or saying at least a few of the following:

  • These people are so friendly!
  • Canada is like America's attic — there's some cool stuff uphere.
  • Other than this colorful money, the metric system and French ontheir signs, Canadians aren't that different from us.
  • It's like Canada is the 51st state! (You might think this is acompliment, but Canadians hate this one.)

Similar, but different

It's easy to think Canadians are just Americans without (asmany) handguns. But socially, they are significantly different. Andif we're looking for Canadian lessons to apply to the Americanhealth care system, recognizing these differences reallymatters.


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Let's start with some basics about the population:

  • Canada's land mass is larger than that of the U.S. (Seriously,check out a globe.)
  • Canada has only 36 million people. That's about 9 percent ofthe U.S. population (comparable to the population ofCalifornia).
  • 90 percent of Canadians live within 100 miles of the U.S.border.
  • Canadian culture is extremely influenced by American TV,magazines, companies, social media, etc.

Why does this matter? It means Canadians are much more educatedabout our American affairs than we are about theirs. And living inAmerica's shadow breeds a touch of “little brother syndrome.”They're ready to compete with you, and you don't even realizethey're in the running.Therefore, if you ask a Canadian if theylike their single-payer health care system, you'll usually get astrong “Yes!” followed by a detailed description of how it's betterthan America's system. Boom, they won. And you didn't even know itwas a competition.

Freedom vs. fairness

A more telling question to ask is: “What does it mean to be aCanadian?” You'll likely get some form of this answer: “Well, we'renot like Americans. We care more about our people than you do. Forexample, our health care system.”

Think about that. Canadians define who they are by contrastingthemselves with Americans, and they bring up health care to do it!Americans wouldn't do either. Even those of us who work in thehealth care system wouldn't think of “health care” when definingour national pride. Instead, I bet your answer would include theword “freedom.”

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