I asked a friend who is well-informed and immensely successful in business why there was so much opposition to universal healthcare in the United States.  I also asked why the Canadian healthcare system is often mentioned as one reason to resist the provision of universal healthcare.  I prefaced my question with the statement that I did understand that cost may be prohibitive but my sense was that the objections were far deeper than cost.  His response follows:

Wow, I am probably not sufficiently savvy to best understand this but, really haven’t heard much of a Canadian call out for the opposition.  The “for” folks call out that Obamacare has allowed 20m uninsured Americans access to universal health care.  Also, children are now allowed on their parents plan until age 26 (was 21, I think but this is a big deal), pre-existing conditions are now NOT an excuse to deny  health care.  The major negative call out are two fold.  First, costs to the Americans on company plans has increased significantly to cover the costs of those enrolled in Obamacare.  The insurance companies view this very negatively as they are struggling to break even on the care coverage of this population.  Secondly, and this is a big one, people were told that they would be able to retain their preexisting doctors, and this has proved to be false.  So, the call out is the quality gap between in network physicians and previous principle physicians.  Personally, I think there has been a lot of positives here but, clearly, the program needs some serious tweaking.

His reference to networked positions is to the concept of HMOs which are employed physicians who have agreed to a fee structure and medical methodology which is imposed by the network managers. (One might suggest that this is very similar to the Canadian system where our political overlords mandate what our Canadian physicians are paid and are allowed to do.)

I did have exposure to the HMO network when my dad was receiving end-of-life care. My observation was that HMO provided care is not of the same quality as a non HMO physician. Interestingly under the private insurance channel the insurance buyer has an option of HMO or non-HMO. No surprises that the non-HMO insurance is more expensive as the insurance buyer and their physician have the option of care which is in the best judgement of the physician versus the best judgement of a bureaucrat who is making decisions based on minimal cost.