Healthcare in Canada
Canada (with the exception of the province of Quebec) is one of the few countries with a universal healthcare system that does not include coverage of prescription medication (other such countries are Russia and some of the former USSR republics even though Russia is considering a switch to full coverage of many prescription medications in the near future). Residents of Quebec who are covered by the province's public prescription drug plan pay an annual premium of $0 to $660 when they file their Quebec income tax return. Pharmaceutical medications are covered by public funds in some provinces for the elderly or indigent, or through employment-based private insurance or paid for out-of-pocket. Most drug prices are negotiated with suppliers by each provincial government to control costs but more recently, the Council of the Federation announced an initiative for select provinces to work together to create a larger buying block for more leverage to control costs of pharmaceutical drugs. More than 60 percent of prescription medications are paid for privately in Canada. Family physicians (often known as general practitioners or GPs in Canada) are chosen by individuals. If a patient wishes to see a specialist or is counselled to see a specialist by their GP, a referral is made by a GP in the local community. Preventive care and early detection are considered critical and yearly checkups are recommended for everyone.
List of countries with universal health care
The United States as a whole does not have a fully implemented universal health care system, but about 92% of its citizens have health insurance coverage as of 2017. Furthermore, Massachusetts became the first state to mandate universal health insurance in 2006. Furthermore, the Patient Protection and Affordable Care Act (PPACA) as amended by the Health Care and Education Reconciliation Act of 2010, sought to have expanded insurance coverage to legal residents by 2014. The act provides for federally mandated health insurance to be implemented in the United States during the 2010–2019 decade with the Federal government subsidizing legal resident households with income up to 400% of the Federal poverty level. This threshold varies according to State and household size, but for an average family of four, subsidies would be available for families whose income was about $88,000 or lower. In June 2010 adults with pre-existing conditions became eligible to join a temporary high-risk pool. In 2014, applicants of the same age began to be able to obtain health insurance at the same published rate regardless of health status — the first time in U.S. history that insurers no longer had the right to load the premium or deny coverage prior to contract, or cancel a policy after contract due to an adverse health condition, or test result indicating that one may be imminent. The law prohibits insurers from capping their liability for a person's health care needs, a move expected to rectify medically induced bankruptcy. As of October 7, 2016, the U.S. uninsured rate fell to 10.9% from the 14.6% recorded when President Obama came into office. During the debates about proposed Obamacare, more and more Americans dropped their existing insurance and the uninsured rate peaked at 17.1% just before Obamacare, the Affordable Care Act, started its "exchanges" and made the new plans available. 85.4% of Americans had insurance when Obama entered office; 89.1% had insurance by the time he left office.
The Congressional Budget Office and related government agencies scored the cost of a universal health care system several times since 1991, and have uniformly predicted cost savings, partly from the elimination of insurance company overhead costs. In 2009, a universal health care proposal was pending in Congress, the United States National Health Care Act (H.R. 676, formerly the "Medicare for All Act").