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Single payer system still make financial decisions about who gets care and who doesn't.

"It's crazy that I live in Canada, but now I'm looking at having to sell my house for coverage of my medication."[1]

[1]http://www.cbc.ca/news/canada/british-columbia/a-tale-of-2-f...




That doesn't seem to be the issue:

> Helen Anderson, provincial lead for systemic therapy for the BC Cancer Agency, said that Ibrance is currently under active review for coverage in B.C.


Does help her much right now, does it?

There are several expensive medications that the Canadian health system has elected not to cover.

Here is another example where if the husband didn't have drug coverage through his employer, he would have been on the hook for the entire cost. Eventually he had to shell out $3,000 per month.[1]

At first, he says, his company insurance covered the price of the drug. But years later – Gary’s employer changed insurers and he was now on the hook to pay more than $3,000 a month.

[1]https://globalnews.ca/news/1654757/canadian-patients-struggl...


> Does help her much right now, does it?

No, but if that's the standard, I'm fairly certain we can find a lot more "no insurance, couldn't get treatment at all" stories in the US than we can "Canadian needs unusual, not-yet-approved medication" ones.

> There are several expensive medications that the Canadian health system has elected not to cover.

You'll find the American medical system does the same.

https://www.mercurynews.com/2007/12/21/teen-dies-hours-after...

https://www.today.com/news/man-battles-health-insurer-drug-c...

All medical systems will have rules and timelines for approval of drugs and procedures. Sometimes they'll lead to unfortunate situations.

In the US, though, approval's just the first step. You might then have to scrape together the $6k deductible for your family's bronze plan. You might have to wait until next year to switch insurers to one who covers that particular med.


Commercial insurers in the US cover far more new and experimental treatments than the Canadian system does. The drug mentioned in the CBC article? Full coverage in the US, from the day of approval.

Covered in Canada? Maybe never. And that's one of the best drugs out there to treat that type of cancer.

I'm not arguing the US system is better than Canada's. Just calling out there are trade offs with single payer systems. If American's think they can move to a single payer system and keep all the bells and whistles they have now, they will be deeply disappointed.

And your 2nd link actually proves my point. The drug in the article is not covered in many Canadian provinces at all. The guy in the article is being denied the drug because it's not approved for his mutation. Most people with the correct mutation do get coverage for that drug (again, a new, state of the art drug).


> Covered in Canada? Maybe never.

Sure, but that's true in the US here, too.

No insurance? No med. ERs aren't gonna give you it.

Can't make your $6k bronze plan deductible? No med. Maybe you'll qualify for a patient assistance program from the drug company, maybe not.

> If American's think they can move to a single payer system and keep all the bells and whistles they have now, they will be deeply disappointed.

It's entirely possible to have a supplemental private health insurance system for the experimental or unapproved stuff. You can get private coverage for stuff like IVF in Australia, for example.

A lot of America's bells and whistles are already inaccessible to a large portion of the population.

> And your 2nd link actually proves my point. The drug in the article is not covered in many Canadian provinces at all. The guy in the article is being denied the drug because it's not approved for his mutation. Most people with the correct mutation do get coverage for that drug (again, a new, state of the art drug).

As the article mentions, the insurer approved their sibling with the same mutation for the same medication. Private insurance can be just as capricious as a single-payer's approval system.




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