I am a Canadian with a lot of American friends. I cannot believe how much they spend on healthcare. Here's some of the major issues I've spotted.

• Their insurance payments are still higher than what is deducted from my paycheck and theirs doesn't scale with how much they make. Like it's insane the cost of what is being paid for healthcare. It's not a "tax" but it's still money you need to pay for a service that opting out of entirely will mean likely dying by something preventable. When I have been jobless or making so little money as to just scrape by my medical payments have dropped to zero. Theirs has just caused them to take risks by dropping it or forcing them more quickly into debt. Theirs is based out of something closer how many family members need coverage and how personally safe they want to be meaning there are less safe but cheaper options.

• There are gaps where private insurance doesn't cover. You get taken accidentally to the wrong hospital in an ambulance you are immediately paying more for "out of network hospitals"

• Insurance just covers a deductible, not all services have the same deductible so you can end up very poor for having the wrong kind of health issue. The only thing I have ever paid for in a situation is $100 for a cast. That is what an uninsured person in the US practically pays for an aspirin.

• Their healthcare plans are often provided by their work meaning leaving their current jobs often mean putting themselves in financial or physical danger if they want to quit. This makes them more personally exploitable to business as a whole.

• Medical coverage is approved or denied by insurance adjusters. These people are NOT doctors and are constantly under pressure to deny anything that isn't highly defensible in a courtroom. This means you essentially have random people informing your available healthcare options which is basically practicing medicine without a licence.

• Their hospitals are not faster where it counts. You still get placed in queue for life threatening issues at about the same rate. Emergency rooms, oncology and all the specialists take about the same time. The one place where it's better for timeframes are joint surgeries and elective surgeries.

If you are personally unhappy with the state of your health care then fight to make the funding of it more of a thing and be prepared to chip in. Of course it isn't free. It's not a charity where doctors are just doing side gigs to help out and medical equipment is donated. Everyone gets bent out of shape that "I don't have a choice it's taxed!" but look over the fence and you'll realize how fairly our system is priced and run based on that lack of choice. Like I will never feel as unsafe here as a citizen as my American friends. I literally worry about them so much whenever they are unemployed, travelling to a new city or in the midst of divorces, job transfers or any period of financial instability because it's a sword of Damocles. We need to reinvigorate a pride in doing one's civic duty to pitch in and make things better across the board rather than just "got mine, fuck you." Creating a public good does have cost but you are unprepared for what a private system will charge for the same thing but less safe.