Originally Posted by SteveZ

And the system may be the greatest thing since sliced bread in the right set of circumstances.

Let's not forget that Canada's total population is approximately 5 million less than California's and approximately 10% of the USA's. Canada and the USA are within 0.3% of the same land mass size, with over 80% of Canada's population within 100 miles of the Canada/USA border.

So, an effort in the USA to mirror Canada's social medicine system would immediately involve setting up a structure at least ten times larger than Canada's. Such an undertaking would be monstrous and not happen overnight. In fact, it may take at least as long as Canada took (1946-1961), as Canada started the system one-province-at-a-time. The logic of that is self-evident, as each province was able to learn from the successes and failures of the previous province, making the system more efficient each time. In a comparable population setting, it would be like each California county establishing a medical care system one-at-a-time, with the whole state eventually tied together.

So, do we really think we are smarter, better capable, and more efficient than our Northern Neighbors that we can just set up such a system nationally from the get-go and have it work even half-right? Common sense says start off with a small state (e.g., one of the Dakota's, Rhode Island, etc.) based on state desire to be the pilot program, give them grant money to make it work, and then expand the network state-by-state if this is the type of care we want. From a program management standpoint, anything else is doomed to be fraught with cost overruns, fraud and mismanagement. As lives are at stake, doesn't it make more sense that if we really do this, we learn from how others have done it and emulate what was considered successful?

If it took Canada 15 years to set up such a program to handle a population 90% smaller than the USA's, what makes us think we can do it with the stroke of a federal pen and the "wisdom" of Congress? Talk about arrogance!